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Periodontitis (Gum Disease)

Chronic inflammatory disease of tooth-supporting periodontal tissues caused by dysbiotic plaque biofilm leading to progressive destruction of periodontal ligament, alveolar bone, and ultimately tooth loss if untreated.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Periodontitis (Gum Disease)?

Periodontitis is a chronic multifactorial inflammatory disease characterized by progressive destruction of the tooth-supporting apparatus including periodontal ligament, alveolar bone, and cementum, induced by dysbiotic plaque biofilm in susceptible hosts.

Key pathogens include 'red complex' bacteria (Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola). Disease progresses from gingivitis through bacterial dysbiosis triggering exaggerated host immune response with neutrophil-mediated and T-cell-mediated tissue destruction.

2017 EFP/AAP classification: Stages I-IV based on clinical attachment loss (CAL), radiographic bone loss, and tooth loss; Grades A-C based on progression rate (% bone loss/age, smoking, diabetes status). Periodontitis affects systemic health (cardiovascular disease, diabetes, adverse pregnancy outcomes, Alzheimer disease).

Symptoms

Bleeding gums on brushing or eating (early sign)
Red, swollen, tender gums
Gum recession exposing tooth roots
Persistent bad breath (halitosis)
Bad taste in mouth
Loose or shifting teeth
Pus discharge from gums (advanced)
Spaces forming between teeth

Risk Factors

Smoking (most important modifiable risk factor)
Diabetes mellitus (especially uncontrolled)
Genetic susceptibility (family history)
Poor oral hygiene with plaque accumulation
Stress and psychosocial factors
Hormonal changes (pregnancy, menopause)
Medications causing dry mouth or gingival overgrowth
Systemic conditions (HIV, leukemia, immunosuppression)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Bleeding gums persisting beyond 1-2 weeks
  • Gum recession or pocket formation
  • Loose teeth or change in bite
  • Persistent bad breath despite oral hygiene
  • Family history of severe periodontitis
  • Diabetes diagnosis with periodontal symptoms
  • Annual periodontal screening for high-risk patients
  • Pre-pregnancy periodontal evaluation

Treatment Methods

01
Phase I (initial therapy): oral hygiene instruction, scaling and root planing under local anesthesia in 1-4 quadrants
02
Adjunctive antimicrobials: locally delivered chlorhexidine chip, doxycycline gel, minocycline microspheres in deep pockets
03
Systemic antibiotics for aggressive/Grade C: amoxicillin 500 mg + metronidazole 250 mg TID for 7-14 days
04
Re-evaluation at 4-6 weeks: probing depths, bleeding on probing, attachment levels
05
Phase II (surgical therapy): flap surgery for residual pockets >5 mm, regenerative procedures for intrabony defects
06
Regenerative techniques: guided tissue regeneration, enamel matrix derivative (Emdogain), bone grafts, growth factors
07
Resective surgery: osseous surgery for horizontal bone loss, gingivectomy for fibrous tissue
08
Phase III (maintenance): supportive periodontal therapy every 3-6 months lifelong
09
Risk factor modification: smoking cessation, diabetes control (HbA1c <7%), stress management
10
Multidisciplinary care: medical management of systemic diseases, restorative dentistry for missing teeth

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Periodontitis is a chronic, inflammatory disease of the tooth-supporting tissues characterized by progressive loss of periodontal attachment and alveolar bone. It develops from untreated gingivitis and is influenced by host response, smoking, diabetes and genetics. Staging and grading (2017 EFP/AAP classification) guide management through non-surgical therapy, adjunct antimicrobials and periodontal surgery when indicated.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.