If the insult continues, inflammation spreads below the alveolar crest, causing which condition?

• A. Acute gingivitis
• B. Chronic periodontal disease
• C. Pulpitis
• D. Periapical abscess

Answer: (B)

When inflammation reaches below the alveolar crest, it means the supporting structures of the tooth—the periodontal ligament, cementum, and especially the alveolar bone—are involved. That pattern reflects periodontitis, where there is attachment loss and bone loss over time due to a chronic inflammatory process. Gingivitis stays confined to the gingival tissue above the crest and is generally reversible with proper plaque control. Pulpitis and periapical abscess are endodontic problems involving the pulp or root apex, not the supporting bone around the tooth. So the continued insult that penetrates beneath the crest best fits chronic periodontal disease.