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What is Periodontal (Gum) Disease?

The term “periodontal” means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the surrounding bone itself when in its most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the pocket between the teethand the gum, it becomes much more difficult to remove and treat.  Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and supporting bone.  If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread bacterial further into tissue.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

  • Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession.  It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.

  • Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual.  It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.

  • Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.

  • Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone.  A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.

Here are some of the more common treatments for periodontal disease:

  • Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed.  The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection.  A prescription mouthwash may be incorporated into daily cleaning routines.

  • Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures.  A membrane may be inserted into the affected areas to assist in the regeneration process.

  • Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums.  Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.

  • Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone.  Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.

Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.

Testimonials.

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Testimonials

All service was great! My dental technician did an excellent cleaning and I love their computer program that shows your potential cavities. I was able to see for myself whether I had problems or not.

I felt like they did not over-recommend things and were supportive of preventative methods and giving teeth the chance to bounce back with proper hygeine before jumping to "You need a filling". I had some questions, and they had no problem answering them

Elle B. , Arlington VA

10 Stars if Possible!
After the cleaning Dr. Cotes came in and he was great as well. He gave me a full dental exam and even took time to explain the clicking I get in my jaw. He gave me multiple options for teeth whitening and even told me the prices so there would be no up front surprises depending on which method I went with. He took the time to answer any question a threw at him and without trying to rush me out for the next patient. Not really sure what Megan S. is talking about in her review but I did see her only other review on the site was negative as well...just sayin...

Overall:
I would give Dr. Cotes and his staff 10 stars if it was possible. Everyone knows going to the Dentist is a crappy process. I didn't think it was this possible to have a decent time at the Dentist Office and be taken care of in a timely manor!!!

Dustin S. , Arlington VA

Dr. Cote is just that good. I was referred to Dr. Cote by a friend at work, and I am SO thankful for that reference. The man is a consummate professional, has a friendly staff and has provided me with nothing short of stellar care for the last year. He explained things to me that my lifelong dentist never took the time to do before (like, how I can proactively strengthen the enamel on my teeth). He's got hi-tech gear that indicated areas where future problems might crop up and he's kept an eye on them during every return visit. I have never felt empowered and reassured in a dentist's office, but Dr. Cote is that good.

Dentistry can be a very personal enterprise, and since I had the same dentist since birth, finding a new dentist in DC was a harrowing experience. I actually walked out of three dentists offices (too sketchy for my tastes) before settling going to Dr. Cote. I live in the District, but I'm willing to suffer the indignity of Pentagon City just to have Dr. Cote take care of my teeth.

Evan M. , Washington DC

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