Periodontal Diseases

       

Periodontal or gum disease is a pathological inflammatory condition of the gum and bone support (periodontal tissues) surrounding the teeth.

The two most common periodontal diseases are:

Gingivitis – inflammation of the gum at the necks of the teeth, and

Periodontitis – inflammation affecting the bone and tissues of the teeth.

Gingivitis

Gingivitis occurs in both chronic and acute forms. Acute gingivitis is usually associated with specific infections, micro-organisms, or trauma. Chronic inflammation of the gum tissue surrounding the teeth is associated with the bacterial biofilm (plaque) that covers the teeth and gums. Gingivitis was once seen as the first stage in a chronic degenerative process which resulted in the loss of both gum and bone tissue surrounding the teeth. It is now recognized that gingivitis can be reversed by effective personal oral hygiene practices.

Periodontitis

When periodontal disease affects the bone and supporting tissue, it is termed periodontitis and is characterized by the formation of pockets or spaces between the tooth and gums.

This may progress and cause chronic periodontal destruction leading to loosening or loss of teeth. Though the majority of adults are affected by gingivitis, gingivitis, fortunately, does not always develop into periodontal disease. Progression of gum disease is influenced by a number of factors which include oral hygiene and genetic predisposition.

Factors Affecting Periodontal Disease

The rate of progression of periodontal disease in an individual is dependent on the virulence (or strength of attack) of the bacterial plaque and on the efficiency of the local and systemic immunoinflammatory responses in the person (host). The overall balance between the bacterial plaque challenge and the body’s immunoinflammatory responses are critical to periodontal health.

Diet also impacts on periodontal health, from both the perspective of plaque build-up and that of the body’s immunoinflammatory responses. Stress has also been linked to periodontal disease, but it is not clear whether the relationship has a physiological basis or is due simply to the fact that individuals under stress are less likely to perform regular good oral hygiene.

Because periodontal disease is linked to an increased susceptibility to systemic disease (e.g., cardiovascular disease, infective endocarditis, bacterial pneumonia, low birth weight, diabetes), it is important not only for oral health but also for general health to control periodontal disease.