Gum Disease (Periodontitis)

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Periodontitis, also known as pyorrhea, is an inflammatory process leading to bone loss around the teeth and possible tooth loss. Periodontitis is a slow process that may take years or decades to become a noticeable problem. Type II diabetes and tobacco use can significantly speed the process due to their effect on the body's response to infection and blood flow in the gums. Periodontitis usually is not associated with any pain due to its slow, insidious nature; therefore, a patient may not notice the progression of the disease without regular dental check-ups.

The process of gum disease is similar to the formation of a cavity; although, different bacteria are involved. Food particles accumulate on the teeth and along the gum line. Bacteria form colonies and a biofilm below the gum line, making it difficult for the patient to clean. This biofilm triggers an inflammatory response from the body. The supporting structures of the tooth (periodontal ligament and bone) "see" the infection and retreat away from it. This process leads to "bone loss", the loosening of teeth, recession of the gums (getting long in the tooth), and potential tooth loss. The bone loss is measured at the hygiene appointment, and a patient may hear the term "pocket depth" or "probing depth". This is simply the measurement from the crest of the gums to the bottom of the gum pocket allowing a measurement in millimeters of bone loss.

Treatment of gum disease involves scaling and root planing (SCRP), which is a meticulous cleaning on the surface of the tooth root below the gum line. Periodontal disease is not curable, once the bone is lost, it cannot be regained. The purpose of SCRP and maintenance appointments is to slow or halt the progression of the disease to create healthier gums and prevent long term tooth loss. Most importantly, home care is the key to long term success of periodontal therapy.