• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Periodontitis

Pyorrhea - gum disease; Inflammation of gums - involving bone

Last reviewed: February 25, 2014.

Periodontitis is inflammation and infection of the ligaments and bones that support the teeth.

Causes

Periodontitis occurs when inflammation or infection of the gums (gingivitis) is allowed to progress without treatment. Infection and inflammation spreads from the gums (gingiva) to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out. Periodontitis is the primary cause of tooth loss in adults. This disorder is uncommon in young children, but increases during the teen years.

Plaque and tartar build up at the base of the teeth. Inflammation from this build-up causes a pocket to form between the gums and the teeth, which fills with plaque and tartar. Soft tissue swelling traps the plaque in the pocket. Continued inflammation leads to damage of the tissues and bone surrounding the tooth. Because plaque contains bacteria, infection is likely, and a tooth abscess may also develop. This also increases the rate of bone destruction.

Symptoms

Note: Early symptoms resemble gingivitis.

Exams and Tests

An exam of the mouth and teeth by the dentist shows soft, swollen, red-purple gums. Deposits of plaque and tartar may be seen at the base of the teeth and the pockets in the gums may be enlarged. In most cases, the gums are painless or mildly tender, unless a tooth abscess is also present. Teeth may be loose and gums may be pulled back exposing the base of the teeth.

Dental x-rays show the loss of supporting bone. They may also show the presence of plaque deposits under the gums.

Treatment

The goal of treatment is to reduce inflammation, remove "pockets" in the gums, and treat any underlying causes of gum disease.

Rough surfaces of teeth or dental appliances should be repaired.

It is important to have the teeth cleaned thoroughly. This may involve use of various tools to loosen and remove plaque and tartar from the teeth. Proper flossing and brushing is always needed, even after professional tooth cleaning, to reduce your risk of gum disease. Your dentist or hygienist will show you how to brush and floss properly. You may benefit from medicines that are put on your gums and teeth. Patients with periodontitis should have a professional tooth cleaning every three months.

Surgery may be necessary. Deep pockets in the gums may need to be opened and cleaned. Loose teeth may need to be supported. Your dentist may need to remove a tooth or teeth so that the problem doesn't get worse and spread to nearby teeth.

Outlook (Prognosis)

Some people find the removal of dental plaque from inflamed gums to be uncomfortable. Bleeding and tenderness of the gums should go away within 1 or 2 weeks of treatment. (Healthy gums are pink and firm in appearance.)

You need to perform careful home brushing and flossing for your entire life or the problem may return.

Possible Complications

When to Contact a Medical Professional

Consult your dentist if signs of gum disease are present.

Prevention

Good oral hygiene is the best means of prevention. This includes thorough tooth brushing and flossing, and regular professional dental cleaning. The prevention and treatment of gingivitis reduces the risk of development of periodontitis.

References

  1. Amsterdam JT. Oral medicine. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 70.
  2. Kawar N, Gajendrareddy PK, Hart T. Periodontal disease for the primary care physician. Dis Mon. 2011;57(4):174-183. [PubMed: 21569880]
  3. Chow AW. Infections of the oral cavity, neck, and head. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 60.

Review Date: 2/25/2014.

Reviewed by: Ilona Fotek, DMD, MS, Palm Beach Prosthodontics Dental Associates, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Fact sheet: Gingivitis and periodontitisFact sheet: Gingivitis and periodontitis
    Gingivitis (inflammation of the gums) often does not cause any immediate symptoms. Yet it may spread to other parts of the periodontium (the bone and soft tissue responsible for keeping our teeth firmly anchored) and cause damage there. This is called periodontitis. Even if this does not cause any symptoms at first, consequences become apparent later on. If periodontitis gets worse, it can lead to teeth becoming loose and eventually falling out. Treatment and better dental hygiene can counteract gingivitis. They can also usually help to slow down periodontitis.
See all (16) ...

Figures

  • Gingivitis.
    Swollen gums.

PubMed Health Blog...

read all...

MedlinePlus.gov links to free, reliable, up-to-date health information from the National Institutes of Health (NIH) and other trusted health organizations.

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...