What is Periodontal Disease?


what is periodontal disease

Periodontal disease (perio = around, dontal = the teeth) refers to a severe form of gum disease. Typically, periodontal disease is caused by a lack of regular brushing and flossing and can be made worse by bad diets, unhealthy lifestyle choices and/or existing medical conditions.

It’s a very serious condition because while it might not show up when you smile in the mirror at first, it will eventually affect your entire mouth, and can cause tooth loss. In addition to negatively impacting oral health, the plaque that causes periodontal disease can break away and lodge in your veins, arteries, the heart and even the brain (in fact, the existence of gum disease significantly elevates your risk of heart disease, and is associated with Alzheimer’s and other serious medical conditions).

Quick Note: Gingivitis is also called gum disease, but gingivitis is not the same as periodontal disease. Gingivitis means “inflammation of the gums.” It can happen at any age and is often a precursor to periodontal disease. Most patients with gingivitis and who start taking better care of their teeth will never develop periodontal disease.

Your dentist is usually the one who diagnoses periodontal disease, and the treatment is largely dependent on how serious the condition is when it’s noted as well as your age, your current health condition, and lifestyle.

What Causes Periodontal Disease (Periodontitis)?

Your mouth is filled with all kinds of bacteria – some worse than others. When you eat, breathe, talk, smile – these bacteria mix and mingle with saliva, mucous and other particles – forming a slick coating on your teeth. We call this coating plaque. When you brush and floss regularly, this plaque is almost completely washed away. When you visit the dentist for a checkup and cleaning, a thorough dental cleaning eliminates the rest of it.

If, however, you skip any of these important oral hygiene steps, plaque hardens and solidifies – becoming tartar. While visible plaque and tartar on the teeth are unsightly, the most dangerous plaque and tartar is the kind that becomes trapped between the teeth and gums (this is the stuff your dentist uses a metal pick and/or a water pick to dislodge before s/he cleans your teeth). Over time, the bacteria harbored there infect the gums and this condition is called periodontitis or periodontal disease.

Symptoms of periodontitis

While these are common symptoms of periodontitis, they do not mean you have gum disease. If any of these sound familiar to you, call your dentist and schedule a checkup.

  • Bad breath with no other explanation
  • Swollen, bleeding and/or tender gums
  • Painful chewing
  • Receding gums or teeth that look longer than they used to (looking through old photos and comparing them to your current smile is an accurate way to see if your gums have receded)
  • Sensitive teeth

In mild cases, periodontitis causes inflamed gums. In more moderate to severe cases, inflamed gums begin to pull away from the teeth, forming pockets. These pockets allow plaque and tartar to form underneath the gum line, where further infections ensue.

In the meantime, your body launches an immune system attack to fight these infections. In doing so, the same bacterial toxins released to fight the bacteria also break down the connective tissue and bone that holds teeth in place. Ultimately, untreated periodontal disease can cause teeth to loosen and fall out. It will also continue to destroy the gums, bones and other tissues that hold teeth in place.

Who’s at Risk for Developing Periodontal disease?

Anyone who doesn’t take proper care of their teeth (brushing and flossing at least twice a day, and visiting a dentist at least twice per year) is at risk of developing gum disease. However, certain risk factors increase your chances even further. These include:

  • Smoking and chewing tobacco
  • Hormonal changes in girls/women – particularly during pregnancy
  • Diabetes
  • Prescription and over-the-counter medications that cause dry mouth

How is Periodontitis Treated?

Periodontal disease is treated according to its severity, your health, and your lifestyle.

In the early stages

If caught in the early stages, you may be able to get by with a thorough dental cleaning and strict instructions regarding brushing, flossing and more regular visits to the dentist. Your dentist may also recommend lifestyle changes such as quitting smoking, minimizing sugary foods and beverages, etc.

In the middle stages

If infections are beyond the scope of good oral hygiene, your dentist will discuss other treatment options that include:

Deep teeth cleaning (scaling and root planning)

This type of cleaning goes beyond the normal dental cleaning – using specialized instruments that access teeth and roots underneath the gums. First, the dentist, periodontist and/or dental hygienist scale the teeth to remove tartar build-up. Then they plane both the tooth and the roots as needed, scraping away uneven patches that tend to harbor bacteria.

This treatment can result in swollen, bleeding and very tender gums that heal fairly quickly. Your dentist may also prescribe an antibiotic medication to eradicate existing – and prevent further – infection.