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Periodontic Definitions
Periodontal Disease
The word periodontal is defined as “around the tooth” and periodontal disease is a chronic bacterial infection affecting the gums and the bones that support the teeth. The infection can affect one tooth or many teeth. The mildest form of the disease is gingivitis, (gum tissue involvement only), and the more serious condition is known as periodontitis (gum, bone and attachment fibres involved).
The main cause of periodontal disease is bacterial plaque. This is a sticky colourless film that is constantly forming on the teeth. If the plaque is not removed, it can quickly transform into a hard substance called tartar. Tartar can only be successfully removed by a dental professional.
The bacteria in plaque infect the gums, causing redness and inflammation. This can eventually destroy the tissue that supports the teeth, including bone. The gums then begin to separate from the teeth, forming pockets.
Good oral hygiene involving brushing and flossing, along with regular dental examinations and professional cleanings, reduces the risk of periodontal disease.
However, tobacco use, stress, poor nutrition, hormonal changes, and family history, as well as certain health conditions (such as diabetes and other systemic disease, immune compromised states) and medications, may also be risk factors for periodontal disease.
Gingivitis
Gingivitis is the mildest form of periodontal disease and causes redness and swelling of the gums. The gums may be tender or painful to the touch and also bleed easily during brushing or flossing. However, although there is usually little discomfort at this stage, gingivitis can lead to more serious conditions if left untreated. The best way to deal with gingivitis is to pay attention to your oral health with regular brushing and flossing. This will help to remove plaque before it can turn into tartar.
A professional cleaning by your dentist is still recommended usually twice a year.
Periodontitis
Periodontitis is diagnosed when bone loss is detected during a dental X-ray, combined with deep pockets and often receding gums. Over time, plaque can spread below the gum line and the toxins in the plaque can irritate the gums. This leads to the tissues and bone that support the teeth being broken down. The teeth separate from the gums and small pockets form between them. These pockets also become infected and deepen as periodontitis progresses. This process may only produce mild symptoms, but eventually teeth may become loose and need to be removed. The condition is more common in adults, but can occur at any age.
As mentioned before, there may be predisposing risk factors such as diabetes or smoking, among others.
Gingival Recession
Gingival recession is also known as receding gums. This process occurs when gum tissue is lost, exposing root surface. Gum recession is a common dental problem affecting all ages, including teenagers.
Gum recession can be caused by:
- Periodontal diseases that destroy gum tissue and bone that hold teeth in place
- Aggressive teeth brushing that can cause both the tooth enamel and gum tissue to wear away
- Crooked teeth or a misaligned bite that places excessive force on the teeth or bone
- Jewelry from piercings of the lip or tongue that can rub the gums
- Trauma to the gum tissue
- Orthodontic tooth movement in patients who have thin gum tissue
- Tooth malposition in the jaw may predispose an individual to recession
- Some individuals are born with thinner gum tissue and are more susceptible to gum recession
- Smokeless tobacco use.
Gum recession can cause tooth sensitivity and also result in longer teeth, which can be of an aesthetic concern for patients. Recession should not be ignored as it may also be the first sign of gum disease. Periodontists are able to provide treatments that can repair issues with the gum and help to prevent further damage.
Oral Pathology
Oral pathology refers to the diseases of the mouth and jaw. The mouth performs a variety of functions and is prone to a range of dental and medical conditions. The mouth is also one of the body’s most important warning systems and can provide early signs of what may be serious health issues.
Assessments
The skin on the inside of the mouth is normally smooth and coral pink in colour. Any changes to this may be an indication of a medical issue, the most serious of which is oral cancer. Potential signs include red or white patches in the mouth, lumps or thickening of the skin inside the mouth, sores that bleed easily or don’t heal, a persistent sore throat or hoarseness, or difficulty chewing or swallowing. Some of these issues may be noticed on the lips, tongue, throat, palate, cheeks, face, and on the gums around the teeth. Regular self-examinations are recommended, and if you do have suspicious sores or lumps, you should consult a medical or dental professional.