User:Ian Furst/sandbox/Periodontal disease

Periodontitis is an inflammatory disease of the teeth and gums that occurs in roughly 50% of those over 30, and 70% of those over 65.

Causes
It is caused by the build-up of bacteria on teeth, otherwise known as plaque caused by poor oral hygiene. Left in place the plaque hardens into calculus, or tarter, and causes even more inflammation. Eventually, the gums detach, pull away from the tooth, bone is lost, and teeth become loose, uncomfortable and fall out.

Contributing Causes
Aside from plaque, we know that smoking, diabetes, family history, and certain diseases or medications, also contribute to periodontitis.

Symptoms
While it is usually painless, periodontitis does cause redness, swelling, bleeding, and recession of the gums along with bad breath.

Diagnosis
The diagnosis of periodontitis involves measuring the gap between the gum and tooth, typically referred to as the probing, or pocket depth, and bone loss on dental x-rays.

Severity
The severity of the disease is judged by a combination of probing depths, bone loss, and risk factors such as diabetes and smoking.

Treatment
Since periodontitis is an inflammatory disease, it does not respond well to antibiotics or mouth rinses. Instead, it is managed with improving the patient’s ability to clean their teeth, managing risk factors, and regular dental cleanings, called scaling and root planing, to remove the plaque around the teeth.

Surgical Treatment
If the pockets become too deep, scaling and root planing cannot remove the plaque deep beneath the gums, and periodontal surgery is required. During surgery the gum is pulled back to clean the teeth, smooth uneven bone and reshape areas of the tooth that are prone to trapping bacteria.

Regeneration
In some cases, the tissues that have been lost can be regenerated through the use of bone grafts and other materials.

Prognosis
Once the teeth are cleaned and the inflammation controlled, evidence shows that the disease can be halted as long as the patient cleans their teeth daily, has scaling and root planing multiple times per year, and regular check-ups to control any new areas of inflammation.