Periodontal disease

What are periodontal diseases?

The word periodontal literally means "around the tooth." Periodontal diseases, also called gum diseases, are serious bacterial infections that destroy the gums and the surrounding tissues of the mouth. Dental caries, or cavities, in the tooth affect only the tooth. Periodontal disease affects the bones around the tooth, the gums, the coverings of the roots of the teeth, and the membrane of the tooth. A dentist specializing in periodontal disease is called a periodontist.

If the inflammation is left untreated, the disease will continue and the underlying bones around the teeth will dissolve and will no longer be able to hold the teeth in place. Chronic inflammation, resulting from a periodontal disease, is responsible for 70 percent of all adult tooth losses, and affects 75 percent of people at some point in their lives.

What causes periodontal disease? 

As with many other oral health diseases, bacteria and plaque build-up is often the culprit. In fact, plaque build-up is the leading cause of gum disease. Other potential causes of gum disease include the following:

  • Genetics
  • Poor oral hygiene
  • Food stuck in the gums frequently (may be due to a malocclusion)
  • Mouth breathing (may lead to severe drying of the gums and teeth in front of the mouth)
  • A diet low in nutrients and/or a vitamin C deficiency
  • Smoking / the use of smokeless tobacco
  • Autoimmune or systemic diseases
  • Diabetes
  • Hormonal changes in the body
  • Bruxism (incessant clenching and grinding of the teeth)
  • Certain medications (some medications cause an overgrowth of the gums that can lead to periodontal disease)

Facts about periodontal disease:

  • About 66 percent of young adults have periodontal disease
  • About 50 percent of children have periodontal disease
  • Periodontal disease is the most common cause of tooth loss in adults

What are the symptoms of periodontal disease? 

The following are the most common symptoms of gum disease. However, each child may experience symptoms differently. Symptoms may include:

  • Red, swollen, tender gums
  • Bleeding while brushing and/or flossing
  • Receding gums
  • Loose or separating teeth
  • Persistent odorous breath
  • Dentures no longer fit
  • Pus between the teeth and gums
  • A change in bite and jaw alignment

The symptoms of gum disease may resemble other conditions or medical problems. Consult your child's dentist or other oral health specialist for a diagnosis.

How is periodontal disease diagnosed? 

Periodontal disease is usually diagnosed based on a complete history and physical examination of your child and your child's mouth. Your child's physician will probably refer the child to a dentist for complete evaluation and treatment. At the dentist, x-rays (a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film) of the teeth may be taken to help in the diagnosis and treatment of the problem.

What are the different types of periodontal disease? 

The different types of periodontal disease are often classified by the stage the disease has advanced to at the time of evaluation, including:

  • Gingivitis
    With gingivitis, the mildest form of periodontal disease, the gums are likely to become red, swollen, and tender, causing them to bleed easily during daily cleanings and flossing. Gingivitis can be divided into four groups, including:
    • Acute - gingivitis that has sudden onset, does not last long and is painful.
    • Subacute - a less severe form of acute gingivitis.
    • Recurrent - gingivitis that returns after treatment.
    • Chronic - gingivitis that has slow onset, lasts a long time, and is usually painless.
      Treatment by your child's dentist and proper, consistent care at home help to resolve the problems associated with gingivitis. If the gingivitis is not treated, it may lead to periodontitis.
  • Mild periodontitis
    Untreated gingivitis leads to mild periodontitis. This stage of gum disease shows evidence of the bone around the tooth starting to erode. The following are the most common symptoms of periodontitis:
    • Red, bleeding gums.
    • Bad taste in the mouth.
    • Pockets around the bottom of the teeth in the gum line.
    • The teeth may become loose and spread apart (as the disease worsens).
    • Tooth loss
      Prompt medical attention is necessary to prevent further erosion and damage.
  • Moderate to advanced periodontitis
    This most advance stage of gum disease shows significant bone and tissue loss surrounding the teeth.

Treatment for periodontal disease: 

Specific treatment for periodontal disease will be determined by your child's dentist based on:

  • Your child's age, overall health and medical history.
  • Extent of the disease.
  • Your child's tolerance for specific medications, procedures or therapies.
  • Expectations for the course of the disease.
  • Your opinion or preference.

Treatment may include any, or a combination of, the following:

  • Plaque removal
    Deep cleaning can help remove the plaque and infected tissue in the early stages of the disease, while smoothing the damaged root surfaces of the teeth. The gums can then be reattached to the teeth.
  • Medication
  • Surgery
    When the disease is advanced, the infected areas under the gums will be cleaned, and the tissues will then be reshaped or replaced. Types of surgeries include:
    • Pocket reduction.
    • A regeneration procedure.
    • A soft tissue graft.
    • Crown lengthening.