Classification
The classification system for periodontal diseases and conditions listed seven major categories of periodontal diseases, of which the last six are termed destructive periodontal disease because they are essentially irreversible. The seven categories are as follows:
- Gingivitis
- Chronic periodontitis
- Aggressive periodontitis
- Periodontitis as a manifestation of systemic disease
- Necrotizing ulcerative gingivitis/periodontitis
- Abscesses of the periodontium
- Combined periodontic-endodontic lesions
Moreover, terminology expressing both the extent and severity of periodontal diseases are appended to the terms above to denote the specific diagnosis of a particular patient or group of patients.
Extent
The extent of disease refers to the proportion of the dentition affected by the disease in terms of percentage of sites. Sites are defined as the positions at which probing measurements are taken around each tooth and, generally, six probing sites around each tooth are recorded, as follows:
- mesiobuccal
- mid-buccal
- distobuccal
- mesiolingual
- mid-lingual
- distolingual
Signs and Symptoms
In the early stages, periodontitis has very few symptoms and in many individuals the disease has progressed significantly before they seek treatment. Symptoms may include the following:
- Redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food
- Gum swelling that recurs
- Halitosis, or bad breath, and a persistent metallic taste in the mouth
- Gingival recession, resulting in apparent lengthening of teeth.
- Deep pockets between the teeth and the gums
- Loose teeth, in the later stages
Patients should realize that the gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume that painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that patient.
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