Overview: Periodontitis refers to a number of inflammatory diseases affecting the tissues that surround and support the teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. Periodontitis involves progressive loss of the alveolar bone around the teeth and may eventually lead to the loosening and subsequent loss of teeth if left untreated.

Causes: Periodontitis is caused by a convergence of bacteria that adhere to and grow on the tooth's surfaces, along with an overly aggressive immune system response against these bacteria. Although the different forms of periodontitis are all caused by bacterial infections, a variety of factors affect the severity of the disease. Important "risk factors" include smoking, poorly controlled diabetes, and inherited (genetic) susceptibility.

Diagnosis: A diagnosis of periodontitis is established by inspecting the soft gum tissues around the teeth with a probe and radiographs by visual analysis to determine the amount of bone loss around the teeth. Specialists in the treatment of periodontal diseases are known as periodontists and in the USA periodontics is an American Dental Association-recognized specialty.

Treatment: The cornerstone of successful periodontal treatment starts with establishing excellent oral hygiene. This includes twice daily brushing with daily flossing, mouthwash use. Also the use of an interdental brush (called a Proxi-brush) is helpful if space between the teeth allows. Persons with periodontitis must realize that it is a chronic inflammatory disease and a lifelong regimen of excellent hygiene and professional maintenance care with a periodontist or a dentist is required to maintain affected teeth.

Initial Therapy: Removal of bacterial plaque and calculus is necessary to establish periodontal health. The first step in the treatment of periodontitis involves non-surgical cleaning below the gumline with a procedure called Scaling and Root planing. This procedure involves use of specialized curettes to mechanically remove plaque and calculus from below the gumline, and may require multiple visits and local anesthesia to adequately complete.

Surgery: If the initial non-surgical treatment was not successful in controlling periodontitis, or if anatomical bony defects persist, periodontal surgery may be necessary to control periodontal disease. There are a myriad of procedures which may be applied, depending on each tooth's site-specific disease pattern. These procedures are usually performed by a periodontist. These procedures include (but are not limited to):

• Pocket Reduction Procedures
• Regenerative Procedures
• Crown Lengthening
• Soft Tissue Grafts