Causes and Types of Periodontal Disease
Causes of Periodontal Disease
Periodontal disease, which is also known as gum disease and periodontitis, is a progressive disease which, if left untreated, may result in tooth loss. Gum disease begins with the inflammation and irritation of the gingival tissues which surround and support the teeth. The cause of this inflammation is the toxins found in plaque which cause an ongoing bacterial infection.
The bacterial infection colonizes in the gingival tissue, and deep pockets form between the teeth and the gums. If treated promptly by a periodontist, the effects of mild inflammation (known as gingivitis) are completely reversible. However, if the bacterial infection is allowed to progress, periodontal disease begins to destroy the gums and the underlying jawbone, promoting tooth loss. In some cases, the bacteria from this infection can travel to other areas of the body via the bloodstream.
Common Causes of Gum Disease
There are genetic and environmental factors involved in the onset of gum disease, and in many cases, the risk of developing periodontitis can be significantly lowered by taking preventative measures.
Here are some of the most common causes of gum disease:
- Poor dental hygiene - Preventing dental disease starts at home with good oral hygiene and a balanced diet. Prevention also includes regular dental visits which include exams, cleanings, and x-rays. A combination of excellent home care and professional dental care will preserve the natural dentition and support of bony structures. When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacterial toxins and can cause gingivitis or periodontitis, which ultimately lead to tooth loss.
- Tobacco use - Research has indicated that smoking and tobacco use are some of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build-up on teeth, deep pockets in the gingival tissue, and significant bone loss.
- Genetic predisposition - Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
- Pregnancy and menopause - During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
- Chronic stress and poor diet- Stress lowers the ability of the immune system to fight off disease which means bacterial infection can beat the body's defense system. Poor diet or malnutrition can also lower the body's ability to fight periodontal infections, as well as negatively affecting the health of the gums.
- Diabetes and underlying medical issues - Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body's ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.
- Grinding teeth - The clenching or grinding of teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one's teeth is usually associated with a “bad bite” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
- Medication - Many drugs including oral contraceptive pills, heart medicines, anti-depressants, and steroids affect the overall condition of teeth and gums, making them more susceptible to gum disease. Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.
Treatment of Gum Disease
Periodontists specialize in the treatment of gum disease and the placement of dental implants. A periodontist can perform effective cleaning procedures in deep pockets such as scaling and root planing; they can also prescribe antibiotic and antifungal medications to treat infection and halt the progression of the disease.
In the case of tooth loss, the periodontist is able to perform tissue grafts to promote natural tissue regeneration, and insert dental implants if a tooth or several teeth are missing. Where gum recession causes a “toothy” looking smile, the periodontist can recontour the gingival tissue to create an even and aesthetically pleasing appearance.
Preventing periodontal disease is critical in preserving the natural dentition. Addressing the causes of gum disease and discussing them with your dentist will help prevent the onset, progression, and recurrence of periodontal disease.
If you have any questions or concerns about the causes or treatments pertaining to gum disease, please ask your dentist.
Types of Periodontal Disease
Periodontal disease (also known as periodontitis and gum disease) is a progressive disease which affects the supporting and surrounding tissue of the gums, and also the underlying jawbone. If left untreated, periodontal disease can result in loose, unstable teeth, and even tooth loss. Periodontal disease is in fact the leading cause of tooth loss in adults in the developed world and should not be taken lightly.
Periodontal disease begins when the toxins found in plaque start to attack the soft or gingival tissue surrounding the teeth. This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear to recede. The resulting pockets between the teeth deepen and, if no treatment is sought, the tissue which makes up the jawbone also recedes causing unstable teeth and tooth loss.
Types of Periodontal Disease
There are many different varieties of periodontal disease, and many ways in which these variations manifest themselves. All require immediate treatment by a periodontist to halt the progression and save the gum tissue and bone.
Here are some of the most common types of periodontal disease along with the treatments typically performed to correct them:
Gingivitis
Gingivitis is the mildest and most common form of periodontitis. It is caused by the toxins in plaque and leads to periodontal disease. People at increased risk of developing gingivitis include pregnant women, women taking birth control pills, people with uncontrolled diabetes, steroid users and people who control seizures and blood pressure using medication.
Treatment: Gingivitis is easily reversible using a solid combination of home care and professional cleaning. The dentist may perform root planing and deep scaling procedures to cleanse the pockets of debris. A combination of antibiotics and medicated mouthwashes may be used to kill any remaining bacteria and promote the good healing of the pockets.
Chronic Periodontal Disease
Chronic periodontal disease is the most common form of the disease, and occurs much more frequently in people over 45. Chronic periodontal disease is characterized by inflammation below the gum line and the progressive destruction of the gingival and bone tissue. It may appear that the teeth are gradually growing in length, but in actuality the gums are gradually recessing.
Treatment: Unfortunately unlike gingivitis, chronic periodontal disease cannot be completely cured because the supportive tissue cannot be rebuilt. However, the dentist can halt the progression of the disease using scaling and root planing procedures in combination with antimicrobial treatments. If necessary, the periodontist can perform surgical treatments such as pocket reduction surgery and also tissue grafts to strengthen the bone and improve the aesthetic appearance of the oral cavity.
Aggressive Periodontal Disease
Aggressive periodontal disease is characterized by the rapid loss of gum attachment, the rapid loss of bone tissue and familial aggregation. The disease itself is essentially the same as chronic periodontitis but the progression is much faster. Smokers and those with a family history of this disease are at an increased risk of developing aggressive periodontitis.
Treatment: The treatments for aggressive periodontal disease are the same as those for chronic periodontal disease, but aggressive periodontal disease sufferers are far more likely to require a surgical intervention. This form of the disease is harder to halt and treat, but the dentist will perform scaling, root planing, antimicrobial, and in some cases laser procedures in an attempt to save valuable tissue and bone.
Periodontal Disease Relating to Systemic Conditions
Periodontal disease can be a symptom of a disease or condition affecting the rest of the body. Depending on the underlying condition, the disease can behave like aggressive periodontal disease, working quickly to destroy tissue. Heart disease, diabetes and respiratory disease are the most common cofactors, though there are many others. Even in cases where little plaque coats the teeth, many medical conditions intensify and accelerate the progression of periodontal disease.
Treatment: Initially, the medical condition which caused the onset of periodontal disease must be controlled. The dentist will halt the progression of the disease using the same treatments used for controlling aggressive and chronic periodontal disease.
Necrotizing Periodontal Disease
This form of the disease rapidly worsens and is more prevalent among people who suffer from HIV, immunosuppression, malnutrition, chronic stress or choose to smoke. Tissue death (necrosis) frequently affects the periodontal ligament, gingival tissues and alveolar bone.
Treatment: Necrotizing periodontal disease is extremely rare. Because it may be associated with HIV or another serious medical condition, it is likely the dentist will consult with a physician before commencing treatment. Scaling, root planing, antibiotic pills, medicated mouth wash and fungicidal medicines are generally used to treat this form of the disease.
If you have any question or concerns about the different types of periodontal disease and treatments, please ask your dentist.