Periodontitis - Mouth and Dental Disorders - MSD Manuals

Periodontitis is one of the main causes of tooth loss in adults and is the main cause of tooth loss in older people. Infection destroys the bone that holds ... MSDManual PleaseconfirmthatyouarenotlocatedinsidetheRussianFederation Yes No LeavethisSite? Thelinkyouhaveselectedwilltakeyoutoathird-partywebsite.Wedonotcontrolorhaveresponsibilityforthecontentofanythird-partysite. 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Thelipsundergochangeswithaging,asdoallpartsofthebody.Somechangesmayindicateamedicalissue;othersareharmless.Aspeopleage,thelipstendtobecomethinner.Deficienciesofcertainvitaminsandmineralscanleadtoinflammationofthelips(cheilitis),causingthemtobecomered,cracked,painful,swollen,and/orscaly.Deficiencyofwhichofthefollowingvitaminsormineralscancausethesesymptoms?   Iron  VitaminD  Thiamin  VitaminC MoreContent Videos 3DModels News SOCIALMEDIA Periodontitis (Pyorrhea) By JamesT.Ubertalli ,DMD,Hingham,MA Lastfullreview/revisionSep2020|ContentlastmodifiedSep2020 CLICKHEREFORTHEPROFESSIONALVERSION GETTHEQUICKFACTS TopicResources 3DModels(0) Audios(0) Calculators(0) Images(5) LabTest(0) Tables(0) Videos(0) Periodontitis:FromPlaquetoToothLoss Periodontitis:FromPlaquetoToothLoss Periodontitis:FromPlaquetoToothLoss Periodontitis:FromPlaquetoToothLoss Periodontitis PeriodontitisisasevereformofgingivitisGingivitisGingivitisismildformofperiodontaldiseasecharacterizedbyinflammationofthegums(gingivae).Gingivitisresultsmostoftenfrominadequatebrushingandflossingbutmayresultfrommedical...readmore,inwhichtheinflammationofthegumsextendstothesupportingstructuresofthetooth.PlaqueOverviewofToothDisordersCommontoothdisordersincludeCavities(causedbytoothdecay)PulpitisPeriapicalabscessImpactedteethreadmoreandtartarOverviewofToothDisordersCommontoothdisordersincludeCavities(causedbytoothdecay)PulpitisPeriapicalabscessImpactedteethreadmorebuildupbetweentheteethandgumsandthenspreadtotheboneundertheteeth.Thegumsswellandbleed,thebreathsmellsbad,andteethbecomeloose.Dentiststakex-raysandmeasurethedepthofpocketsinthegumstodeterminehowsevereperiodontitisis.Repeatedprofessionalcleaningsandsometimesdentalsurgeryandantibioticsareneeded.Periodontitisoccursinpeoplewhoaresusceptibletoamoreseriousinfectionofperiodontaltissue(tissuesurroundingtheteeth)thanoccursinsimpleguminflammation(gingivitisGingivitisGingivitisismildformofperiodontaldiseasecharacterizedbyinflammationofthegums(gingivae).Gingivitisresultsmostoftenfrominadequatebrushingandflossingbutmayresultfrommedical...readmore).Manydiseasesanddisorders,includingdiabetesDiabetesMellitus(DM)Diabetesmellitusisadisorderinwhichthebodydoesnotproduceenoughorrespondnormallytoinsulin,causingbloodsugar(glucose)levelstobeabnormallyhigh.Urinationandthirstare...readmore(especiallytype1),DownsyndromeDownSyndrome(Trisomy21)Downsyndromeisachromosomedisordercausedbyanextrachromosome21thatresultsinintellectualdisabilityandphysicalabnormalities.Downsyndromeiscausedbyanextrachromosome21...readmore,CrohndiseaseCrohnDiseaseCrohndiseaseisaninflammatoryboweldiseasewherechronicinflammationtypicallyinvolvesthelowerpartofthesmallintestine,thelargeintestine,orbothandmayaffectanypartofthe...readmore,leukopenia,andAIDSHumanImmunodeficiencyVirus(HIV)InfectionHumanimmunodeficiencyvirus(HIV)infectionisaviralinfectionthatprogressivelydestroyscertainwhitebloodcellsandcancauseacquiredimmunodeficiencysyndrome(AIDS).HIVistransmitted...readmore,canpredisposeapersontoperiodontitis.InpeoplewithAIDS,periodontitisprogressesquickly.Smoking,vitaminCdeficiencyVitaminCDeficiencyIndevelopedcountries,vitaminCdeficiencycanoccurfromadietlowinvitaminC,butseveredeficiency(causingscurvy)isuncommon.Noteatingenoughfreshfruitsandvegetablescancause...readmore(scurvy),andemotionaldistressalsoareriskfactorsforperiodontitis.Periodontitiscanaffectpeopleofanyage,includingyoungchildren.Somepeoplehaveseveregingivitisformanyyearswithoutdevelopingperiodontitis.Othersmaydevelopperiodontitis,especiallyatearlyages(20to30yearsold),withoutfirsthavingsignificantgingivitis.Periodontitisisoneofthemaincausesoftoothlossinadultsandisthemaincauseoftoothlossinolderpeople.Infectiondestroysthebonethatholdstheteethinplace.Theerosionweakenstheattachmentsandloosenstheteeth.Anaffectedtoothmayeventuallyfalloutorneedtobepulled(extracted).CausesofPeriodontitisMostperiodontitisistheresultofinflammationofthegums(gingivitisGingivitisGingivitisismildformofperiodontaldiseasecharacterizedbyinflammationofthegums(gingivae).Gingivitisresultsmostoftenfrominadequatebrushingandflossingbutmayresultfrommedical...readmore)andalong-termaccumulationofplaque(afilmlikesubstancemadeupprimarilyofbacteria,saliva,fooddebris,anddeadcellsthatiscontinuallybeingdepositedonteeth)andtartar(hardenedplaque)ontheteethandthegums.Pocketsformbetweentheteethandgumsandextenddownwardbetweentherootofthetoothandtheunderlyingbone.Thesepocketscollectplaqueinanoxygen-poorenvironment,whichpromotes,inpeoplewithcertainimmunesystemsusceptibilities,thegrowthofaggressiveformsofbacteria.Theplaqueandbacteriacausechronicinflammationthatdamagesthetissueandbonethatholdteethinplace.Ifthediseasecontinues,eventuallysomuchboneislostthatthetoothmaybecomepainfullylooseandthegumsrecedeGumRecessionGumrecessionisthelossoftissueatthegumlinewithexposureoftherootofthetooth.Recessionusuallyoccursinthin,delicategumtissueorinresponsetooveraggressivetoothbrushing...readmore.Toothlosstypicallystartsinaperson's40s.DidYouKnow...Periodontitisisthemaincauseoftoothlossinolderpeople.Periodontitis:FromPlaquetoToothLossHealthygumsandboneholdthetoothfirmlyinplace.Plaquebuildupirritatesthegums,andtheybecomeinflamed(gingivitisGingivitisGingivitisismildformofperiodontaldiseasecharacterizedbyinflammationofthegums(gingivae).Gingivitisresultsmostoftenfrominadequatebrushingandflossingbutmayresultfrommedical...readmore).Intime,thegumspullawayfromthetooth,creatingapocketthatfillswithmoreplaque.Thepocketsgetdeeper,andtheplaquehardensintotartar.Moreplaqueaccumulatesontop.Bacterialinfectionmovesdowntotherootofthetoothandeventuallydestroysthebonesupportingthetooth.Withoutthissupport,thetoothloosensandfallsoutorrequiresextractionbecauseofaperiodontalabscess.Therateatwhichperiodontitisdevelopsdiffersconsiderably,evenamongpeoplewithsimilaramountsoftartar.Suchdifferencesoccurbecauseeachperson'splaquecontainsdifferenttypesandnumbersofbacteriaandbecauseperiodontitisresultsfromtheperson'suniqueimmunesystemresponsetobacteriaintheplaque.Periodontitismaycauseburstsofdestructiveactivitythatlastsformonthsfollowedbyperiodswhenthediseaseapparentlycausesnofurtherdamage.SymptomsofPeriodontitisTheearlysymptomsofperiodontitisaretender,swollen,bleeding,andredgumsandbadbreath(halitosisBadBreathBadbreathisafrequentorpersistentunpleasantodortothebreath.Certaindiseasesproducesubstancesthataredetectableonthebreath,buttheseodorsaretypicallymildandnotconsidered...readmore).Asmoreandmoreboneislost,theteethloosenandshiftposition,andchewingbecomespainful.Frequently,thefrontteethtiltoutward.Periodontitisusuallydoesnotcausepainunlessaninfection,suchasacollectionofpus(abscess)formsinapocket,theteethloosenenoughtomovewhilechewing,orthepersonhasperiodontitiscausedbyhumanimmunodeficiencyvirus.DiagnosisofPeriodontitisAdentist'sevaluationSometimesx-raysTodiagnoseperiodontitis,dentistsinspecttheteethandmeasurethedepthofthepocketsinthegumswithathinprobe.X-raysaretakentoseehowmuchbonehasbeenlost.TreatmentofPeriodontitisTreatmentofriskfactorsProfessionalcleaningsSometimessurgeryandtoothremovalSometimesantibioticsPeoplewhohaveriskfactors,suchaspoororalhygiene,diabetes,andsmoking,shouldreceivetreatmentfortheseriskfactors.Treatmentofriskfactorsincreasesthesuccessofthedentist'streatmentsofperiodontitis.Unlikegingivitis,whichusuallydisappearswithgoodoralhygiene(dailybrushingandflossing),periodontitisrequiresrepeatprofessionalcare.Peoplewhohavegoodoralhygienecancleanonly2to3millimeters(1/10inch)belowthegumline.However,dentistscancleanpocketsupto6to7millimeters(¼inch)deepusingscalingandroot-planingtechniques,whichthoroughlyremoveplaqueandtartarandthediseasedrootsurface.Forpockets5millimeters(1/5inch)deepormore,surgeryisoftenrequired.Dentistsorperiodontistsmayaccessthetoothbelowthegumlinebysurgicallyopeningaflapofgumtissue(periodontalflapsurgery).Theythoroughlycleantheteethandcorrectbonedefects(sometimesbybonegrafting)undertheflapandthensewtheflapbackinplace.Dentistsorperiodontistsmayalsoremovepartoftheinfectedandseparatedgum(agingivectomy)sothattherestofthegumcanreattachtightlytotheteethandpeoplecanthenremovetheplaqueathome.Sometimesteethareremoved(extracted).Ifthemouthissoreaftersurgery,achlorhexidinemouthrinseusedfor1minutetwiceadaymaybetemporarilysubstitutedforbrushingandflossing.Dentistsmayprescribeantibiotics(suchasamoxicillinormetronidazole),especiallyifacollectionofpus(abscessDentalAbscessAnabscessisacollectionofpus.Pusisamixofwhitebloodcells,deadtissue,andbacteria.Itbuildsupwhereveryourbodyisfightinganinfection.Adentalabscessisanabscessthat...readmore)hasdeveloped.Dentistsmayalsoinsertmaterials(filamentsorgels)thatcontainantibioticsintodeepgumpockets,sothathighconcentrationsofthedrugcanreachthediseasedarea.Periodontalabscessescauseaburstofbonedestruction,butimmediatetreatmentwithsurgeryandantibioticsmayallowmuchofthedamagedbonetoquicklygrowback.MoreInformationaboutPeriodontitisThefollowingaresomeEnglish-languageresourcesthatmaybeuseful.PleasenotethatTHEMANUALisnotresponsibleforthecontentoftheseresources.MouthHealthy:Thisgeneralresourceprovidesinformationonoralhealth,includingnutritionandguidanceonselectingproductsthatcarrytheAmericanDentalAssociation'ssealofapproval.Thereisalsoadviceonfindingadentistandhowandwhentoseeone.NationalInstituteofDentalandCraniofacialResearch:Thisgovernmentsitecoversawidevarietyoftopicsrelatedtooralanddentalhealth(inEnglishandSpanish),includingdefinitionsofcommontermsandthelatestinformationonclinicaltrialsrelatedtooralanddentaldiseases. NOTE: ThisistheConsumerVersion. DOCTORS: CLICKHEREFORTHEPROFESSIONALVERSION CLICKHEREFORTHEPROFESSIONALVERSION ©2022MerckSharp&DohmeCorp.,asubsidiaryofMerck&Co.,Inc.,Kenilworth,NJ,USA GumRecession WasThisPageHelpful? Yes No TemporomandibularDisorders OTHERTOPICSINTHISCHAPTER AcuteNecrotizingUlcerativeGingivitis(ANUG) DentalImplant–RelatedConditions Gingivitis GumRecession Periodontitis Othersalsoread Periodontitis EffectsofAgingontheMouthandTeeth Gingivitis Testyourknowledge LipSores,LipInflammation,andotherChanges Thelipsundergochangeswithaging,asdoallpartsofthebody.Somechangesmayindicateamedicalissue;othersareharmless.Aspeopleage,thelipstendtobecomethinner.Deficienciesofcertainvitaminsandmineralscanleadtoinflammationofthelips(cheilitis),causingthemtobecomered,cracked,painful,swollen,and/orscaly.Deficiencyofwhichofthefollowingvitaminsormineralscancausethesesymptoms?   Iron  VitaminD  Thiamin  VitaminC MSDandtheMSDManuals MerckandCo.,Inc.,Kenilworth,NJ,USA(knownasMSDoutsideoftheUSandCanada)isaglobalhealthcareleaderworkingtohelptheworldbewell.Fromdevelopingnewtherapiesthattreatandpreventdiseasetohelpingpeopleinneed,wearecommittedtoimprovinghealthandwell-beingaroundtheworld. TheManualwasfirstpublishedin1899asaservicetothecommunity.ThelegacyofthisgreatresourcecontinuesastheMSDManualoutsideoftheUnitedStatesandCanada.LearnmoreaboutourcommitmenttoGlobalMedicalKnowledge. 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