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Gingivitis and periodontitis in adults: Classification and dental treatment

Rebecca S Wilder, BSDH, MS
Antonio J Moretti, DDS, MS
Section Editor
Daniel G Deschler, MD, FACS
Deputy Editor
Daniel J Sullivan, MD, MPH


Periodontal or gum disease is a common condition affecting the tissues that comprise the dental supporting structure: gingiva, cementum, periodontal ligament, and the alveolar bone (figure 1). Periodontal disease is broadly classified as either gingivitis or periodontitis; these conditions are distinguished by the presence of alveolar bone involvement that occurs with periodontitis and not with gingivitis [1,2].

This topic will review the classification of gingivitis and conditions associated with gingivitis and periodontitis. The pathogenesis, clinical manifestations, and antibiotic treatment of odontogenic infections are discussed in detail separately. (See "Epidemiology, pathogenesis, and clinical manifestations of odontogenic infections" and "Complications, diagnosis, and treatment of odontogenic infections".)


Periodontal disease may be a risk factor for a number of conditions, including cardiovascular and pulmonary diseases and pregnancies resulting in low birth weight [3-5]. Clinicians should encourage regular dental visits and incorporate oral examination into their office practice, inspecting for inflamed gingiva, bleeding, or suppuration around teeth.

Cardiovascular disease – The relationship between periodontal disease and cardiovascular disease is discussed separately. (See "Epidemiology, pathogenesis, and clinical manifestations of odontogenic infections", section on 'Association with cardiovascular risk'.)

Diabetes mellitus – Poorly controlled diabetes may be a risk factor for increased severity of periodontitis and poor response to periodontal treatment. Patients may present with xerostomia, candidiasis, and caries as well as periodontal disease. Consensus guidelines for dental and medical providers have been developed by an expert panel to aid in recognizing diabetes and providing appropriate attention to dental and gingival health in patients with diabetes [6].

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Literature review current through: Dec 2017. | This topic last updated: Dec 05, 2017.
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