periodontitis, inflammation of the soft tissues around the teeth, characterized by swollen tender gums (gingivitis), that may lead to the eventual loss of teeth. Periodontitis begins with the deposition of bacterial plaque on the teeth below the gum line, irritating and eroding the neighboring tissues. At this state, the condition is reversible, but, left untreated, the inflamed margin of the gum begins to recede, exposing the roots of the teeth. Eventually, the alveolar bone that anchors the teeth becomes involved, loosening the teeth so much that they may fall out. Removal of all plaque deposits and affected soft tissues can arrest but not reverse alveolar deterioration. However, placement of modified bone chips into existing defects may, in favorable conditions, stimulate growth of new bone.
Risk factors that increase the likeliness of gingivitis and periodontitis include smoking, metabolic diseases such as diabetes, hormonal changes during pregnancy, and certain medications (such as those that suppress the immune system or treat cardiovascular conditions) that enlarge the gums and obstruct proper dental cleaning. Symptoms of advanced periodontitis include bleeding gums, gum recession, pain while chewing, and tooth loss.
Although the precipitating cause of periodontitis is poor dental hygiene leading to plaque deposition, an inherent susceptibility to osteoporosis and degeneration of connective tissues may also play a role in the more-severe consequences of the disease. Familial juvenile periodontitis, an inherited condition resulting in tooth loss in early adulthood, is an extreme manifestation of this systemic susceptibility.