There are two types of periodontal diseases: gingivitis and periodontitis. Periodontal means "around the tooth," so all periodontal diseases involve the gums. They are caused by bacterial infections of the gums and the resultant problems of those infections.
Gingivitis is the mildest form of periodontal disease, but if left untreated it can progress to periodontitis.
There are several types of periodontitis with varying degrees of symptom severity. The most common types are: aggressive, chronic, necrotizing and periodontitis caused by systemic disease.
Predispositions
The different types of periodontal disease are more prevalent in some populations than others.
Gingivitis can affect anyone, and it is mainly a result of insufficient oral hygiene. It can often be reversed by improving hygiene.
Aggressive periodontitis occurs in healthy individuals, generally after they have progressed past gingivitis.
Chronic periodontitis can occur at any age, but it is more common in adults.
Periodontitis caused by systemic diseases, such as diabetes and heart conditions, generally occurs during childhood.
Necrotizing periodontitis is prevalent in individuals with suppressed immune function, including those with HIV and AIDS, those suffering from malnutrition, and those with any kind of immune dysfunction.
First signs
The first signs of a periodontal disease are bleeding, red or swollen gums. This is usually an indication of gingivitis, but it can appear in the early stages of the other periodontal diseases as well. Persistent bad breath, mouth sores and receding gums are all early symptoms as well.
Plaque
Left untreated, plaque will begin to grow beneath the gum line as well as above it. You cannot see it below the gum line, but once there it causes more bacteria to form. That bacterial growth can cause the gums to come loose from the teeth, form recesses in the gums and loosen teeth. Eventually teeth may fall out or have to be removed from periodontitis.
Gum Appearance
Some diseases affect your gums' appearance. Receding gums make your teeth appear longer, as the gum line has receded away from your tooth. Necrotizing periodontitis can kill gum tissue, leaving black or grayish spots where the gum tissue has died. The gums can lose the normal triangular shape where it follows the contour between teeth. It can swell and hang lower over the teeth, and it will generally have a rounder or bulging shape. Pus may drain from the gums or pockets formed by the gums.
Alignment
Periodontal disease can affect the alignment of teeth. This will be especially noticeable if you wear dentures or partials, as they will no longer fit properly. The teeth can shift and form gaps due to the erosion of the connective tissue of the gums and the teeth. The jaw bone can also lose density, which will make teeth loose and even fall out.
