Periodontal disease affects the supporting structures of the teeth. This includes gingiva, periodontal ligament, root cement (cementum), and alveolar bone. What are the stages of periodontal diseases? GINGIVITIS It is a type of gum disease characterized by induced inflammation of the gingiva characterized by red, swollen tissues which bleed when brushed or probed. It’s the early stage of periodontal disease that is limited to the gingiva. Gingivitis is a common clinical finding that affects nearly everyone during their lifetime. Clinical characteristics: redness, consistency change from firm to spongy, free margin often bleeds on brushing CHRONIC PERIODONTITIS It’s a common gum disease characterized by inflammation of the oral tissues caused by the accumulation of large amounts of dental plaque and the destruction of the tooth's junctional epithelium and connective tissue. It’s most common in adults but can happen in children and teens. Subgingival calculus is frequently linked to a variable microbial pattern. It can be related to local predisposing factors (tooth-related or iatrogenic). Chronic periodontitis may be modified by or related to systemic diseases (diabetes mellitus, HIV/AIDS infection) and other personal habits such as smoking and emotional stress. Clinical characteristics: enlargement or recession of the gingiva, root furcation exposure, increased tooth mobility, drifting of teeth, finally exfoliatin AGGRESSIVE PERIODONTITIS It’s a severe type of gum disease that causes rapid destruction of the gum attachments and the supporting alveolar bone. It’s common in a younger group of patients, which may be associated with familial history of aggressive periodontitis. Disease progression is rapid, and the degree of destruction of the connective tissue attachment and bone is severe. Clinical characteristics: circumpubertal onset under 30 years of age, rapid attachment loss and bone destruction, patient otherwise clinically healthy except periodontal condition, common initial symptoms are movement of first molars and incisors NECROTISING ULCERATIVE GINGIVITIS It’s a type of gum disease characterized by painful ulceration of the tips of the papillae. Gray necrotic tissue is visible, and there is associated bad breath. The condition is called necrotizing ulcerative periodontitis in the presence of connective tissue attachment loss and bone loss. There are two types of necrotizing ulcerative periodontitis described, based on its relationship to acquired immunodeficiency syndrome (AIDS); non-AIDS type and AIDS-associated. Clinical characteristics: ulceration and necrosis gingival margin covered by pseudomembranous slough, the erythematous halo surrounded the ulcerated margins, extremely painful and spontaneously bleeding, localized lymphadenopathy

What are the early warning signs of periodontal disease? *erythematous and edematous gingiva *bleeding gum *halitosis (bad breath) *gum recession *pocket formation *attachment loss Periodontal Abscess It’s a type of gum disease characterized by an infection in a periodontal pocket that can be acute or chronic and asymptomatic if freely draining. It usually arises in the preexisting periodontal lesion. It’s precipitated by: alteration in subgingival flora, host resistance, diabetes mellitus, and trauma. Clinical characteristics: erythematous and edematous gingiva, throbbing pain, extreme sensitivity of the affected gingiva, mobility or extrusion of the adjacent tooth, foul taste, and lymphadenopathy Perio-endo Lesion It is a type of gum disease characterized by lesions that may be independent or coalescing. The bacterial source originates either in the periodontium or the root canal system. Clinical characteristics: periodontal ligament widening, apical abscess, and external resorption Gingival Enlargement It’s a type of gum disease characterized by thickening of the gingiva, which can happen as a response caused by plaque or calculus, repeated friction or trauma, changes in hormone levels, or the use of some medications. In rare instances, certain benign and malignant neoplasms may also cause tissue enlargement. Gingival enlargement can be classified based on etiologic factors and pathologic changes.  Can you fix a periodontal disease? YES! We can fix periodontal diseases, which can be treated. There are two ways of healing periodontal diseases: Medication Gum diseases are mainly caused by microbial plaque, which is dominated by bacteria, so antimicrobial drugs and mouthwashes can treat periodontal diseases. Usually, we use amoxicillin metronidazole, doxycycline, and mouthwashes like hydrogen peroxide and chlorhexidine. Non – medication Scaling is one of the treatments of gum disease, which is the removal of plaque and calculus from the crown and root surfaces of the teeth. Curettes and scalers are used for this. Root planing is one of the treatments of periodontal disease, which is a procedure similar to scaling, but on root planing, we go beyond the cementum to include subgingival areas. Debridement is a gum tissue treatment involving the surgical removal of dead tissues.

Can periodontal disease kill you? Gum disease doesn’t kill you by itself, it’s not a fatal disease, but it can cause significant esthetic problems, psychological problems, and bad breath. Esthetic: it’s clear the face is one of the main things that people care about and give value to, so if there is any gum disease on a person like gingivitis, it has a profound effect on the beauty and esthetics of a person. Psychological problems: gum diseases have a significant psychological impact on people as a person who has periodontal problems like gingivitis or calculus deposits can’t smile freely, and they can develop depression over time if it’s not treated. Bad breath (halitosis): is the term used to describe unpleasant odors exhaled in breathing. 85%-90% of bad breath originates in the mouth. Since the mouth is exposed to less oxygen and inactive at night, the smell is usually worse upon waking (morning breath). Do systemic diseases have a role in periodontal diseases? It's a well-established fact that the primary cause of gum disease is bacterial plaque. The toxins and enzymes produced by the bacterial plaque produce an inflammatory response. This response can be affected by a variety of systemic factors that can alter the response of the tissue. Furthermore, certain systemic disorders can directly affect the gum tissues, representing the periodontal manifestations of systemic diseases. So patients with diabetes mellitus, HIV/AIDS, cardiac conditions, blood disorders, or leukemia must contact their general dentist or periodontist. Can smoking cause periodontal diseases? While the initial belief was that smokers’ poor oral hygiene contributed to gum disease, it is now known that smoking causes immunosuppression. The oral consequences of smoking include decreased bleeding on probing, underdiagnosed inflammation, increased attachment loss, bone loss, and poor response to periodontal treatment.