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March/April • 2010

 

Types of Periodontal Disease

Gingivitis

Gingivitis is the mildest form of disease. Gingivitis is often caused by inadequate oral hygiene.  It causes the gums to become red, swollen, and bleed easily.  There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good at home oral care. Untreated gingivitis can advance to Periodontitis.

Aggressive Periodontitis

This form of Periodontitis progresses quickly and therefore can be seen in younger patients. It can occur in localized areas or be widespread throughout the mouth.  Common features include rapid gum tissue attachment loss and bone destruction. 

Chronic Periodontitis

It is recognized as the most frequently occurring form of Periodontitis.  It occurs from chronic inflammation within the supporting tissues of the teeth.  The symptoms include progressive attachment and bone loss and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a Manifestation of Systemic Diseases

This form of Periodontitis varies and occurs in conjunction with a systemic disease.  It can be associated with diseases such as diabetes or leukemia, or immune altered diseases such as Hypophosphates, Downs Syndrome, LED, Papillon-Lefevre Syndrome, Histiocytosis, Neutrogena, or Agranulocytosis.  In these cases, it often have onsets at a young age and can cause rapid tissue and bone destruction. 

Necrotizing Periodontal Diseases

This is an infection characterized by necrosis (ulcerations) of gingival tissues between the teeth.  Bone loss can also occur in certain cases.  These lesions are most commonly observed in individuals with systemic conditions including, but not limited to, HIV infection, malnutrition, smoking and immunosuppressant.

Abscesses of the Periodontium

These are acute forms of periodontal disease.  There are usually associated with tissue swelling and pain.  If the abscess is confined to the gums, its called a Gingival abscess, if it extends into the bone, its called a periodontal abscess.

Periodontitis Associated With Endodontic Lesions

In this form of disease, localized areas of bone loss can occur in association with root canal infections.  Periodontal destruction to the end of a tooth root can allow a passageway for bacteria from the outside of the tooth to get into the root canal.  A root canal infection can also spread out into the periodontal tissues and contribute to bone loss.  In these cases it is important to determine from which location (outside the tooth, or inside the tooth) the infection originated from.

Developmental or Acquired Deformities and Conditions

Localized gingival recession can occur under certain conditions. This tooth-related factor results in  exposed root surfaces that can cause sensitivity, esthetic problems,  root surface cavities or contributes to plaque-induced gingival disease.