Parodontitis

Parodontitis is a chronic inflammatory disease of the tissues surrounding the teeth, collectively called the periodontium. It develops after the accumulation of bacterial plaque and the host’s inflammatory response, leading to destruction of supporting connective tissue and bone. Clinically, it can cause gum recession, pocket formation, increased tooth mobility, and eventual tooth loss if untreated.

Most cases begin as gingivitis, a reversible inflammation of the gums. Over time, progression to periodontitis results in clinical attachment loss and bone loss. Risk factors include smoking, diabetes, age, genetic susceptibility, and poor plaque control, as well as local factors such as tartar buildup, malpositioned teeth, and orthodontic appliances.

Diagnosis is based on periodontal probing to measure pocket depth and clinical attachment level, bleeding on probing, and radiographic evidence of alveolar bone loss. The 2018 classification specifies stages (1–4) of severity and grades (A–C) reflecting progression rate and risk factors.

Treatment aims to control infection and halt progression. It typically begins with non-surgical therapy, including scaling and root planing and patient hygiene instruction. Adjunctive antiseptics or antibiotics may be used in selected cases. Advanced cases may require flap surgery, regenerative procedures, or soft-tissue grafts, followed by regular supportive periodontal therapy.

Prevention focuses on effective plaque control, smoking cessation, management of diabetes, and regular dental check-ups to monitor and maintain periodontal health. Periodontitis is associated with systemic conditions, and its management should be integrated with medical care when relevant.