Periodontal Disease

The term “periodontal” means “around the tooth.” Periodontal disease (also known as periodontitis, pyhorrea and gum disease) is a common inflammatory condition, which affects the soft tissue around the tooth and supporting bone.

Periodontal disease is most often preceded by gingivitis. Gingivitis occurs when plaque accumulates around the teeth irritating the gums. This causes the gums to become inflamed and bleed. Plaque that is not removed gets hard becoming tartar (calculus) that can form above and below the gums. Calculus that has formed under the gums becomes much more difficult to remove and to treat. Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone. If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease
Types of Periodontal Disease

When left untreated, the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Chronic periodontitis – Is characterized by inflammation within supporting tissues causing deep pockets and gum recession. The teeth may appear longer as the gums are receding. Chronic periodontitis is the most common form of periodontal disease.

Aggressive periodontitis – This form of gum disease typically occurs in an otherwise healthy individual. It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.

Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.

Periodontitis caused by systemic disease – This form of gum disease often begins at an early age. Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Symptoms of Periodontal Disease

  • Red, swollen or tender gums
  • Bleeding while brushing, flossing, or eating hard food
  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer
  • Loose teeth
  • Sores in your mouth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures
Diagnosis of Periodontal Disease

Periodontal disease is diagnosed during a periodontal examination. This type of exam should always be part of your regular dental check-up. A periodontal probe is gently used to measure the sulcus (pocket or space) between the top of the gum and the base where the tissue attaches to bone. The depth of a healthy sulcus measures 3 mm or less and does not bleed. The periodontal probe helps indicate the depth of the pocket. As periodontal disease progresses, the pockets usually get deeper. The pocket depths, amount of bleeding, inflammation, and tooth mobility lead to your diagnosis.

Treatment for Periodontal Disease

Dr. Ratliff specializes in the treatment of gum disease and the placement of dental implants. There are many surgical and nonsurgical treatments Dr. Ratliff may choose to perform, depending upon the exact condition of the teeth, gums and jawbone. A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.

Scaling and root planing – In order to preserve the health of the gum tissue, the bacterial plaque and calculus (tartar) which initially caused the disease, must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary.

Tissue regeneration – When the bone and gum tissues have been destroyed, Dr. Ratliff may decide to re-grow lost bone. A membrane may be inserted into the affected areas to assist in the regenerative process.

Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the bone and gums allowing the patient to better clean their teeth.

LANAP Treatment – Depending on the extent of your disease, Dr. Ratliff may recommend laser treatment to reduce your pocket and help regrow bone.

Untreated and Treated Examples