What is Periodontal (Gum) Disease?

The term “periodontal”means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is an infection of the gums. It starts out as plaque, an opaque film on the teeth that hardens to form calculus or tartar. As tartar accumulates, it harbors bacteria which attacks the soft tissue around the gums. This early stage of gum disease is called Gingivitis. Symptoms include red swollen gums, bleeding, bad breath and, sometimes, an unpleasant taste in the mouth. Untreated, Gingivitis becomes Periodontitis. At this severe stage, bacteria destroys both the gums and the supporting bone structurel Pockets form where teeth are separated from the gums and surrounding bones. Left untreated, Periodontitis eventually results in tooth loss.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

• Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession.  It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
  
  
• Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual.  It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
  
  
• Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
  
  
• Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone.  A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.

Here are some of the more common treatments for periodontal disease:

• Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed.  The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection.  A prescription mouthwash may be incorporated into daily cleaning routines.
  
  
• Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures.  A membrane may be inserted into the affected areas to assist in the regeneration process.
• LANAP (Laser Periodontal Therapy)- LANAP™ surgical laser protocol alternative to gum surgery, is a less painful, less traumatic way to treat periodontal disease at any stage. 
  LANAP™ uses a special kind of laser called the PerioLase-MVP-7™, invented by two dentists in Cerritos, California. Dr. Robert Gregg and Dr. Delwin McCarthy spent years developing a better way to treat gum disease. The laser fiber, which is only about as wide as three human hairs, is inserted between the gum tissue and your tooth, where it painlessly removes the noxious elements that cause gum disease. The sense of recovery is immediate, due to the laser’s ability to seal blood vessels, lymphatics and nerve endings. Of course, your tissue needs time to recover, regenerate and heal over the course of time, but after LANAP™ sessions, you can drive your car, go back to work, or do anything else you like.
  
  
  

• Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone.  Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.

Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.