What Is Periodontal Disease?

Q: I hear the words "periodontal disease" from time to time, but what does it really mean?

A: Periodontal disease is an infection caused by several different types of bacteria. The severity of the periodontal disease can range from a mild inflammation (called gingivitis) to more advanced disease, in which the gums pull away from the teeth and the bone that supports and surrounds the teeth is lost.

Inflammation is usually caused by the bacteria and their toxic byproducts. If left untreated, periodontal disease leads to receding gums and erosion of the bone that surrounds and supports your teeth. Periodontal disease can be made worse by several factors, including poor dental hygiene and smoking. In more severe forms, genetics may be a factor. In other instances, gum inflammation is caused by dehydration of the mouth. This happens in people who breathe through the mouth while sleeping. Medications used to treat seizure disorders, some neurologic disorders, high blood pressure, and depression can cause gum tissues to become unhealthy. Be sure to tell your dentist or periodontist the names and doses of any medications you are taking.

Most cases in adults

Q: Is there a typical age range for patients with periodontal diseases?

A: Periodontal diseases can occur at any age, but most cases are in adults. Gingivitis is the earliest, most easily reversed form of periodontal disease. It is often diagnosed in children when hormonal changes occur and oral hygiene may be inadequate. As kids mature and their social lives change, their attention to oral hygiene usually improves and periodontal diseases may begin to subside. Most periodontal diseases are diagnosed in middle age; more than 50 percent are in people 55 and older. Symptoms, which may not be present in the early stages, include bleeding gums, a bad mouth odor, loosening or hypersensitive teeth, and difficulty chewing. Early diagnosis is critical for successful treatment.

Good home care

Q: What kind of treatment is available for periodontal diseases?

A: The first line of defense is good oral care at home. You should brush twice a day and floss once a day. The bacteria accumulate on the teeth in plaque, and it is that plaque at the gumline and just beneath the gumline in the shallow space, or sulcus, between the tooth and the gum where the bacteria attack the gums. So you should pay particular attention to cleaning around the gumline and just inside the sulcus. Angle the toothbrush at 45 degrees to the tooth and gum and use a gentle scrubbing motion to remove the plaque. Also move the floss between the teeth and clean just beneath the gumline. It is also important to avoid smoking. Tell your health care provider or dentist about any changes in your mouth that may be a side effect of medications. Stress reduction also helps. You should see your dentist every three to six months to have your teeth cleaned. In some cases, minor surgery may be needed to treat periodontal disease. Antibiotics aren't usually prescribed unless cleaning and surgical methods don't work. Left untreated, periodontal diseases can lead to loss of teeth, and to gums and bone that may not be able to support implants or dentures. Chronic periodontal diseases may even contribute to general health problems.