What Is Periodontal Disease?

The word "periodontal" literally means "around the tooth".  Periodontal disease is an inflammatory, bacterial-driven infection that destroys the gums and supporting bone that hold your teeth in your mouth.  Periodontal disease can affect one tooth or many teeth.

The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth.  If the plaque is not removed on a daily basis, it can turn quickly into a hard substance called calculus or tartar.  Calculus is so hard it can only be removed by an oral health professional, such as a dentist, periodontist or dental hygienist.  The bacteria in plaque infect the gums and release poisons/toxins that can cause redness or inflammation (irritation).  The inflammation and poisons themselves cause destruction of the tissues that support the teeth, including the bone.  When this happens, the gums separate microscopically from the teeth, forming pockets that fill with even more plaque causing even more infection.  Over time, the deeper the pockets get, the more virulent (bad) the bacteria becomes, in turn, causing increased destruction - an insidious cycle.

One of the major problems with periodontal disease is that it is chronic in nature and generally does not "hurt" the patient until it reaches its most severe/advanced states.  Without careful, ongoing treatment and maintenance, periodontal disease can and often does recur.

Periodontal disease can be multi-factorial.  This means that there can be additional co-factors that can affect the health of your gums.  Some examples of secondary and tertiary co-factors may include:

• Tobacco use significantly increases the risk of developing periodontal disease and can negatively affect treatment.
• Hormonal Changes during puberty, pregnancy and menopause can cause the gums to become red, tender and bleed easily.
• Genetics and family history of periodontal disease indicate a greater likelihood of developing this disease.
• Stress can make it more difficult for the body to fight off infection, including periodontal disease.
• Medications such as oral contraceptives, antidepressants and certain heart medicine, can affect oral health.
• Destructive Habits such as improper oral hygiene technique, oral piercing, drug or alcohol abuse can affect periodontal health.
• Poor Nutrition can make it harder for the body to fight off infection.
• Systemic Diseases that interfere with the body's immune system may worsen the condition of the gums and supporting bone.

There are several types of periodontal disease.  The following is an overview of the most common:

• Chronic Periodontal Disease - Most common, typical "garden variety" disease.  This condition is resulting from inflammation within the soft tissues surrounding the teeth causing progressive attachment and bone loss.  It is diagnosed by bone loss on a dental X-ray, the formation of gum pockets and/or receding gums.  It is most common in adults over 40 years, but can occur at any age.

• Aggressive Periodontal Disease - This form occurs in patients who are otherwise in good health.  Common features include rapid/accelerated attachment loss and bone destruction.  This is most often found in patients under the age of 30 years.

• Periodontal Disease as a Manifestation of Systemic Disease - As the name indicates, this form is associated with one of several systemic diseases that are related to periodontal disease.  A good example of this would be diabetes.

• Necrotizing Periodontal Diseases - These types of periodontal diseases cause ulcers in the gums between the teeth and are most commonly observed in individuals with certain conditions including, but not limited to, HIV, malnutrition and immunosuppression.  Stress, smoking, and poor oral hygiene sometimes can contribute to this problem.