Periodontitis (gum inflammation)

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Periodontitis is inflammation and infection of the ligaments and bones that support the teeth. Periodontitis occurs when inflammation or infection of the gums (gingivitis) is untreated or treatment is delayed. Infection and inflammation spreads from the gums (gingiva) to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out.

In the early stages, periodontitis has very few symptoms and in many individuals the disease has progressed significantly before they seek treatment.

Symptoms may include redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food (e. g. apples) ,though this may occur even in gingivitis, where there is no attachment loss. It may also appear gum swelling that recurs, spitting out blood after brushing teeth, halitosis, or bad breath, and a persistent metallic taste in the mouth, gingival recession, resulting in apparent lengthening of teeth which may also be caused by heavy handed brushing or with a stiff tooth brush.

Patients should realize that the gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume that painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that patient.

Causes and Risk factors

Periodontitis is the primary cause of tooth loss in adults. This disorder is uncommon in childhood but increases during adolescence. Plaque and tartar 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 the plaque in the pocket.

Continued inflammation eventually causes destruction of the tissues and bone surrounding the tooth. Because plaque contains bacteria, infection is likely and a tooth abscess may also develop, which increases the rate of bone destruction.

Diagnosis and Treatment

Antibiotics, scaling, and root planning is performed for moderate disease. More serious cases require surgery including bone grafting and flap procedures. There is an association between periodontal disease and heart disease and having healthy gums will decrease the risk of heart attacks and other cardiovascular disease.