Periodontal disease

Periodontal disease
Paro1.JPG
Radiograph showing bone loss between the two roots of a tooth (black region). The spongy bone has receded due to infection under tooth, reducing the bony support for the tooth.
Synonyms	Gum disease, pyorrhea, periodontitis
Pronunciation	Periodontitis
Specialty	Dentistry
Symptoms	Red, swollen, painful, bleeding gums, loose teeth, bad breath
Complications	Tooth loss, gum abscess
Causes	Bacteria related plaque build up
Risk factors	Smoking, diabetes, HIV/AIDS, certain medications
Diagnosis	Dental examination, X-rays
Treatment	Good oral, regular professional cleaning
Medication	oral
Frequency	538 million (2015)

Periodontal Disease

Disease of the gums in the mouth.

Gingivitis before and after

Gingivitis before and after

Pathophysiology

Periodontal diseases are mainly the result of infections and inflammation of the gums and bone that surround and support the teeth.

Stages

In its early stage, called gingivitis, the gums can become swollen and red, and they may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out. Periodontal disease is mostly seen in adults. Periodontal disease and tooth decay are the two biggest threats to dental health.

Risk factors

According to the CDC, about 47.2% of adults aged 30 years and older have some form of periodontal disease, and about 70.1% of adults 65 years and older have periodontal disease.

Causes

Bacteria in the mouth infect tissue surrounding the tooth, causing inflammation around the tooth leading to periodontal disease. When bacteria stay on the teeth long enough, they form a film called plaque, which eventually hardens to tartar, also called calculus. Tartar build-up can spread below the gum line, which makes the teeth harder to clean. Then, only a dental health professional can remove the tartar and stop the periodontal disease process.

Warning signs

The following are warning signs of periodontal disease:

• Bad breath or bad taste that won’t go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Gums that have pulled away from your teeth
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures

Risk factors

• Smoking
• Diabetes
• Poor oral hygiene
• Stress
• Heredity
• Crooked teeth
• Underlying immuno-deficiencies—e.g., AIDS
• Fillings that have become defective
• Taking medications that cause dry mouth
• Bridges that no longer fit properly
• Female hormonal changes, such as with pregnancy or the use of oral contraceptives
• Certain factors increase the risk for periodontal disease:

Prevention

Gingivitis can be controlled and treated with good oral hygiene and regular professional cleaning. More severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. Such treatment might include deep cleaning of the tooth root surfaces below the gums, medications prescribed to take by mouth or placed directly under the gums, and sometimes corrective surgery.