Periodontitis (less commonly known as pyorrhea) is a cluster of diseases that affect the tissues that support and surround teeth. These tissues are collectively known as the periodontium. The disease is caused by microbes that grow on the tooth surface. another feature of the disease is the fact that once these microbes establish themselves, the immune response by the body tends to be over-aggressive, which can lead to tissue loss and other problems. Typically this disease is diagnosed using a multi-faceted approach, which includes using hand instruments to measure the depth of periodontal pockets and taking X-ray films of the patients mouth to determine bone loss.
The most recent classification system for periodontal diseases was developed in 1999 and is broken into seven major categories. The only reversible category is the first category. All of the subsequent categories are considered a destructive disease because damage caused by the disease cannot be undone and is permanent. The seven categories, in order, are as follows; (1) Gingivitis, (2) Chronic Periodontitis, (3) Aggressive Periodontitis, (4) Periodontitis as a manifestation of a systemic disease, (5) Necrotizing ulcerative gingivitis/periodontitis, (6) Abscesses of the periodontium, and (7) Combined periodontic-endodontic lesions. These seven categories are used to diagnose specific patients, as well as refer to a group of patients that suffer from one of the above conditions. Periodontitis is considered local if less than thirty percent of the mouth is affected, and generalized if more than thirty percent of the mouth is affected.
Tooth surfaces are referred to by various names in dentistry, including mesial, distal, buccal, and lingual. If you drew a midline through the front two teeth, this is considered the midline. mesial is towards the midline, whereas distal is away from the midline. Lingual is towards the tongue side, where as buccal (or sometime labial or facial) is towards the cheek and outside of the teeth. 6 measurements are taken when diagnosing the disease. Three (mesio,mid, and distal) are taken on the buccal surface, and three more (mesio, mid, and distal) are taken on the lingual surface. These measurements determine how much periodontal ligament (which attach the tooth and suspend it in the bone) has been lost3. attachment of less than 2mm is considered mild, and greater than 5mm lost is considered severe. Any amount of loss between the 2 is considered moderate.
A number of symptoms present in the mouth of a patient who suffers from periodontitis, included red swollen gums, halitosis, gingival recession (apparent lengthening of teeth due to gum loss) and occasionally loose teeth. However, more interestingly are the correlations between periodontitis and symptoms occurring in other areas of the body besides the mouth. A correlation between inflammation in other parts of the body and periodontitis have been found in multiple studies4,5. This link has been...