What is Periodontal (Gum) Disease?

by Rana Baroudi

Dr. Baroudi is a Board Certified Periodontist. She has successfully passed the American Board of Periodontology oral and written examinations covering all phases of periodontal disease, its treatment and dental implants. She is also an Associate Clinical Professor of Periodontology at UCSF where she enjoys teaching and lecturing on a bi-monthly basis.

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What is Periodontal (Gum) Disease?

The term “periodontal”means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in its most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and 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.

Understanding Periodontal (Gum) Disease

Periodontal disease, commonly referred to as gum disease, is a complex inflammatory condition that affects the supporting structures of the teeth. At its onset, it manifests as gingivitis, a mild form of gum inflammation. If left unaddressed, gingivitis can develop into more severe forms of periodontal disease, characterized by an insidious breakdown of both bone and soft tissue surrounding the teeth.

The initial irritation and inflammation of the gums arise from toxins present in dental plaque. As the body’s immune response is triggered, a chronic inflammatory reaction ensues. Instead of defending against the plaque toxins, this reaction inadvertently prompts the body to start breaking down its own bone and soft tissue. What’s alarming is that as periodontal disease progresses, the outward symptoms can be subtle. Often, individuals may not notice the teeth gradually detaching from the now infected gum tissue. However, a visible sign of the disease’s progression is the formation of deepening pockets between the teeth and gums. These pockets indicate the ongoing destruction of the soft tissue and bone, a hallmark of advanced periodontal disease.

To understand the scope of periodontal disease, let’s delve into its various types:

  1. Chronic Periodontitis: The most prevalent form of periodontal disease, chronic periodontitis, is characterized by inflammation within the tooth’s supporting tissues. This leads to the formation of deep pockets and noticeable gum recession. At a glance, it might seem as though the teeth are growing longer. However, the actual scenario is quite the opposite; the gums are receding. This type of periodontal disease has a progressive nature, marked by a gradual loss of attachment to the tooth. However, this slow progression can occasionally be punctuated by episodes of rapid deterioration.
  2. Aggressive Periodontitis: As the name suggests, aggressive periodontitis rapidly deteriorates the gums’ health. What’s intriguing about this form is that it can occur in individuals who are otherwise in good health. It’s characterized by swift loss of gum attachment, extensive bone destruction, and has been observed to have familial tendencies, suggesting a genetic predisposition.
  3. Necrotizing Periodontitis: This severe form of periodontal disease typically affects individuals grappling with systemic conditions such as HIV, immunosuppressive treatments, or malnutrition. Necrotizing periodontitis results in the necrosis or tissue death of the periodontal ligament, alveolar bone, and gingival tissues, making it particularly devastating.
  4. Periodontitis Caused by Systemic Disease: Certain medical conditions can directly influence the onset and progression of gum disease. This form of periodontal disease usually manifests at an earlier age. Underlying medical conditions, including respiratory ailments, diabetes, and cardiovascular diseases, are frequently linked with this type of gum disease.

Addressing Periodontal Disease: A Guide to Treatment Options

Periodontal disease, if not addressed in a timely manner, can lead to irreversible damage to the oral framework. But with advancements in modern dentistry, a multitude of surgical and non-surgical options have emerged to counteract this malady. A thorough periodontal examination serves as the starting point, providing insights into the state of the teeth, gums, and jawbone, guiding the course of subsequent treatments.

Below is an in-depth look at prevalent treatments for periodontal disease:

  1. Scaling and Root Planing:
    • Description: Often referred to as a deep cleaning, scaling and root planing is an essential non-surgical treatment. The procedure involves removing bacterial plaque and tartar from the surface of the teeth and root areas.
    • Process: Dental professionals meticulously clean the gum pockets, targeting the deep-seated bacterial colonies and calculus responsible for the infection. If the infection is severe, antibiotics may be directly applied to the pockets, further aiding in recovery.
    • Post-Treatment Care: For extended protection and to curb potential reinfections, a specialized prescription mouthwash may be introduced into the patient’s daily oral hygiene routine.
  2. Tissue Regeneration:
    • Description: In instances where periodontal disease has led to significant bone and gum tissue loss, tissue regeneration becomes crucial.
    • Process: Grafting procedures involve using natural or synthetic materials to promote tissue regrowth. A specialized membrane can be used to separate the bone from the soft tissue, facilitating optimal conditions for both bone and gum regeneration.
    • Benefits: This procedure not only restores lost tissue but also strengthens the foundational structures of the teeth.
  3. Pocket Reduction Surgery:
    • Description: Pocket reduction surgery aims to reduce the deep pockets that form between the teeth and gums, a direct result of advancing periodontal disease.
    • Process: During this surgical procedure, the gum tissue is folded back to provide access to the deep pockets, facilitating thorough cleaning. The tissue is then sutured back into place, ensuring a tighter fit around the teeth.
    • Additional Considerations: In some cases, the jawbone may be reshaped to eliminate any craters or indentations that could harbor bacteria.
  4. Dental Implants:

For those navigating the complexities of periodontal disease, it’s imperative to actively engage with a dental professional well-versed in these treatments.

Dr. Rana Baroudi: Your Trusted Periodontist in San Jose, CA

Selecting the right periodontist is pivotal in one’s journey to reclaiming oral health. Dr. Rana Baroudi, renowned in San Jose, CA, embodies excellence in periodontal care. Boasting a distinguished track record in treating periodontal gum disease and a genuine commitment to patient care, Dr. Baroudi remains the top choice for many seeking meticulous and empathetic dental services. Place your trust in her hands, and let her guide you through the path to radiant oral health.