Periodontal Disease

What are periodontal diseases?

The word periodontal literally means around the tooth. Periodontal diseases, also called gum diseases, are serious bacterial infections that destroy the gums and the surrounding tissues of the mouth. If the inflammation is left untreated, the disease will continue and the underlying bone around the teeth will dissolve and will no longer be able to hold the teeth in place. Generally, periodontal disease isn't painful, so it is possible to have it and not be aware of it. A dentist specializing in periodontal disease is called a periodontist.

Periodontal disease that is more advanced than gingivitis is not common in children.

What causes periodontal disease?

As with many other oral health diseases, bacteria and plaque buildup are often the culprits. In fact, bacterial plaque buildup is the leading cause of gum disease. Other factors that contribute to gum disease include:

  • Genetics

  • Poor oral hygiene

  • Food stuck in the gums (may be due to a malocclusion)

  • Mouth breathing (may lead to severe drying of the gums and teeth in the front of the mouth)

  • Diet low in nutrients and/or a vitamin C deficiency

  • Smoking / the use of smokeless tobacco

  • Autoimmune or systemic diseases

  • Diabetes

  • Hormonal changes in the body

  • Bruxism (repeated involuntary clenching or grinding of the teeth)

  • Certain medications (some medications can cause an overgrowth of the gums that can lead to periodontal disease)

What are the signs and symptoms of periodontal disease?

The following are the most common signs and symptoms of gum disease. However, each child may experience symptoms differently. Signs and symptoms may include:

  • Red, swollen, tender gums

  • Bleeding while brushing and/or flossing

  • Receding gums (gums that pull away from the teeth)

  • Loose or separating teeth

  • Persistent bad breath

  • Partial dentures that no longer fit

  • Pus between the teeth and gums

  • A change in bite and jaw alignment

The signs and symptoms of gum disease may resemble other conditions or medical problems. Consult your child's dentist or other oral health specialist for a diagnosis.

What are the different types of periodontal disease?

The different types of periodontal disease are often classified by the stage the disease has advanced to at the time of evaluation, including:

  • Gingivitis. With gingivitis, the mildest form of periodontal disease, the gums are likely to become red, swollen, and tender, causing them to bleed easily during daily cleanings and flossing. Gingivitis can be divided into four groups, including: 

    • Acute. Gingivitis that has sudden onset, does not last long, and is painful.

    • Subacute. A less severe form of acute gingivitis.

    • Recurrent. Gingivitis that returns after treatment.

    • Chronic. Gingivitis that has slow onset, lasts a long time, and is usually painless.

  • Mild periodontitis. Untreated gingivitis leads to mild periodontitis. This stage of gum disease shows evidence of the development of periodontal pockets (gums pulling away from the teeth, causing the crevice between the teeth and gums to deepen) and early loss of bone around the teeth. The following are the most common signs and symptoms of periodontitis:

    • Red, bleeding gums

    • Bad taste in the mouth

    • Pockets around the bottom of the teeth in the gumline

    • The teeth may become loose and spread apart as the disease worsens

    • Tooth loss

  • Moderate to advanced periodontitis. This most advanced stage of gum disease shows significant bone loss, deepening of periodontal pockets, and possibly receding gums surrounding the teeth. Teeth may loosen and need to be extracted. 

What are the treatments for periodontal disease?

Specific treatment for periodontal disease will be determined by your child's dentist based on:

  • Your child's age, overall health, and medical history

  • Extent of the disease

  • Your child's tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include any, or a combination of, the following:

  • Tartar (calculus) and plaque removal beneath the gums. Deep cleaning (also called scaling and root planing) can help remove the plaque and calculus beneath the gum and infected tissue in the early stages of the disease, while smoothing the damaged root surfaces of the teeth. The gums can then reattach to the teeth.

  • Medication. Antibacterial medications may be placed topically in the periodontal pockets or taken orally.

  • Surgery. When the disease is advanced, the infected areas under the gums will be cleaned, and the tissues will then be reshaped or replaced. Types of surgeries include:

    • Pocket reduction

    • A regeneration procedure

    • A soft tissue graft

    • Crown lengthening


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