Periodontal Disease

Periodontal disease Periodontal disease or gum disease is an infection of the gum and bone around the teeth. If it is not treated, with time the teeth become loose and eventually need to be extracted. The gingival do not attach to the teeth as firmly as one might think. Periodontal disease affects this sulcus. Eventually, in periodontal disease, the tissues supporting the tooth break down. If only the gingival is involved in this breakdown, the disease is called gingivitis. If only the connecting tissues and bone are involved, it is called periodontitis.

Gingivitis

Periodontitis

1. Gingival Disease Gingivitis has been traditionally defined as the presence of clinical signs of inflammation that are confined to the gingiva and associated with teeth showing no attachment loss. Gingivitis is the mildest form of periodontal /gum disease. Gingivitis is often caused by inadequate oral hygiene, which leads to plaque buildup. Gingivitis is quite common. Almost 75% of adults over age 35 have some evidence of this condition. Other factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use. The bacteria in dental plaque irritate the gums and cause infection. When your body launches an immune response against these invaders, the gums become inflamed. People with gingivitis usually experience little or no discomfort. Therefore, it is important to recognize the symptoms, such as gums that are red, swollen or bleed easily.

Healthy Gums

Gingivitis Infection

Gingivitis is reversible with professional treatment and good home oral care. However, if gingivitis is left untreated, it can advance to periodontitis. Gingival diseases are classified into two categories: a. dental plaque induced gingival diseases; b. non-plaque induced gingival lesions. a. Dental Plaque-Induced Gingival Disease

A gingival disease that is the result of an interaction between microorganisms found in the dental plaque biofilm and the tissues and inflammatory cells of the host. This plaque-host interation can be altered by the effects of local factors, systemic factors, medications, and malnutrition that can influence the severity and duration of the response. Gingival diseases modified by systemic factors may be exacerbated by dental plaque. Gingival disease modified by medications have become more prevalent due to increased use of anticonvulsants, immunosuppressive drugs, calcium channel blockers, etc and show increased effect in the presence of dental plaque. Gingival diseases modified by malnutrition with plaque accumulation show increased effect in the condition known as scurvy (vitamin C deficiency). Systemic factors contributing to gingivitis, such as the endocrine changes associated with puberty, the menstrual cycle, pregnancy, and diabetes may be exacerbarated because of alterations in the gingival inflammatory response to plaque. This appears to be caused by the affects of the systemic conditions on the cellular and immunologic functions of the host. Gingival diseases modified by medications are increasingly prevalent be cause of the increased use of anticonvulsant and oral contraceptive drugs known to induce gingival enlargement. Gingival diseases modified by malnutrition have received attention because of clinical descriptions of bright, red, swollen, and bleeding gingival associated with severe ascorbic acid deficiency or scurvy. Nutritional deficiencies are known to affect immune function and may have an impact on the host’s ability to protect itself against some of the detrimental effects of cellular products such as oxygen radicals.