By: Dr. Jaklin Bezik, Periodontist
Gingivitis and periodontitis. For many people, a common misconception is that gingivitis and periodontitis are the same. While they are, without a doubt, closely related, it is important to note that these are two different diseases. Let’s take an in depth look at both gingivitis and periodontitis, and see how they differ.
Gingivitis is the inflammation or irritation of the gingiva, or gums. Gingivitis is caused by a build-up of certain types of bacteria on the teeth, which collect on the surface of the teeth and are called plaque. Unlike most of the other surfaces of the body, the teeth do not have any way of shedding their outer surfaces, thus allowing plaque to build up on the surface unless they are intentionally removed. These plaque feed on food particles which enter into the mouth and sometimes become stuck while eating, which produces toxic byproducts. These byproducts initiate the body’s immune system to attack both the plaque and the surrounding tissue, which leads to damage of the gum tissue.
Periodontitis is caused by the inflammation of the periodontal areas, which are the structures within the mouth that surround and support the tooth. Periodontitis involves the loss of the alveolar bone (the bone that supports the tooth and root) and connective tissues in the jaw. This occurs because of the body’s immune response to plaque. As the body initiates a host response to attack plaque, the gum tissue is also damaged, leading it to separate from the tooth and form spaces called periodontal “pockets”. The plaque then invades these spaces, and further progressive loss of the bone and other connective tissues within the oral cavity is caused by the continued immune response to destroy the plaque in these pockets. The loss of the bone and connective tissues may become so advanced that the gums too, begin to retract and teeth become loose and fall out.
Differences Between Gingivitis and Periodontitis Disease
While both of these diseases share the similarities of being caused by the immune system’s response to plaque, there are several ways to distinguish the two.
- Gingivitis always precedes periodontitis, and is a necessary condition for periodontitis to form. Therefore, if a person does not get gingivitis, then they cannot get periodontitis. However, there does not need to be any pre-existing periodontal disease present for gingivitis to arise.
- Gingivitis involves mainly the inflammation or destruction of the gum tissues, while periodontitis revolves mainly around the damage to the surrounding alveolar bone and connective tissue.
- The tissue damage which occurs due to gingivitis is temporary, because of the ability of the body to quickly heal and regenerate this type of tissue. Because periodontitis damages the bone, which cannot be easily regenerated, this is usually considered to be permanent damage.
- Gingivitis is usually physically obvious, with symptoms such as bleeding or reddened gums. Periodontitis is not as obvious, and there may be little pain associated with it as the bone is damaged. Also, because the damage occurs beneath the gums within the jaw itself, it is not as physically noticeable as gingivitis.
- Gingivitis can usually be successfully treated by removing the gingivitis causing plaque. This can be done through methods such as proper brushing and flossing or using antibacterial mouthwashes. Periodontitis, however, will require specialist treatment to remove the plaque buildup from beneath the gums, and may at times require surgery such as bone grafts or guided tissue regeneration in order to restore some of the damaged bone.
Treating Gingivitis and Periodontitis
There may be times where it is necessary for a dentist to carry out specialized procedures in order to treat either gingivitis or periodontitis disease. Two popular treatments for these diseases are root planning and scaling, which are usually done in tandem with each other. These treatments involve using instruments to remove the plaque in hard to reach areas and then as well as smoothing out the tooth surface to make it more difficult for plaque and tartar to adhere to the tooth exterior. In cases of moderate to severe periodontitis, a dentist may suggest bone grafts or guided tissue regeneration, which uses material in order to re-grow lost bone in order to prevent against tooth loss, as well as to improve the aesthetic appearance.
The best way to treat these two diseases, however, is not to get them in the first place! With a good oral hygiene regimen, which includes brushing teeth properly twice a day, flossing at least once a day, and staying away from food and beverages that put you at an increased risk of plaque, you are well on your way in avoiding the dangerous duo of gingivitis and periodontitis.