Types of Periodontal Disease

Periodontal disease (also known as periodontitis and gum disease) is a progressive condition that affects the supporting tissues of the gums and the underlying jawbone.

If left untreated, periodontal disease can result in loose, unstable teeth and even tooth loss. In fact, periodontal disease is the leading cause of tooth loss in adults in the developed world and should be taken seriously.

How Periodontal Disease Develops

Periodontal disease begins when toxins found in dental plaque attack the soft gingival tissue surrounding your teeth. Harmful bacteria embed themselves in the gums and multiply rapidly, creating a bacterial infection. As the infection progresses, it burrows deeper into the tissue, causing inflammation between the teeth and gums. Your body's natural response is to destroy the infected tissue, which causes the gums to recede. This creates deeper pockets between the teeth, and without treatment, the infection spreads to the jawbone, leading to unstable teeth and eventual tooth loss.

Common Types of Periodontal Disease

There are several varieties of periodontal disease, each manifesting differently and requiring specific treatment approaches. All forms require immediate professional treatment to halt progression and preserve gum tissue and bone. Here are the most common types of periodontal disease and their typical treatments:

Gingivitis

Gingivitis is the mildest and most common form of periodontal disease. It's caused by toxins in plaque and represents the earliest stage before progression to more serious periodontitis. People at increased risk include pregnant women, women taking birth control pills, individuals with uncontrolled diabetes, steroid users, and those taking seizure or blood pressure medications.

Treatment: Gingivitis is completely reversible with a combination of improved home care and professional cleaning. Your dentist may perform scaling and root planing procedures to remove debris from gum pockets. Antibiotics and medicated mouth rinses may be prescribed to eliminate remaining bacteria and promote healthy healing.

Chronic Periodontal Disease

Chronic periodontal disease is the most common form of advanced gum disease, occurring more frequently in people over 45. It's characterized by inflammation below the gum line and progressive destruction of gum and bone tissue. While teeth may appear to be growing longer, this is actually due to gradual gum recession.

Treatment: Unlike gingivitis, chronic periodontal disease cannot be completely cured because supportive tissue cannot be fully rebuilt. However, your dentist can halt disease progression using scaling and root planing combined with antimicrobial treatments. When necessary, surgical procedures such as pocket reduction surgery and tissue grafts may be performed to strengthen bone and improve the appearance of your smile.

Aggressive Periodontal Disease

Aggressive periodontal disease is characterized by rapid loss of gum attachment and bone tissue, often with a family history component. While essentially the same as chronic periodontitis, it progresses much faster. Smokers and those with a family history face increased risk of developing this aggressive form.

Treatment: Treatment approaches mirror those for chronic periodontal disease, but patients with aggressive periodontitis are more likely to require surgical intervention. This form is more challenging to control, requiring intensive treatment including scaling, root planing, antimicrobial therapy, and sometimes laser procedures to preserve valuable tissue and bone.

Periodontal Disease Related to Systemic Conditions

Periodontal disease can be a symptom of other medical conditions affecting the body. Depending on the underlying condition, the disease may behave aggressively, rapidly destroying tissue. Heart disease, diabetes, and respiratory disease are common contributing factors, though many other conditions can intensify and accelerate periodontal disease progression, even when minimal plaque is present.

Treatment: Initially, the underlying medical condition must be managed and controlled. Your dentist will then use the same treatment approaches employed for aggressive and chronic periodontal disease to halt further progression.

Necrotizing Periodontal Disease

This rare but serious form rapidly worsens and is more common among people with HIV, compromised immune systems, malnutrition, chronic stress, or tobacco use. Tissue death (necrosis) frequently affects the periodontal ligament, gum tissues, and supporting bone.

Treatment: Because necrotizing periodontal disease may be associated with HIV or other serious medical conditions, your dentist will likely consult with your physician before beginning treatment. Treatment typically includes scaling, root planing, antibiotic medications, medicated mouth rinses, and antifungal medicines to address this complex condition.