Periodontitis Health Article

Definition

Periodontitis is a form of periodontal disease resulting in inflammation within the supporting structures of the teeth, progressive attachment, and bone loss. If left untreated, periodontitis can lead to tooth loss.

Description

Plaque and tartar (calculus) accumulate at the base of the teeth. Inflammation causes a pocket to develop between the gums and the teeth, which fills with plaque and tartar. Soft tissue swelling traps this plaque in the pocket, and the bacteria from the plaque begin to develop and grow. Continued inflammation and bacteria growth eventually causes destruction of the tissue surrounding the tooth. An abscess may also develop, which increases the rate of bone destruction. Several bacterial products that diffuse through tissue are thought to play a role in disease formation.

Bacterial endotoxin is a toxin produced by some bacteria that can kill cells. The amount of endotoxin present correlates with the severity of the periodontitis. Other bacterial products include proteolytic enzymes (molecules that digest protein found in cells), thereby causing cell destruction. The immune response has also been implicated in tissue destruction. As part of the normal immune response, WBCs enter regions of inflammation to destroy bacteria. In the process of destroying bacteria, periodontal tissue is also destroyed.

Onset of periodontitus at an early age and an infection characterized by necrosis of the gingival tissue, periodontal ligament, and alveolar bone, have most commonly been observed with individuals with medical conditions including Down syndrome, Crohn's disease, AIDS, and any disease that reduces the number of white blood cells (WBCs) in the body for extended periods of time. Reduction of the number of WBCs makes it difficult for the body to fight off infection.

Distinct types of periodontitis

Although there are many kinds of periodontitis, the following are the ones most often presented at the dentist's office:

• Gingivitis. The mildest type of periodontal disease, gingivitis is the reason that gums redden, swell, and bleed easily. Reversible with professional management and good home care, gingivitis is usually relatively painless or pain free.
• Aggressive periodontitis. This occurs in patients with relative good health, clinically. Aggressive periodontitis includes rapid ligament attachment loss and bone destruction.
• Chronic periodontitis. Patients with inflammation within the supporting tissues of the teeth and progressive attachment of the ligament and bone structure, characterized by pocket formation and/or recession of the gum tissue, are known to have chronic periodontitis. Although it occurs most frequently in adults, it can affect anyone, of any age. This progressive periodontitis affects gums and bones slowly, but can has also been known to advance quickly.
• Periodontitis as a manifestation of systemic disease. In this case, the onset is often at a young age. It is generally associated with one of several physiogenic diseases, such as diabetes.
• Necrotizing periodontal disease. This type of periodontal disease is characterized by necrosis (cell death) of gingival tissues, periodontal ligament, and alveolar bone. People with systemic conditions usually present with these symptoms; they may be malnourished, immunosuppressed, or have the human immunodeficiency virus (HIV).