page_title: Periodontology
section_title: Periodontal diseases
hierarchical_section_title: Periodontology / Periodontal diseases
caption_attribution_description: English: healty gingiva Français&#160;: gencive à l'état sain العربية: لثة في حالة الصحة ، بالامكان ملاحظة الحليمات اللثوية شاغلة كامل الفرجة بين السنية ، اللون الزهري الرائق للثة ، السطح المحبب كقشر البرتقال للثة الملتصقة ، و الخط المخاطي اللثوي الفاصل ما بين اللثة الملتصقة باللون الزهري و المخاطية الفموية ذات اللون الأحمر القاني
context_page_description: Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva, alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.
context_section_description: Periodontal disease encompasses a number of diseases of the periodontal tissues that result in attachment loss and destruction of alveolar bone.
  Periodontal diseases take on many different forms but are usually a result of a coalescence of bacterial plaque biofilm accumulation of the red complex bacteria (e.g., P. gingivalis, T. forsythia, and T. denticola) of the gingiva and teeth, combined with host immuno-inflammatory mechanisms and other risk factors that can lead to destruction of the supporting bone around natural teeth. Untreated, these diseases can lead to alveolar bone loss and tooth loss. As of 2013, Periodontal disease accounted for 70.8% of teeth lost in patients with the disease in South Korea. Periodontal disease is the second most common cause of tooth loss (second to dental caries) in Scotland. Twice daily brushing and flossing are a way to help prevent periodontal diseases.
  
  Healthy gingiva can be described as stippled, pale or coral pink in Caucasian people, with various degrees of pigmentation in other races. The gingival margin is located at the cemento-enamel junction without the presence of pathology. The gingival pocket between the tooth and the gingival should be no deeper than 1-3mm to be considered healthy. There is also the absence of bleeding on gentle probing.
  Periodontal diseases can be caused by a variety of factors, the most prominent being dental plaque. Dental plaque forms a bacterial biofilm on the tooth surface, if not adequately removed from the tooth surface in close proximity to the gingiva a host-microbial interaction gets underway. This results in the imbalance between host and bacterial factors which can in turn result in a change from health to disease. Other local and/or systemic factors can result or further progress the manifestation of periodontal disease. Other factors can include age, socio-economic status, oral hygiene education and diet. Systemic factors may include uncontrolled diabetes or tobacco smoking.
  Signs and symptoms of periodontal disease: bleeding gums, gingival recession, halitosis (bad breath), mobile teeth, ill fitting dentures and build up of plaque and calculus
  Individual risk factors include: Gender, smoking and alcohol consumption, diabetes, obesity and metabolic syndrome, osteoporosis and Vitamin D conditions, stress and genetic factors.
  In 1999 the American Academy of Periodontology (AAP) reworked the existing classification of periodontal diseases from 1989 to alter the weaknesses present. The old classification placed too much emphasis on the age of disease onset and rate of progression, which are often difficult to determine. The 1999 classification was published in the Annals of Periodontology. Below is the abbreviated version of the 1999 classification of periodontal diseases and conditions.
  I. Gingival Diseases
  
  A. Dental plaque-induced gingival diseases
  
  B. Non-plaque-induced gingival lesions
  II. Chronic Periodontitis
  
  (slight: 1–2 mm CAL; moderate: 3–4 mm CAL;
  severe: > 5 mm CAL)
  A. Localised
  
  B. Generalised (> 30% of sites are involved)
  III. Aggressive Periodontitis
  
  (slight: 1–2 mm CAL; moderate: 3–4 mm CAL;
  severe: > 5 mm CAL)
  A. Localised
  
  B. Generalised (> 30% of sites are involved)
  IV. Periodontitis as a Manifestation of Systemic Diseases
  
  A. Associated with haematological disorders
  
  B. Associated with genetic disorders
  
  C. Not otherwise specified
  V. Necrotizing Periodontal Diseases
  
  A. Necrotizing ulcerative gingivitis
  
  B. Necrotizing ulcerative periodontitis
  VI. Abscesses of the Periodontium
  
  A. Gingival abscess
  
  B. Periodontal abscess
  
  C. Pericoronal abscess
  VII. Periodontitis Associated With Endodontic Lesions
  
  A. Combined periodontic-endodontic lesions
  VIII. Developmental or Acquired Deformities and Conditions
  
  A. Localised tooth-related factors that modify or predispose
  to plaque-induced gingival diseases/periodontitis
  
  B. Mucogingival deformities and conditions around teeth
  
  C. Mucogingival deformities and conditions on edentulous
  ridges
  
  D. Occlusal trauma
  In 2018 a new classification of periodontal disease was announced. It was 
caption: Healthy gingiva
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