Periodontal Disease - Introduction

Highlights	Complications	Other Treatments
Introduction	Prevention	Resources
Symptoms	Diagnosis	References
Causes	Treatment
Risk Factors	Medications

Introduction

Periodontal disease refers to a group of problems that arise in the sulcus, thegap between the gum and the tooth.

What is the Periodontium?

Thepart of the mouth that consists of the gum and supporting structures is called the periodontium. It is made up of the following parts:

Gum (gingiva). When healthy, the gingiva is pale pink, firm, and does not move. It has a smooth or speckled texture. The gingival tissue betweenteeth is shaped like a wedge.
Thespace between the gum and tooth, called the sulcus.
Root surface (the cementum).
Connective tissue.
Bone. The crest of the supporting bone, which can be viewed on x-rays, is normally 2 mm below the point where the crown of the tooth meets the root (the cementoenamel junction).

The structure of the tooth includes dentin, pulp and other tissues, blood vessels and nerves imbedded in the bony jaw. Above the gum line, the tooth is protected by the hard enamel covering.

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Periodontal Disease

Periodontal diseases are generally divided into two groups:

Gingivitis, which causes lesions (wounds) that affect the gums.
Periodontitis, which damages the bone and connective tissue that supports the teeth.

The process starts with bacteria. Even in healthy mouths, the sulcus is teeming with bacteria, but they tend to be harmless varieties. Periodontal disease develops usually because of two events in the oral cavity: an increase in bacteria quantity and a change in balance of bacterial types from harmless to disease-causing bacteria. These harmful bacteria increase in mass and thickness until they form a film known as plaque.

Click the icon to see an image of plaque and damaged gum tissue.

In healthy mouths, plaque itself actually provides some barrier against outside bacterial invasion. When it accumulates to excessive levels, however, plaque sticks to the surfaces of the teeth and adjacentgums and causes cellular injury, with subsequent swelling, redness, and heat.

When plaque is allowed to remain in the periodontal area, it transforms into calculus (commonly known as tartar ). This material has a rock-like consistency and grabs onto the tooth surface. It is much more difficult to remove than plaque, which is a softmass.

The most important component leading to the disease process, however, is the body's persistent immune response to the bacterial plaque. Specific immune factors are released that cause inflammation and damage that eventually destroys the support structures and bone and can lead to tooth loss.