Classification & Treatment of Gum Disease

Gum disease is a condition that involves serious gum infection that destroys the bones and tissues that support the teeth. Gum disease is classified according to the severity of damage to the gum, teeth and tissues. Each classification presents different symptomatic stages and requires treatment to prevent its progression, which may result in loss of teeth in the advanced stage.

Significance

• According to the President of the American Academy of Periodontology, Kenneth Bueltmann, the importance of oral examination goes beyond the need for monitoring oral hygiene, but is also essential to identify possible risks for serious medical conditions. The Department of Dental Medicine of Long Island Jewish Medical Center identified enlarged gums as an initial symptom of an underlying systemic disease. Identification of gum disease and classifying it accordingly help to provide adequate treatment necessary to prevent its progression.

Classification

• There are two main types of gum disease, namely gingivitis and periodontitis, which are classified according to the severity of damage. The American Dental Association and the American Academy of Periodontology have developed a system classifying gum disease: Gingivitis is classified as type 1; early periodontitis as type 2; moderate periodontitis as type 3; and advanced periodontitis as type 4.

Features

• The classification system for gum disease is established with consideration of the age of onset, the clinical manifestations, the progression rate of the disease and pathogenic microbial flora. The classification system also identifies the possible disease present.

Description

• Gingivitis involves inflammation and infection of the gingival tissues supporting the teeth, gums, periodontal ligament and tooth socket. The cause is the build-up of plaque deposits that bring bacteria that cause tooth decay. There is no bone loss in gingivitis.

  The Merck Manual describes periodontitis as a more severe form of gum disease wherein the inflammation extends beyond the gums to reach the internal structures supporting the tooth. Early periodontitis manifests bleeding and the gum may begin to pull away from the teeth. Pockets of 3 to 4 mm begin to show between teeth and gums. Moderate periodontitis involves mobility of tooth with the presence of bleeding while pockets of 4 to 6 mm develop between teeth and gums. In the advanced periodontitis stage, the pockets between the teeth and gums may be more than 6 mm, and it is likely that the tooth will fall.

Treatment

• The New York Times Health Guide recommends professional tooth cleaning to remove bacterial deposits to reduce the inflammation in gingivitis. Proper brushing, flossing and the use of antibacterial mouthwash will also help.

  The goal of treatment for periodontitis is to prevent progression of damage and clean the area from pockets of bacteria. Tartar and bacteria are removed from the tooth's surface through the process of scaling, while root planing smooths the root surface to prevent further buildup of tartar. The gum tissues in advanced periodontitis may be unresponsive to nonsurgical treatment and may require dental surgery such as flap surgery, bone grafting, soft tissue graft and guided tissue regeneration.