Periodontitis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Periodontitis, is the name of a collection of inflammatory diseases affecting the tissues that surround and support the teeth. Periodontitis involves progressive loss of the bone around teeth which may lead to loosening and eventual loss of teeth if untreated. Periodontitis is caused by bacteria that adhere to and grow on tooth surfaces (microbial plaque or biofilms), particularly in areas under the gum line. Periodontitis is very common in most populations but the severe forms of the disease are less common. Dentists diagnose periodontitis by inspecting the tissues around the teeth with a probe and by radiographs to detect bone loss around the teeth. Although the different forms of periodontitis are bacterial diseases, a variety of factors affect the severity of the disease. Important "risk factors" include smoking, poorly controlled diabetes, and inherited (genetic) susceptibility.
Epidemiology and Demographics
Periodontitis is a very common disease affecting approximately 50% of U.S. adults over the age of 30 years.
Risk Factors
One of the most predominant risk factors of periodontal disease is tobacco use. Another very strong risk factor is one's genetic susceptibility. Several conditions and diseases, including Down syndrome, diabetes, and other diseases that affect one's resistance to infection also increase susceptibility to periodontitis.
Diagnosis
Physical Examination
Dentists or dental hygienists "measure" periodontal disease using a device called a periodontal probe. This is a thin "measuring stick" that is gently placed into the space between the gums and the teeth, and slipped below the gum-line. If the probe can slip more than 3 millimetres length below the gum-line, the patient is said to have a "gingival pocket" around that tooth.
Treatment
Secondary Prevention
Typically dental hygienists (or dentists) use special instruments to clean (debride) teeth below the gumline and disrupt any plaque growing below the gumline. This is a standard treatment to prevent any further progress of established periodontitis. Studies show that after such a professional cleaning (periodontal debridement), bacteria and plaque tend to grow back to pre-cleaning levels after about 3-4 months. Hence, in theory, cleanings every 3-4 months might be expected to also prevent the initial onset of periodontitis.