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Rather than a single disease entity, periodontal disease is a combination of multiple disease processes that share a common clinical manifestation. The cause includes both local and systemic factors. The disease consists of a chronic inflammation associated with loss of alveolar bone. Advanced disease features include pus and exudates.
Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. [5] In its early stage, called gingivitis, the gums become swollen and red and may bleed. [5] It is considered the main cause of tooth loss for adults worldwide.
[1] [2] At least 16 systemic diseases have been linked to periodontitis. These systemic diseases are associated with periodontal disease because they generally contribute to either a decreased host resistance to infections or dysfunction in the connective tissue of the gums, increasing patient susceptibility to inflammation-induced destruction. [1]
Periodontal pathogens are bacteria that have been shown to significantly contribute to periodontitis. Dental plaque , the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea , protozoa , fungi and viruses.
Gingival enlargement has a multitude of causes. The most common is chronic inflammatory gingival enlargement, when the gingivae are soft and discolored. This is caused by tissue edema and infective cellular infiltration caused by prolonged exposure to bacterial plaque, and is treated with conventional periodontal treatment, such as scaling and root planing.
It is the most minor form of this spectrum, with more advanced stages being termed necrotizing periodontitis, necrotizing stomatitis, and the most extreme, cancrum oris. [2] Necrotizing periodontitis (NP) is where the infection leads to attachment loss, and involves only the gingiva, periodontal ligament and alveolar ligament.
Gingivitis is a non-destructive disease that causes inflammation of the gums; [1] ulitis is an alternative term. [2] The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms (also called plaque) that are attached to tooth surfaces, termed plaque-induced gingivitis.
In equilibrium, the bacterial biofilm produced by the fermentation of sugar in the mouth is quickly swept away by the saliva, except for dental plaque. In cases of imbalance in the equilibrium, oral microorganisms grow out of control and cause oral diseases such as tooth decay and periodontal disease.