Periodontics is that branch of dentistry pertaining
to the diagnosis and treatment of the supporting and
surrounding tissues of the teeth and their substitutes. It
also includes the implantation or transplantation of
teeth and their substitutes. The goal of modern
periodontal therapy is to preserve and maintain
periodontal health, aesthetics, and function of natural
dentition and implanted tooth replacements.
The supportive structures, collectively termed the
periodontium, consist of the gingiva, periodontal
ligaments, and alveolar bone. Diseases that damage the
periodontium are called periodontal diseases.
To prepare for this chapter, review chapters 5, 6,
and 8 of Dental Technician, Volume 1, NAVEDTRA
12572, and chapter 3 of this manual. In chapter 5,
"Oral Pathology," we discuss pathology of the
periodontium. In chapter 6, "Emergency Treatment of
Oral Diseases and Injuries," we discuss diseases of the
periodontal tissues. In chapter 8, "Nutrition and Diet,"
we discuss preventive dentistry and nutrition. In
chapter 3, "Preventive Dentistry," we discuss oral
hygiene and supragingival scaling. In this chapter, we
will cover the functions and indications of
is diagnosed as systemic (affecting the body as a
whole), the patient should be referred to the medical
facility for diagnosis and treatment of the medical
The treatment of periodontal diseases may
encompass both the dental and medical professions.
When the cause of a patient's periodontal disturbance
The dental treatment of a periodontal patient may
require coordinated treatment from other specialty
areas. Often, patients needing periodontal treatment
are referred from specialty areas where they were
seeking treatment for other related dental problems.
For example, the patient may need a prosthetic
appliance to replace some missing teeth. However, the
patient's periodontal condition may require
periodontal treatment before the appliance can be
made. In evaluating and treating the patients
periodontal disease, the periodontist may decide to
eliminate periodontal pockets surrounding some teeth
and determine other teeth are nonrestorable. The
patient is referred to the oral surgeon for removal of
these nonrestorable teeth. The periodontist may
determine that other periodontal problems can be
alleviated by having a general dentist remove and
replace faulty restorations. In some situations, the
services of the orthodontist may be required to
reposition malposed teeth.
Since periodontal disease affects the supportive
structures of the teeth, the primary function of
periodontal treatment is (a) to eliminate the
inflammation and arrest the progress of the disease and
(b) perform periodontal treatment. Several reasons to
eliminate pockets are as follows:
Food, bacterial accumulation, and infection can
exist in pockets that form around the teeth.
Conditions, such as loss of gingival covering,
can lead to exposure of the root and caries can
Inflammatory changes in the gingiva may
increase the susceptibility to necrotizing
ulcerative gingivitis (NUG). Note: NUG is
caused by bacteria usually in the presence of
secondary factors such as stress, smoking, and or
lack of rest.
Inflammation from the pocket walls can cause
Discomfort can occur during mastication.
Most periodontal diseases are characterized by
inflammation that initially affects the gingiva.
Advancement of the inflammatory process, if not
stopped, may proceed to cause damage to periodontal
ligament tissue and alveolar bone. Inflammatory
diseases confined to the gingiva are termed gingivitis,
whereas those that cause damage in the deeper
supporting structures are classified as periodontitis.