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Understanding Periodontal Diseases

Periodontal disease comprises a number of oral health problems that affect the supporting structures of the teeth. These structures include the gums, periodontal ligament, and alveolar bone.

The periodontal ligament is the tissue that attaches the tooth to the alveolar bone, while the alveolar bone is the bone that makes up the tooth socket.

Periodontal disease is among the most widespread oral diseases worldwide, and it has to be taken seriously because it affects not just the oral health, but general health as well.

In this article, we will discuss some forms of periodontal disease, along with the recommended treatment for each.


Gingivitis is the early and most common form of periodontal disease. It pertains to the inflammation of the gum tissue, and is characterized by the presence of red and swollen gums that bleeds easily upon manipulation (i.e. brushing, using toothpicks, etc.).

It is often caused by plaque buildup which is a result of poor oral hygiene. Gingivitis is reversible; it will resolve by practicing good oral hygiene and going to your dentist regularly for professional cleaning.

Good oral hygiene means brushing properly at least twice a day, flossing, and using an alcohol-free mouthwash.


Periodontitis is the more advanced form of periodontal disease that develops when gingivitis is left untreated for a very long time.

It occurs when plaque accumulates deep below the gum line, resulting to the destruction of the periodontal ligament and bone.

It is characterized by the bone destruction and separation of the gums from the teeth (forming what is known as periodontal pocket) in addition to the classic signs of gingivitis. Gum recession and loosening of the affected teeth are also common.

Periodontitis may be classified into two main types: CHRONIC and AGGRESSIVE periodontitis.

Chronic periodontitis, the more common of the two, is often seen in older patients. The destruction of the supporting tissues of the teeth happens very slowly, although there may also be periods of rapid destruction.

Aggressive periodontitis, on the other hand, is the less common but more destructive form. It affects younger patients.

In this type of periodontitis, redness and swelling of the gums is not obvious, but the destruction underneath is occurring very rapidly. If left untreated, both forms result to tooth loss.

Unlike gingivitis, periodontitis is irreversible. The bone lost cannot be brought back, but the periodontal ligament tissue can reattach the tooth back to its supporting bone.

This is possible through periodontal therapy in the form of scaling and root planing, which is more popularly known as deep cleaning.

Scaling and root planing is a more intensive form of treatment that involves the removal not just of plaque deposits, but of diseased tooth root structure as well. Root planning, in particular, results to a tooth root surface that is glassy smooth. This glassy smooth surface facilitates reattachment.

Scaling and root planing may be done through surgical and non-surgical means, with the latter being considered first. Surgical root planing is only considered when its non-surgical counterpart proves to be ineffective.

Necrotizing periodontal disease

Like periodontitis, necrotizing periodontal disease involves the destruction and subsequent necrosis (a.k.a. tissue death) of the gums, periodontal ligament, and bone.

It often affects individuals who are malnourished, diabetic, chronic smokers, and immunocompromised (ex. HIV-positive). This form of periodontal disease is extremely rare, and management involves consultation with a medical doctor before rendering treatment.

Treatment involves scaling and root planing along with prescription of antibiotics and medicated mouthrinse.

Periodontitis as manifestation of systemic diseases

This form of periodontitis, as the name suggests, is brought about by systemic diseases.

These include diabetes, respiratory disorders, and heart disease. Depending of the underlying disease, it may exhibit signs of chronic or aggressive periodontitis.

To treat this type of periodontal disease, the medical condition must be addressed first. Once the medical disease is controlled, your dentist will now be able to treat the periodontal disease with the same treatments used for chronic and aggressive periodontitis.