Periodontitis (Gum Disease)
 

What is Gum Disease? Periodontitis and Gingivitis?

Gum disease is the condition that dentists call 'periodontitis' , sometimes it is used more generally to include gingivitis, though as you will see later, these complaints are quite different.

Let's start by classifying what periodontitis and gingivitis actually mean. Anything with 'itis' on the end means 'swelling of' -so a good example would be tonsillitis meaning swelling of the tonsils.

Ginigivae is 'dentist speak' for gums, so gingivitis literally means swelling of the gums.

Periodontitis is far more significant and where we will focus here. It means swelling of the periodontium, that is the structures that support your tooth.

The disease causes the loss of bony support for your teeth, which if left untreated in susceptible people may eventually lead to the tooth or teeth being lost. This can take many years and fortunately, if detected early, we have excellent ways of slowing it down and in some cases even stopping its progression. We are likely to be able to detect some early changes in susceptible individuals in their late teens.

FACT: Gum disease accounts for 30-35% of teeth needing extractions

Are there Different Types of Gum Disease or Periodontitis?

There are two main types of periodontitis: the first 'chronic periodontitis' is far more common and it classically springs to mind when someone mentions gum disease. Chronic is a term that basically means long term- you may also hear me refer to acute which means short lasting. If a disease is chronic, it suggests that the body's natural defenses are somewhat in balance with the bacteria (an analogy would be a tug of war scenario) and whilst it may progress, it will do so slowly.

There are a couple of acute conditions which occur when the balance is tipped in favour of the bacteria or when some more aggressive bacteria join the fight and overwhelm the natural defenses resulting in a gum infection. These gum infections, which are comparatively rare, include:

Periodontal abscess
ANUG
Acute herpetic gingivostomatitis

The other main type is aggressive periodontitis; it is a particularly nasty form of the disease which causes a much more rapid breakdown- luckily only a very small percentage of all people with periodontitis have this.

Is there a Link between Gum Disease and Heart Disease?

There have been a number of studies (about 40) in recent times suggesting a link between gum disease and heart disease. Exactly how the two are linked has not yet been established. Both diseases are inflammatorary and have a number of mutual risk factors.

Factors that have been shown to increase the risk of getting both heart disease and gum disease (separately) include smoking, diabetes and age (getting older). We are not yet able to say that gum disease 'causes' heart disease or vice versa but if you have chronic heart problems- you are 50% more likely to suffer periodontitis and if you have periodontitis- you are 50% more likley to suffer some heart trouble.

Inflammation is a major risk for heart disease and the concern is that periodontal disease may increase inflammation throughout the body.

Research is ongoing in this area, but it is safe to say that as cardio-vascular (heart) disease is the leading killer of men and women in Australia and the USA, it is responsible for killing one Australian every 11 minutes- it is not worth taking any risks. It has been recommended by both the American Journal of Cardiology and the Journal of Periodontology (which covers nearly all the specialists in both fields) that both medical and dental professionals need to join forces and assess those at risk.

Dentists need to educate their patients on the risks and prevention of developing heart disease and doctors managing heart disease patients need to look in the mouths of their patients for signs of gum disease.

Useful Periodontal Disease Resources