Gingivitis usually precedes periodontitis. However, it is important to know that not all gingivitis progresses to periodontitis. In the early stage of gingivitis, bacteria in plaque builds up, causing the gums to become inflamed (red and swollen) and prone to bleeding during tooth brushing. When gingivitis is left untreated, it can advance to periodontitis, or gum disease, which in fact, is the leading cause of tooth loss in adults. In a person with periodontitis, the inner layer of the gum pulls away from the teeth and causes bone loss which then causes a pocket to form. These pockets between the teeth and gums collect debris (plaque, tartar and calculus) and can become infected.
As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth become mobile, and tooth loss may occur.
Plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:
Periodontal disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. They include:
Even if you do not notice any symptoms, you may still have some degree of periodontal disease.
During a periodontal exam, we typically check for these findings:
The goals of periodontal treatment are to:
Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues.
Periodontal disease prevention starts with plaque control. Proper plaque control consists of professional cleanings at least twice a year combined with daily brushing and flossing. Periodic x-rays and exams are essential to detect early problems. Other health and lifestyle changes that will decrease the risk, severity, and speed of gum disease development include:
Despite following good oral hygiene practices and making other healthy lifestyle choices, the American Academy of Periodontology states that up to 30% of Americans may be genetically susceptible to periodontal (gum) disease. Those who are genetically predisposed may be up to six times more likely to develop some form of gum disease. If anyone in your family has gum disease, it may mean that you are at greater risk as well. If you are more susceptible to gum disease, we may recommend more frequent check-ups, cleanings, x-rays, and treatments to better manage the condition.
According to the Center for Disease Control (CDC), researchers have uncovered potential links between periodontal disease and other serious health conditions. In people with healthy immune systems, the bacteria in the mouth that makes its way into the bloodstream is usually harmless. But under certain circumstances, the CDC says these microorganisms may be associated with health problems such as stroke and heart disease. Diabetes is not only a risk factor for periodontal disease, but periodontal disease may make diabetes worse.