About Periodontal (Gum) Diseases

The healthy periodontal condition is characterized by firm, pink gums that do not bleed when brushed or flossed. There should be no mobility in the teeth. Healthy individuals will have clean breath and a happy, confident smile.

Periodontal (gum) diseases are infections of the gums that gradually destroy the support of your natural teeth. There are many different types of gum disease that may require different treatment approaches. However, dental plaque is the primary cause of periodontal (gum) disease in most people. Fortunately, brushing at least twice per day and flossing at least once per day, using the proper techniques, will prevent most periodontal conditions.

Why is oral hygiene so important?  Periodontal disease and cavities (decay) are both caused by bacterial plaque, which is a sticky, colorless film that constantly forms on your teeth.  Adults past the age of 35 are more likely to lose teeth to periodontal (gum) disease than from cavities (decay), with three out of four adults affected at some point during their life time.  Although periodontal disease can be accelerated by a number of different factors, it remains mainly caused by the bacteria found in dental plaque.  If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (tartar) which harbors bacteria. 

The best way to prevent gum disease is effective daily brushing and flossing, as well as regular professional dental examinations and cleanings. Unfortunately, even with the most diligent home dental care, people can still develop some form of periodontal disease.  Once this disease starts, there is no cure.  However, professional intervention and ongoing maintenance can prevent the progression of periodontal disease.

Other Important Factors Affecting the Health of Your Gums

• Family history of tooth loss
• Tobacco use (smoking cigarettes, chewing tobacco, cigars, pipes)
• Diabetes
• Stress
• Clenching and grinding
• Medication(s)
• Poor Nutrition
• Systemic diseases
• Pregnancy and puberty

Types of Gum Disease

Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.  Millions of people are unaware of the fact that they have a serious infection that can eventually lead to tooth loss if not properly treated.  Periodontal disease can affect one tooth or many teeth.  It begins when the bacteria in plaque causes the gums to become inflamed.

Gingivitis

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

Periodontitis / Periodontal (Gum) Diseases

Untreated gingivitis can advance to periodontitis. Over time, plaque can spread and grow below the gum line, and  toxins produced by the bacteria in plaque can irritate the gums. These toxins stimulate a chronic inflammatory response and interact with your immune system, causing your body to essentially turn on itself. When this happens the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually teeth can become loose and may need to be removed.  Periodontitis is known as a silent disease, much like high blood pressure.  You may not be aware that you have Periodontal (Gum) Disease until you receive a periodontal exam.
There are many forms of periodontitis. The most common are the following:

• Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss (separation of gums) and bone destruction and familial aggregation (genetic predisposition, different bacterial exposures, different life style, etc).
• Chronic periodontitis results in inflammation within the supporting tissues (gums and bone) of the teeth, progressive attachment loss (separation of gums), and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva (gums). It is most prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
• Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease and diabetes are associated with this form of periodontitis.
• Necrotizing periodontal disease is an infection characterized by necrosis (death) of gingival (gum) tissues, periodontal ligament and alveolar bone. This form is most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and/or immunosuppression.

Symptoms of Periodontal (Gum) Disease

Periodontal (gum) disease is often silent, meaning symptoms may not appear until an advanced stage of the disease. However, warning signs of periodontal (gum) disease include the following:

• Red, swollen or tender gums or other pain in your mouth
• Any bleeding while brushing, flossing or eating hard food
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of dentures (flipper / plate)

Periodontal Evaluation

Sometimes the only way to detect periodontal (gum) disease is through a periodontal evaluation. This may be especially important in the following situations:

• If you notice any symptoms of periodontal (gum) disease, including:
• Red, swollen or tender gums or other pain in your mouth
• Any bleeding while brushing, flossing or eating hard food
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of dentures (flipper / plate)
• If you have a family member with periodontal (gum) disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts couples and children at risk for contracting the periodontal disease of another family member.
• If you have heart disease, diabetes, respiratory disease or osteoporosis. Ongoing research and literature show that periodontal disease may be linked to these conditions. The bacteria associated with periodontal disease can travel into the blood stream and pose a threat to other parts of the body. Healthy gums may lead to a healthier body.
• If you feel that your teeth are too short or that your smile is too "gummy." Or if you are missing one or more of your teeth and are interested in a long-lasting replacement option.
• If you are not satisfied with your current tooth replacement option, such as a bridge or dentures, and may be interested in dental implants.
• If you have a sore or irritation in your mouth that does not get better within two weeks.

The above information has been provided by the American Academy of Periodontology (AAP).  The AAP is the professional organization for periodontists - specialists in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants.  Periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.