Periodontal disease is the most common disease of man, found in every culture and society throughout the world’s history. It is a progressive inflammatory reaction of the gingiva (gums) and bone to bacterial plaque. It begins as an inflammation of the gingiva, a condition called gingivitis and is characterized by red, swollen, painful or bleeding gums. Gingivitis is often present without any of these signs or symptoms. If undetected and untreated, the inflammation progresses to early, then moderate, then advanced periodontal disease, called periodontitis. Periodontitis is sometimes called “pyorrhea.” Pyorrhea means “flow of pus.” More teeth are lost due to periodontal disease than all other causes combined, at all levels of society. Periodontitis is characterized by progressive destruction of the bone surrounding and holding teeth in their place, resulting in mobility of teeth; foul and fetid breath; teeth appearing to be getting longer (because the bone holding the tooth in place is being lost) and the presence of pus. Gingivitis and periodontitis are easily detectable by a competent dental hygienist and easily diagnosable by a competent dentist. Most importantly, gingivitis and periodontitis are preventable with proper personal oral hygiene supplemented by regular, periodic visits to a dentist for examination and prophylaxis, or cleaning. The term “prophylaxis” derives from “prophylactic,” meaning prevention. Gingivitis and periodontitis are treatable and the extent of the disease often determines the extent of the treatment required. Conservative treatment might include no more than curettage and root surface refinishing, a simple and relatively inexpensive treatment which can be performed by general or family dentists. Surgical treatment, usually performed by a dental specialist called a periodontist, can include bone recontouring, bone and gum grafting and new, very sophisticated treatment to encourage gingival tissue to grow back to their earlier and healthier level. The failure of a general dentist to detect, diagnose, treat or refer a patient for treatment of, periodontal disease may be negligent and such failures are often litigated in dental malpractice actions.
Periodontitis is the stage of periodontal disease, more advanced than gingivitis, characterized by bone loss, tooth mobility and destruction of the narrow band of tissue which attaches to the bone. “Perio” means ‘around’; “dontal” means ‘tooth’; “itis” always means ‘inflammation.’ Periodontitis is the inflammation of the tissues around the teeth.