What Is Periodontal (Gum) Disease? Healthy Gums
Gingivitis Early Periodontitis
Moderate Periodontitis Advanced Periodontitis
What Is Periodontal (Gum) Disease?
Periodontitis (Periodontal or Gum Disease) is an infection of the gums and the supporting tissues around the teeth.
The word "Periodontitis" literally means "infection around a tooth":
"itis" means infection as in sinusitis= infected sinus
"peri" means around as in perimeter
"dont" means tooth.
Periodontitis is caused by a bacterial invasion and infection of the tissues around teeth. It is like high blood pressure or diabetes, because we do not "cure" these diseases, we "control" them. Gum disease is controlled primarily with good home care and regular cleanings. The gums form a collar of tissue, like a turtle neck sweater around the teeth. At the bottom of the collar of gums is a seal against the tooth, like the seal of the skin against a fingernail. Any one spot along the collar is called the periodontal pocket. The depth of this pocket is measured with a calibrated probe. The deeper the collar of gums, the greater the severity of the disease.
Healthy gum tissue is salmon or coral pink in color with rounded firm edges adjacent to the teeth. Healthy gingiva also may be darkly pigmented. This occurs most commonly in African-Americans, but also occurs in Caucasians, Latinos and Orientals. The tissue is firm in consistency and resilient. It does not bleed on brushing, flossing or mild probing. The collar of healthy gum is usually less than three millimeters deep.
Thanks to television commercials, everyone seems to know that "Gingivitis" is an early form of gum disease. Gingivitis literally means gum (gingiva) infection (itis). Gingivitis occurs when the teeth and gums are not cleaned properly. Bacteria and food debris combine to form a sticky white mass called "plaque". The bacteria organize into colonies and give off toxins and acid wastes. These wastes are mechanically and chemically irritating to the gum tissue. If the bacterial plaque is present long enough, it picks up minerals from the saliva and dark stains from bleeding foods, coffee, etc. The minerals cause the plague to harden like scale in water pipes or on a coffeepot. This crusty rough material then called: "calculus" or "tartar". Calculus is what the hygienist cleans off your teeth at your cleaning. It is very irritating to the gums.
Calculus is a perfect place for the bacteria that causes periodontal disease.
The first clinical symptom will be bleeding on careful probing of the gums. The bleeding occurs because the seal is breaking down around the tooth. Other symptoms are redness and swelling or a puffy appearance to the gums. Gingivitis is similar to getting a splinter under your fingernail. The tissue becomes red swollen and tender as inflammation occurs. The pocket measurements become 3-4 mm deep. The major point is that while the gumseal is under attack, it is still there. This means that gingivitis is reversible with a good thorough cleaning and good home care for 10-14 days. Some special types of gingivitis occur, such as puberty gingivitis, pregnancy gingivitis and drug-induced gingivitis.
When gingivitis is left untreated, it commonly advances to become periodontitis.
The gums will look similar to those in gingivitis, but there is one important difference. The seal around the tooth has been destroyed and the bone is starting to eat itself away.
This is an attempt to get away from the advancing bacterial invasion.
The pockets are 4-5 mm deep.
This
is a progression of the disease process.
The infection has eaten away more bone.
With the loss of the underlying bone, the gums may recede, exposing root surfaces.
Pus may be present.
Pockets are up to 6 mm deep.
At this stage, the infection may still be treated non-surgically. Unfortunately, once the bone has been lost it does not grow back.
The teeth are weakened by the partial loss of the supporting bone.
As
the infection progresses, the bone loss becomes more severe.
The gum tissue often has now become more like scar tissue and some of the redness and swelling appears to be gone.
This can be very deceiving to patients, because the gums look like they are more normal, yet are actually worse off because of the scar-tissue effect.
Scar tissue is tough and does not shrink as swollen tissue does.
The scar tissue must be cut off surgically to get rid of the pockets.
Advance periodontal pockets usually measure greater than 6 mm.
Periodontal therapy is divided into surgical and non-surgical treatment.
The goals of both types of treatment are:
At our Dental Office, we use the non-surgical treatment consisting of:
The goal of all this treatment is to help you get the gums healthy a nd then keep them healthy so that the teeth can remain in you mouth for the rest of your life.
