What Is Periodontal Disease?
Commonly known as gum disease, periodontal disease is a family of
related chronic inflammatory diseases that are caused by bacterial
infections. The disease results in red, swollen gums and can lead
to the destruction of the connective tissue and bone that hold teeth
in place. It is a serious condition, the major cause of tooth loss.
The word "periodontal" means "around the tooth."
Each tooth is embedded in the gum, or gingiva, and attached by connective
tissue to bone. Healthy gums are pale pink, smooth and firm, and
form a peak or cone between adjacent teeth. They surround your teeth
like a turtleneck fits your neck, with just a narrow crevice in
between. It is in this crevice where problems can begin. Even when
your gums are healthy and you brush and floss daily, this crevice
teems with all sorts of bacteria.
Bacteria produce the sticky, soft, colorless substance known as
plaque. As plaque accumulates on the surfaces of teeth and in the
crevices, bacteria release toxins that irritate the gums, triggering
an immune response that causes the gums to swell, turn red and bleed
easily. If you have these symptoms, you may have periodontal disease.
Plaque that is not removed can harden into tartar (calculus). The
buildup of tartar worsens the condition, causing the gums to pull
away from the teeth. Over time, deeper and deeper pockets may form.
Bacteria invade these pockets and from there can infect and destroy
the underlying connective tissue and bone, loosening the teeth.
Not brushing and flossing or getting regular professional cleanings
encourages plaque and tartar formation. Even after you've developed
gum disease, you can stop its progression and reverse its symptoms
by getting professional treatment and practicing good oral hygiene
at home.
There are two major types of periodontal disease: gingivitis and
periodontitis.
Gingivitis
Gingivitis is the stage of periodontal disease when
the gums are inflamed and beginning to pull back from the teeth,
but there is no damage yet to the connective tissue and bone. Ordinary
gingivitis is the most common and least severe form. Gums are red,
swollen and bleed easily. People with gingivitis may have persistent
bad breath. Treatment at this stage of the disease is very effective.
Other forms of gingivitis are associated with certain medications
(including Dilantin®, Procardia®, steroids and cyclosporine),
changes in hormone levels in women or some allergies and skin diseases.
When an allergy or a skin disease is the cause, tissue may literally
peel away from the gum. In the most severe form of gingivitis, known
as acute necrotizing ulcerative gingivitis, the gums are so infected
that tissue begins to die. The gums bleed spontaneously and the
cone of tissue between teeth decays and becomes blunted. The decay
causes pain and produces a bad odor. Patients with AIDS often get
this form of gingivitis. In advanced cases, the gums in the front
may turn yellowish-gray and recede so much that bone is visible.
Periodontitis
Gingivitis may lead to periodontitis, which is characterized
not only by inflamed gums but also by deep pockets between gums
and teeth; in advanced cases, there is destruction of the underlying
connective tissue and bone. The most common type of periodontitis
is adult periodontitis. It may start as early as the teen years,
but symptoms usually don't become noticeable until the mid-30s or
later. Symptoms slowly get worse as the person ages, but may come
and go depending on a person's general health, oral hygiene and
ability to combat the bacteria that cause the inflammation. Periodontitis
is also more common in people with several diseases and disorders,
including type 1 diabetes, AIDS and Down's syndrome.
Children can get periodontitis as well. On rare occasions, babies
can get the disease with the eruption of their first teeth. This
is a condition that affects children at puberty and involves the
first molars and incisors. Consequently, juvenile periodontitis
may be localized. That is, it's restricted to one or two teeth,
or the inflammation and damage may be more widespread. Children
with localized disease have very little plaque and tartar but have
rapid loss of the bone around the affected teeth. Generalized juvenile
disease looks and acts more like adult periodontitis, with inflammation,
buildup of plaque and tartar, and bone loss that loosens teeth.
Young adults (ages 18 to 34) may get a rapidly progressive form
of the disease.
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