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explanation of periodontal terms
Periodontitis: the term for Periodontal Disease: has it’s derivation from the Greek “ Odont: for tooth, Peri: for around, and Itis: for inflammation or infection. Periodontitis is an infection around the teeth. It is a chronic disease that causes bone loss and tooth loss. There are different forms of periodontal disease, some more aggressive than others, and there are multiple associated factors that can complicate and aggravate periodontitis. There is no cure, but most through treatment it can be possible to control periodontal disease. Or (most forms of periodontitis are amenable to periodontal treatment)
Periodontal ligament: The tooth is connected to the bone by a surrounding complex of individual ligament fibers.
Tooth: in health the exposed portion of the tooth is covered by enamel, the hardest material in the body. The root of the tooth is covered by cementum, not enamel. Cementum is much softer, and thinner than enamel. The connective tissue fibers of the gingiva attach to the root surface, and the periodontal ligament fibers attach the bone to the root surface.
Gingiva: the soft tissue immediately surrounding the teeth. The gingiva, or the gum tissue, is a firm tissue capable of withstanding the forces and pressures of chewing food. The gingiva can attach directly to tooth root surfaces, or to bone.
Interproximal Space: The space between the teeth is called the interproximal space. This is the space that is cleaned by flossing. Periodontal disease generally begins and develops in this interproximal space between the teeth.
Alveolar bone: the bone of the upper and lower jaws that attaches to and directly supports the teeth is called the alveolar bone. The bone is protected by the gingival attachment to the teeth. Bacteria can infect the gum and set off a series of events that cause bone loss.
Periodontal Pocket: The gum attaches to the tooth and creates a soft tissue seal or attachment to the tooth, protecting the inner-tissues and bone. The gingival tissue seal is part of a soft collar around the teeth, called the sulcus. This sulcus is like a moat around the castle, it is a space that protects the tooth and supporting bone. This sulcus can become infected, and the soft tissue migrate along the root surface while bone is being lost. This increased space along the tooth surface is called a periodontal pocket, and is a major part of “Periodontitis”. The periodontal pocket is one of the main measurements taken during a periodontal examination.
The tooth is a mineralized structure, as described above that passes through the bone, connective tissue and gingiva (gum).
1. It is a Non-shedding surface which makes it more susceptible to bacterial colonization.
2. The periodontal pocket formed around the tooth in periodontal disease is the location of the majority of the bacterial infection, and this area is Outside the Body, and less accessible to the host defense mechanisms, including antibiotics.
3. The bacteria living in the periodontal pocket have are an exceptionally complex group of bacteria.
a. A deep periodontal pocket may be populated by as much as a billion bacteria.
b. There may be 150 species of subgingival bacteria per mouth.
c. And 30-100 species of subgingival bacteria per site.
Midianos, AAP 2009.
Furcation: Our molar teeth are susceptible to bone loss because they have multiple roots and can have bone loss between the roots. This bone loss between the roots can cause premature loss of the molars. The upper molars are particularly susceptible because they have three roots and two of the three inter-root openings exit in the interproximal space between the teeth. The area between the roots, where the roots split, is called the furcation.
Occlusion: the way the upper and lower teeth come together is called the “Occlusion”, or the “Bite”. The occlusion can bring uneven forces to the teeth, and this force can accentuate periodontal disease and cause increased bone loss around the teeth involved. Sometimes a simple slight reduction of the biting surface of the involved tooth, an “Occlusal Adjustment”, can reduce the negative aspects of exaggerated occlusal pressure on the teeth. Active orthodontic treatment is also utilized to correct the position of teeth with.
Recession: the gingiva can move away from it’s normal position on the tooth root, exposing previously covered root surface. Gingival recession can often be maintained with good oral hygiene and regular maintenance scaling appointments. The main problems associated with gingival recession are root surface decay and continued advancing recession. For problem areas with little or no remaining gingival protection, a gum graft may be possible to increase the amount of gingival tissue.
Endodontic infections: an infection of the soft tissue in the center of the tooth: the tooth pulp. Treated by a root canal or by extraction of the involved tooth.
Mobility: All teeth are able to move, because of the ligament attachment to the bone. If there is too much occlusal force against the tooth, or significant bone loss, or both, teeth can become loose, or mobile.
Tooth Loss: Teeth can become a source of infection to themselves and to neighboring teeth, bone and other anatomic structures. It can become necessary to remove teeth so infected, in order to preserve bone and save surrounding teeth.
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