What is Periodontal (Gum) Disease?

The term “periodontal”means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition which affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in its most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss.

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

  • Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession.  It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.

  • Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual.  It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.

  • Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.

  • Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone.  A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.

Here are some of the more common treatments for periodontal disease:

  • Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed.  The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection.  A prescription mouthwash may be incorporated into daily cleaning routines.

  • Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures.  A membrane may be inserted into the affected areas to assist in the regeneration process.

  • Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums.  Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.

  • Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone.  Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.

Ask your dentist if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.

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Testimonials

Dr. Leong is an amazing dental professional. I've been seeing her for a number of years and she has always been effective, responsive, personable and caring. She managed my Invisalign process and did a great job from start to finish. She's very gentle so pain is never in the equation during my visits with her. She's also just a wonderful person. I consider her both my dentist and my friend. I would recommend her to anyone who's looking for a skilled dental professional.

Linda S. June 10, '17

I have been consistently happy with how Dr. Leong and her staff have cared for my teeth. AND, I've had A Lot of Work for Dr. Leong to do with my teeth! Shortly after my first cleanings, I had cavities to fill, then a molar cracked and I had to get a crown, which Dr. Leong did really well (better than my last dentist for sure!)... Given these positive experiences, I trusted Dr Leong to create Veneers for 8 of my upper front teeth, to totally transform my smile! I am very happy with my smile, get lots of compliments, and have confidence that the work will last me a long time (probably longer than my teeth would on their own... She not only did expert work to prepare my veneers and my teeth, but she also went above and beyond to make sure everything fit and felt right for me.

Matt Apr. 9, '15

Dr. Leong is hands down the best dentist I've ever had. She is extremely friendly and knowledgeable. She educated me about the right way to take care of my teeth without being pushy or judgmental. She explained everything she was doing very thoroughly so that I understood my own health better. She never made me feel rushed and she was never pushy trying to sell me dental work I didn't need, which has happened to me many times with other dentists. She and her staff were top notch.

My appointment was exactly on time and Anna at the front desk had already gotten my insurance information without me having to fill out anything. Everything was very well organized and we started my exam right away.

S. Wang Jan. 06, 15

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Wanda S. Leong, DDS 291 Geary Street, Suite 300 San Francisco, CA. 94102 Phone: 415-433-6825
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