Periodontitis, gingivitis, periodontal diseases, gum disease, pyorrhea

Periodontitis, also known as gum disease and pyorrhea, is a set of inflammatory diseases affecting the tissues surrounding the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth.

What is periodontitis? What causes periodont

Periodontitis means “inflammation around the tooth” – it is a serious gum infection that damages the soft tissue and bone that supports the tooth.
All periodontal diseases, including periodontitis, are infections which affect the periodontium. The periodontium are the tissues around a tooth, tissues that support the tooth. With periodontitis, the alveolar bone around the teeth is slowly and progressively lost. Microorganisms, such as bacteria, stick to the surface of the tooth and multiply – an overactive immune system reacts with inflammation.

What is the difference between periodontitis and gingivitis?

Gingivitis occurs before periodontitis. Gingivitis usually refers to gum inflammation while periodontitis refers to gum disease and the destruction of tissue and/or bone. Initially, with gingivitis, bacteria plaque accumulates on the surface of the tooth, causing the gums to go red and inflamed; teeth may bleed when brushing them. Even though the gums are irritated and bothersome, the teeth are not loose. There is no irreversible damage to bone or surrounding tissue.

Untreated gingivitis can progress to periodontitis. With periodontitis, the gum and bone pulls away from the teeth, forming large pockets. Debris collects in the spaces between the gums and teeth, and infect the area. The patient’s immune system attacks bacteria as the plaque spreads below the gum line. Bone and connective tissue that hold the tooth start to break down – this is caused by toxins produced by the bacteria. Teeth become loose and can fall out.

Put simply, Periodontitis involves irreversible changes to the supporting structures of the teeth, while gingivitis does not.

Periodontitis – Signs and symptoms

In the early stages, periodontitis has very few symptoms, and in many individuals the disease has progressed significantly before they seek treatment.

Redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food (e.g., apples) (though this may occur even in gingivitis, where there is no attachment loss)

– Gum swelling that recurs

– Spitting out blood after brushing teeth

– Halitosis, or bad breath, and a persistent metallic taste in the mouth

– Gingival recession, resulting in apparent lengthening of teeth. (This may also be caused by heavy-handed brushing or with a stiff toothbrush.)

– Deep pockets between the teeth and the gums (pockets are sites where the attachment has been gradually destroyed by collagen-destroying enzymes, known as collagenases)

– Loose teeth, in the later stages (though this may occur for other reasons, as well)

Patients should realize gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that patient.


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