Periodontal diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.

Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily.
There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected.

Causes of Periodontal Disease

The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like smoking tobacco, genetics, stress, pregnancy, puberty, diabetes, certain medications and poor nutrition can all contribute to the onset of periodontal disease.

There are many forms of periodontal disease. The most common ones include the following:

Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care.

Aggressive Periodontitis is a form of periodontitis that occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.

Chronic Periodontitis is a form of periodontal disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss and is characterized by pocket formation and/or recession of the gingiva. It is recognized as the most frequently occurring form of periodontitis. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis, often with onset at a young age, is associated with one of several systemic diseases such as diabetes.

Necrotizing Periodontal Disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions including, but not limited to, HIV infection, malnutrition and immunosuppression.

Treatment of Periodontal Disease

If you're diagnosed with periodontal disease, your periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment.

If you've already lost a tooth to periodontal disease, you may be interested in dental implants - the permanent tooth replacement option.

Periodontal Procedures

Following are some of the procedures that periodontists use to treat patients diagnosed with a periodontal (gum) disease. The main cause of periodontal disease is bacteria in the form of a sticky, colorless plaque that constantly forms on your teeth; however, many other factors can cause periodontal (gum) disease or influence its progression.

Non-Surgical Treatments

MP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

Periodontal Surgery

If you're diagnosed with periodontal disease, your periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:

• Pocket Reduction Procedures
• Regenerative Procedures
• Crown Lengthening
• Soft Tissue Grafts

Dental Implants

If you've already lost a tooth to periodontal disease or other reasons, you may be interested in dental implants - the permanent tooth replacement option.

Cosmetic Procedures

In addition to procedures to treat periodontal disease, many periodontists also perform cosmetic procedures to enhance your smile. Oftentimes, patients who pursue cosmetic procedures notice improved function as well.