Gum disease, or periodontal disease (perio from “around” and dont from “tooth”), is a common condition affecting millions of Americans. Most only have mild gum disease, but about 30% suffer from severe gum disease that causes loss of the bone support for a tooth.
Gum disease is caused by inflammation of the gums as a result of bacteria in plaque, the sticky film that forms on your teeth. Gum disease can progress to affect the bone and ligaments that support the teeth, and can cause eventual tooth loss.
In its mildest form, gum disease is known as gingivitis. In this stage there is some inflammation of the gums but no lasting damage to the bone and connective tissue.Symptoms of gingivitis include non-painful swelling and redness of the gums and there can be bleeding when brushing or flossing.
In cases of periodontitis, gum disease has advanced below the gum line. Toxins produced by the bacteria in the plaque irritate the gums, causing chronic infection that eats away at the bone and connective tissue around the tooth. The plaque hardens, becoming what’s known as tartar or calculus, which gives bacteria more surface area on which to grow. As a result, the gums start to detach from the tooth, forming a pocket between the teeth and gums.
We can detect periodontal disease by probing the depth of the gum pockets. A pocket depth of around 4 mm indicates beginning gum disease. A pocket depth of 7 mm or more indicates severe gum disease with the highest risk of permanent damage.
Periodontitis (gum disease) is a difficult condition that is often diagnosed at a late stage because it can progress slowly and without dramatic symptoms. Subtle signs of active gum infection can be bleeding with brushing and flossing, and puffy, irritated gum tissue. As the disease progresses, teeth can start to loosen or shift, spaces may open up, the gumline recedes, and the gums can spontaneously bleed or feel swollen. These outer signs are the result of bone loss. As the bone foundation weakens the teeth are less stable. Healthy gums are an important immune system barrier that protects from invasive bacteria. As bacteria invade deeper into pockets, they are also able to get into the bloodstream causing problems far from the mouth. Many diseases are complicated by active gum infection including: heart disease, diabetes, pregnancy, joint replacement, autoimmune diseases, and liver disease.