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Periodontitis

Definition

Periodontitis is inflammation and infection of the ligaments and bones that support the teeth.

Alternative Names

Pyorrhea - gum disease; Inflammation of gums - involving bone

Causes

Periodontitis occurs when inflammation or infection of the gums (gingivitis) is untreated or treatment is delayed. Infection and inflammation spreads from the gums (gingiva) to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out. Periodontitis is the primary cause of tooth loss in adults. This disorder is uncommon in childhood but increases during adolescence.

Plaque and tartar accumulate at the base of the teeth. Inflammation causes a pocket to develop between the gums and the teeth, which fills with plaque and tartar. Soft tissue swelling traps the plaque in the pocket. Continued inflammation eventually causes destruction of the tissues and bone surrounding the tooth. Because plaque contains bacteria, infection is likely and a tooth abscess may also develop, which increases the rate of bone destruction.

Symptoms

  • Breath odor
  • Gums that appear bright red or red-purple
  • Gums that appear shiny
  • Gums that bleed easily (blood on toothbrush even with gentle brushing of the teeth)
  • Gums that are tender when touched but are painless otherwise
  • Loose teeth
  • Swollen gums

Note: Early symptoms resemble gingivitis.

Exams and Tests

Examination of the mouth and teeth by the dentist shows soft, swollen, red-purple gums. Deposits of plaque and calculus may be visible at the base of the teeth, with enlarged pockets in the gums. The gums are usually painless or mildly tender, unless a tooth abscess is also present. Teeth may be loose and gums may be receded.

Dental x-rays reveal the loss of supporting bone and may also show the presence of plaque deposits under the gums.

Treatment

This version of the Encyclopedia has no treatment information. Please discuss any and all treatment options for your condition with your healthcare professional.

Outlook (Prognosis)

Some people find the removal of dental plaque from inflamed gums to be uncomfortable. Bleeding and tenderness of the gums should go away within 1 or 2 weeks of treatment. (Healthy gums are pink and firm in appearance.)

You need to follow careful oral hygiene for your entire life or the disorder may return.

Possible Complications

  • Infection or abscess of the soft tissue (facial cellulitis)
  • Infection of the jaw bones (osteomyelitis)
  • Return of periodontitis
  • Tooth abscess
  • Tooth loss
  • Tooth flaring or shifting
  • Trench mouth

When to Contact a Medical Professional

Consult your dentist if signs of gum disease are present.

Prevention

Good oral hygiene is the best means of prevention. This includes thorough tooth brushing and flossing, and regular professional dental cleaning. The prevention and treatment of gingivitis reduces the risk of development of periodontitis.


Review Date: 5/28/2008
Reviewed By: Jason S. Baker, DMD, Oral and Maxillofacial Surgeon, Private Practice, Yonkers, New York. Review provided by VeriMed Healthcare Network
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