Periodontal Disease

What is Periodontal Disease?

Periodontal disease, or gum disease, is an infection of the tissues surrounding the teeth and bone resulting in a loss of attachment. If left untreated, periodontal disease usually leads to the loss of teeth. Periodontal disease can affect a single tooth or many teeth. It begins when the bacteria in plaque cause the gums to become inflamed.

It begins with gingivitis where the gums redden, swell and bleed easily. There is usually little or no discomfort, and gingivitis usually appears due to inadequate oral hygiene. Fortunately, gingivitis is reversible with professional treatment and good oral home care.

With time, plaque can spread and grow below the gum line. The bacteria stimulate a chronic inflammatory response in which the body destroys the tissues and bone that support the teeth in an effort to clear the infection. As the tissues are destroyed, the disease progresses creating pockets that become increasingly hard to keep clean. A vicious cycle develops and the destruction continues. Often, this destructive process creates little if any discomfort. With time, the teeth can become loose and may have to be removed.

Causes of Periodontal Disease

Plaque and Calculus (Tartar)
Many factors contribute to periodontal disease. Bacterial plaque is the initiating factor. Plaque is the sticky material that adheres to your teeth. When allowed to grow undisturbed, it can mineralize and create deposits that stick to your teeth called calculus (sometimes referred to as tartar). The presence of plaque and calculus is a constant irritation to your gums and provokes your body to create the inflammation that destroys the bone and tissue leading to tooth loss.

Smoking
Considerable research shows that smoking is a risk factor for periodontal disease. Good evidence suggest that smoking increases your risk for periodontal disease three-fold. It impairs your immunity and slows your ability to heal properly.

Genetics
Your family history may have a great bearing on your risk for periodontal disease and it expression. If close family members lost teeth at an early age, you may be at elevated risk. Even with immaculate home care, genetics may conspire against you. Proper treatment will help minimize the impact.

Pregnancy and Puberty
Pregnancy and puberty are times of hormonal changes. These changes can even affect your gums. Your gums can become red, tender, and bleed easily at times of the changes. This may make you more susceptible to gum disease. Most importantly, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.

Stress
Stress also is a risk factor for periodontal disease. Stress weakens the immune response and allows infections such as periodontal disease to progress more rapidly.

Medications
Some drugs have well-known side effects that can affect your oral health. Make sure you inform all your dental providers of the medications you are taking.

Clenching or Grinding Your Teeth
Clenching and grinding your teeth can be damaging to the teeth and gums. When you clench or grind your teeth, you can speed up the progression of gum disease.

Diabetes
Diabetes is a major risk factor for periodontal disease. Having diabetes impairs your ability to fight off infection. This means you are more susceptible to the destructive nature of periodontal disease. Maintaining optimal blood sugar is the best way to minimize the impact of diabetes.

Poor Nutrition
A well-rounded proper diet is essential to your body being able to maintain peak immunity. Missing certain key nutrients can accelerate bone loss and slow healing.

Other Systemic Diseases
Diseases that interfere with the body’s immune system may worsen the condition of the gums.

Types of Periodontal Disease

Gingivitis
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is reversible with professional treatment and good oral care at home.

Aggressive Periodontitis
Aggressive periodontitis is a form of periodontitis that occurs in patients who are otherwise clinically healthy. Common features include a rapid loss of bone and tissue attachment. It tends to run in families and is often more difficult to treat.

Chronic Periodontitis
This common form of periodontal disease results in inflammation, bleeding, and bone loss and causes pocketing of the gums and sometimes recession. It is recognized as the most frequently occurring form of periodontitis. It is usually found in adults, but can occur at any age. Overall, the bone loss occurs slowly, but you may have periods of rapid loss. There is often little or no discomfort experienced as the disease progresses.

Periodontitis as a Manifestation of Systemic Diseases
This periodontitis is associated with a systemic illness such as Down’s syndrome, diabetes, or neutropenia.

Necrotizing Periodontal Diseases
This type of infection is characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are often found in immunosuppressed individuals.

Material and content above was adapted from American Academy of Periodontology website www.perio.org