Periodontal Diseases

Definition

Periodontal diseases are a group of diseases that affect the tissues that support and anchor the teeth. Left untreated, periodontal disease results in the destruction of the gums, alveolar bone (the part of the jaws where the teeth arise), and the outer layer of the tooth root.

Description

Periodontal (meaning "around the tooth") disease is usually seen as a chronic (long-term) inflammatory disease. An acute (sudden) infection of the tissue surrounding the teeth (periodontal tissue) may occur, but acute inflammation usually resolves on its own and is not treated by a dentist.

Periodontal diseases affect the gums, which consist of the gingiva, periodontal ligament, cementum, and alveolar bone. The gingiva is a pink-colored mucous membrane that covers part of the teeth and the alveolar bone. The periodontal ligament, also called the periodontal membrane, is the tough, fibrous tissue that holds the teeth in the gums. The cementum is a bony layer that covers the lower parts of the teeth. The alveolar bone is a set of ridges along the jaw bones (maxillary and mandible) from which the teeth arise.

Periodontal disease most often develops when a pocket or space is formed between the teeth and the gums. This pocket is called the gingival sulcus. A number of distinct forms of periodontal disease are known, including gingivitis, acute necrotizing ulcerative gingivitis, adult periodontitis, and localized juvenile periodontitis. Although many people have some form of periodontal disease, serious cases are not common.

Gingivitis is an inflammation of the outermost soft tissue of the gums. The gums become red and inflamed, lose their normal shape, and bleed easily. Gingivitis may remain a chronic disease for years without affecting other periodontal tissues. Chronic gingivitis may lead to a deepening of the pockets between the gum and tooth. In some children, gingivitis and bleeding gums are among the early signs of leukemia.

Acute necrotizing ulcerative gingivitis is seen mainly in young adults. This form of gingivitis is characterized by painful, bleeding gums, and death (necrosis) and erosion of gums between the teeth.

Localized juvenile periodontitis is a less common form of periodontal disease and is seen mainly in young people. Localized juvenile periodontitis usually affects the molars (back grinding teeth) and incisors. Among the distinctions that separate this form of periodontitis are the low incidence of bacteria in the periodontal pocket, minimal plaque formation, and mild inflammation.

Pericoronitis is a condition found in children whose molars are in the process of erupting through the gum. The disease is seen more frequently in the lower molar teeth. As the molar emerges, a flap of gum still covers the tooth. The flap of gum traps bacteria and food, leading to mild irritation. If the upper molar fully emerges before the lower one, it may bite down on the flap during chewing and increase the irritation of the flap, leading to infection. In severe cases, the infection can spread to the neck and cheeks.

Periodontitis, also called pyorrhea, is a condition in which gingivitis has extended down around the tooth and into the supporting bone structure. Plaque and tarter build-up lead to the formation of large pockets between the gums and teeth. When this happens, anaerobic bacteria (bacteria that do not need oxygen) grow in the pockets. The pockets eventually extend down around the roots of the teeth where the bacteria cause damage to the bone structure supporting the teeth.

Herpetic gingivostomatitis, which is relatively common in children, is an inflammation of the gums and mouth caused by the herpes simplex virus. This disease is contagious, but tends to heal without medical intervention in about two weeks.

Desquamative gingivitis occurs mainly in postmenopausal women and is not well understood.

Trench mouth, also called Vincent's disease, is a suddenly developing (acute) complication of gingivitis. It causes tissue death and open sores on the gums and is often accompanied by fever, fatigue, and painful bleeding gums. Trench mouth usually develops because of poor oral hygiene, stress, fatigue, and smoking. It requires immediate treatment by a dentist, since pain can increase to the point where eating and swallowing become difficult, and the inflammation can spread to nearby tissues of the face and neck.

Content licensed from:

Author Info: Tish Davidson A.M., John T. Lohr Ph.D., Thomson Gale, Gale, Detroit, Gale Encyclopedia of Children's Health, 2006

This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.