Page 91 - Journal of Laser Dentistry 1

of periodontitis are periodontists; their field is known as "periodontology" or "periodontics".

The word "periodontitis" comes from peri ("around"), odont ("tooth") and - itis ("inflammation").

Classification

The 1999 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:

1. Gingivitis

2. Chronic periodontitis 3. Aggressive periodontitis

4. Periodontitis as a manifestation of systemic disease

5. Necrotizing ulcerative gingivitis/periodontitis 6. Abscesses of the periodontium 7. 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:

1. mesiobuccal 2. mid-buccal 3. distobuccal 4. mesiolingual 5. mid-lingual 6. distolingual

If up to 30% of sites in the mouth are affected, the manifestation is classification as

localized ; for more than 30%, the term

generalized is used.

Severity

The severity of disease refers to the amount of periodontal ligament fibers that have been lost, termed clinical attachment loss . According to the American Academy of Periodontology, the classification of severity is as follows:

• Mild : 1–2 mm of attachment loss

• Moderate : 3–4 mm of attachment loss

• Severe : ≥ 5 mm of attachment loss

Signs and symptoms

Periodontitis manifesting as painful, red, swollen gums, with abundant plaque.

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 (e.g. apples) (though this may occur even in gingivitis, where there is no attachment loss)

Gum swelling that recurs

Halitosis, or bad breath, and a persistent metallic taste in the mouth

Gingival recession, resulting in apparent lengthening of teeth. (This may also be