What is Periodontology and Periodontal Disease?

PERIODONTOLOGY is the area of dentistry dealing with the supporting structures of the teeth. This includes the gums, bone and roots of the teeth.

PERIODONTAL DISEASE, also known as "gum disease", is a group of conditions that affect the gums, bone and roots of the teeth.  Though it is often assumed to be a disease of “older people”, it is often diagnosed in early adulthood and there are forms that may even affect children.  These are bacterial infections whose primary cause is a sticky, colorless film that forms on the teeth known as bacterial plaque.  It forms on your teeth every day and is removed with proper brushing and flossing.  If this is not removed, it hardens and forms calculus.  This substance is very hard and so adherent to the tooth; it can only be removed during a professional tooth cleaning.  Calculus not only attracts more plaque, but if it forms below the gum-line, it makes plaque removal more difficult.  This puts one at an increased risk for periodontal disease.

Periodontal disease is the most common infection in the United States.  In fact, more than 75% of Americans over the age of 35 have some form of periodontal disease. Despite its high incidence, many are unaware that they have it.  It is usually painless, but if left untreated, periodontal disease can result in bad breath, red swollen and bleeding gums and eventually tooth loss.  Periodontal disease is the leading cause of adult tooth loss.

There are many forms of periodontal disease, but the most common ones are gingivitis and periodontitis.  Gingivitis is the mildest form of periodontal disease.    It causes the gums to become red, swollen and bleed easily. It occurs when bacterial plaque, which initially forms above the gum line, works its way down below the gum line.  Here the bacteria in the plaque produce toxins that irritate the gums.  Gingivitis is reversible.  With professional tooth cleanings and effective brushing and flossing, healthy gums (gingiva) may be is restored. 

If gingivitis is left untreated, it can develop into periodontitis.  Periodontitis is a loss of the bone and tissues that surround the tooth.  This occurs when plaque is allowed to remain below the gum line and progress deeper into the tissue.  This process occurs as a result of the production of toxins by the bacteria in plaque, as well as the bodies production of chemicals in response to these toxins.  These chemicals are produced by the person’s own immune system.  They cause breakdown and destruction of the tissues and bone that support the teeth.   This creates a separation between the gum and the tooth causing what is referred to as a "periodontal pocket".  This "pocket" harbors the bacteria that cause periodontal disease and cause it to progress.  As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed.  Often, this destructive process has very mild or no symptoms at all.  Nonetheless, it can lead to tooth loss.

Periodontitis may be treated in a variety of ways, depending on its severity.   The most important part of treatment, regardless of the severity of disease, is ensuring that plaque is effectively removed.   Performing this includes proper brushing and flossing every day.  Antimicrobial mouth rinses are helpful as well.  Treatments include scaling and root planning, also known as a "deep cleaning".  Sometimes surgical treatment is required to address periodontal pockets.