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Periodontitis

A chronic infection that affects the gums and the bones that support the teeth. Bacteria and the body's own immune system break down the bone and connective tissue that hold teeth in place. Teeth may eventually become loose, fall out, or have to be removed.

PubMed Health Glossary
(Source: NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases)

About Periodontitis

When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth"). In periodontitis, gums pull away from the teeth and form spaces (called "pockets") that become infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line.

Bacterial toxins and the body's natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed. NIH - National Institute of Dental and Craniofacial Research

What works? Research summarized

Evidence reviews

Occlusal interventions for periodontitis in adults

Occlusal overload occurs when excessive force damages the supporting structure of a tooth. Approximately 15% of the world's adult population have advanced gum disease which causes the supporting structure of teeth to be compromised. When occlusal overload occurs at a tooth with advanced gum disease there is uncertainty about whether this is detrimental to achieving gum health. Interventions to reduce the effect of occlusal overload on periodontally compromised teeth are sometimes used. The evidence to support the effectiveness of these interventions is limited. This systematic review looked at the evidence for occlusal interventions in patients with periodontitis and found one randomised controlled trial that met the inclusion criteria. The results of this one trial were inconclusive. The main conclusion from this systematic review is there is no evidence for or against the use of occlusal interventions in clinical practice. There is a clear need for adequately powered bias‐protected randomised controlled trials to answer this research question.

Treatment for gum disease (periodontitis) for the management of disease involving the heart and blood vessels in patients with chronic gum disease

The main question addressed by this review produced by the Cochrane Oral Health Group was whether or not treatment for moderate to severe gum disease (periodontitis) also has an effect on the prevention or management of heart and blood vessel (cardiovascular) disease.

Treating all teeth (full mouth) within 24 hours for chronic gum disease (periodontitis) in adults

Long lasting (chronic) gum disease causes damage to the gums and soft tissue structures around teeth. This review seeks to evaluate the effectiveness of full‐mouth treatments carried out within 24 hours compared to the more conventional treatment of partial mouth scaling and root planing (SRP) usually done over a number of weeks. The treatments being reviewed are full‐mouth scaling (FMS) and full‐mouth disinfection (FMD). A secondary aim was to establish if there was a difference in effectiveness between FMS and FMD. This review updates our previous review published in 2008.

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Summaries for consumers

Gingivitis and periodontitis: Treatment of periodontitis: Cleaning, scaling, care

Advanced periodontitis can cause teeth to loosen and fall out. Treating the disease in a systematic way can usually stop periodontitis from getting worse. Good oral hygiene is absolutely essential for treatment success.Besides caring for teeth and gums, there are several different ways for dentists to prevent or treat periodontitis. Systematic treatment of periodontitis consists of the following steps:Improved oral hygiene and professional teeth-cleaningRemoving film and deposits below the gumline (subgingival scaling) and planing the roots of the teethConfirmation of treatment successSurgery with local anesthetic, if neededFollow-up careStatutory insurers in Germany will cover some of the costs involved in the systematic treatment of periodontitis, but a special request must be filed in advance. This should include a treatment and cost plan provided by your dentist. Your health insurer can let you know which services will be covered in your specific case.

Gingivitis and periodontitis: Overview

Gingivitis (inflamed gums) is usually harmless and goes away quickly. But sometimes gingivitis can spread to the tissues that support our teeth and keep them firmly in place (periodontium). This is called periodontitis. You can read about what can be done to stop it from getting worse and preventative oral hygiene.

Occlusal interventions for periodontitis in adults

Occlusal overload occurs when excessive force damages the supporting structure of a tooth. Approximately 15% of the world's adult population have advanced gum disease which causes the supporting structure of teeth to be compromised. When occlusal overload occurs at a tooth with advanced gum disease there is uncertainty about whether this is detrimental to achieving gum health. Interventions to reduce the effect of occlusal overload on periodontally compromised teeth are sometimes used. The evidence to support the effectiveness of these interventions is limited. This systematic review looked at the evidence for occlusal interventions in patients with periodontitis and found one randomised controlled trial that met the inclusion criteria. The results of this one trial were inconclusive. The main conclusion from this systematic review is there is no evidence for or against the use of occlusal interventions in clinical practice. There is a clear need for adequately powered bias‐protected randomised controlled trials to answer this research question.

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Terms to know

Bone
A living, growing tissue made mostly of collagen.
Connective Tissue
Supporting tissue that surrounds other tissues and organs. Specialized connective tissue includes bone, cartilage, blood, and fat.
Gingiva (Gum)
The tissue of the upper and lower jaws that surrounds the base of the teeth. Also called gums.
Plaque
In medicine, a small, abnormal patch of tissue on a body part or an organ. Plaques may also be a build-up of substances from a fluid, such as cholesterol in the blood vessels.
Tartar
Calculus or tartar is a form of hardened dental plaque. It is caused by the continual accumulation of minerals from saliva on plaque on the teeth. Its rough surface provides an ideal medium for further plaque formation, threatening the health of the gingiva (gums).
Tooth
One of a set of bone-like structures in the mouth used for biting and chewing.

More about Periodontitis

Photo of an adult

See Also: Gingivitis

Other terms to know: See all 6
Bone, Connective Tissue, Gingiva (Gum)

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