Periodontitis (pyorrhea), generally called gum disease or periodontal disease, usually begins with bacterial growth in mouth and if not treated properly may end with tooth loss, caused by destruction of the gums – the tissue that surrounds teeth.
What is the difference between gingivitis and periodontitis?
Gingivitis (inflammation of the gums) is a condition that usually precedes periodontitis (gum disease). Not all gingivitis progresses to periodontitis.
In early stages of gingivitis: bacteria in plaque builds up, causing the gums to become inflamed. They bleed easily during brushing. At this stage the gums are usually irritated, but the teeth are firmly planted in their sockets. No irreversible bone or other tissue damage has occurred.
When gingivitis is left untreated it can cause periodontitis.
Gum disease is the leading cause of tooth loss in adults.
What periodontitis looks like: the inner layer of the gum and bone pull away from the teeth and form the so-called “pockets. These small spaces between teeth and gums collect debris and can become infected. The immune system resists the bacteria as the plaque spreads and grows below the gum line.
As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, become loose and tooth loss occurs.
What causes gum disease?
Plaque is the primary cause of gum disease, but there are plenty of other factors that can contribute to periodontal disease:
Hormonal changes (during pregnancy, puberty, menopause and monthly menstruation) that make gums more sensitive, thus making it easier for gingivitis to develop.
Illnesses may affect the condition of your gums – i.e. diseases such as cancer or HIV that interfere with the immune system. Diabetes affects the body's ability to use blood sugar, so patients are at higher risk of developing infections, periodontal disease and cavities.
Medications can affect oral health.
• Some of them lessen the flow of saliva. Some drugs can cause abnormal growth of gum tissue. Discuss all the medications you take with your dentist to find out if you’re at risk.
• Habits such as smoking sometimes make it harder for gum tissue to repair itself and may cause problems.
• Poor oral hygiene (i.e. not brushing and flossing daily) makes it easier for gingivitis to develop.
• Family history of dental disease can be a contributing factor for the development of gum disease, gingivitis, pyorrhea, etc.
Gingivitis
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen and bleed. Usually there is little to no discomfort at this early stage. Gingivitis is often caused by poor oral hygiene. Good news is gingivitis is reversible. With professional treatment and good oral home care you will be able to restore your gums and have healthy mouth and teeth.
Some dactors that may contribute to gingivitis development are:
• diabetes
• smoking
• age
• genetic predisposition
• various systemic diseases and conditions
• high stress levels
• inadequate nutrition
• puberty
• hormonal fluctuations
• pregnancy
• substance abuse
• HIV infection
• use of certain medication
Periodontitis
Periodontitis is a serious gum infection. It damages the soft tissue and destroys the bone that supports teeth. Periodontitis can cause tooth loss and even increased risk of heart attack or stroke among other serious health problems.
Periodontitis is common, but also largely preventable. It is often a result of poor oral hygiene. Brushing at least twice a day, flossing daily and getting regular dental checkups can greatly reduce the risk of developing periodontitis.
Untreated gingivitis problems could advance to periodontitis. Plaque spreads and grows below the gum line. Toxins produced by the bacteria in plaque irritate the gums. Toxins stimulate a chronic inflammatory response that causes a condition in which the tissues and bone supporting the teeth are gradually broken down and destroyed.
Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. This destructive process often has only mild symptoms, but eventually teeth can become loose and may fall off or have to be removed.
There are many forms of periodontitis.
Among some of the most common are:
Aggressive periodontitis occurs in otherwise clinically healthy patients. Common features include rapid attachment loss and bone destruction and familial aggregation.
Chronic periodontitis results in inflammation of the supporting tissues of the teeth, progressive attachment and bone loss. This is also the most frequent form of periodontitis. It is characterized by pocket formation and recession of the gingiva.
Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions like heart disease, respiratory disease, and diabetes are often associated with such form of periodontitis.
Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with serious systemic conditions such as HIV infection, prolonged malnutrition and immuno-suppression.
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