Have you experienced tender or bleeding gums? Periodontal disease is the infection and inflammation of the gums, ligaments, and bone surrounding your teeth. It's important to know the causes, treatments, and steps to prevent gum disease so you can protect your oral and overall health.
What Is Periodontal Disease?
Periodontal means "around the tooth," so periodontal disease refers to the infection and inflammation of the gums, ligaments, or bone that surround your teeth and can vary in severity. The early stages include gingivitis, where the infection is found only in your gums, and they become inflamed, red, and may even bleed. Gingivitis is treatable, and the effects can be reversed if caught early enough.
What Causes Periodontal Disease?
Poor oral hygiene or uncontrolled bacteria from dental plaque and the toxins produced by that bacteria cause periodontal disease. If not removed, plaque biofilm can spread below the gumline. Those toxins cause infection and inflammation in the gums and destroy the tissues and bones that support your teeth.
Next, your gums begin to pull away from the teeth, forming periodontal pockets, or spaces between the teeth and the gum tissue starts to recede. When these pockets become infected and deepen, more gum tissue and bone are destroyed. Eventually, this destruction will cause your gums to recede and your teeth to become loose, and you may even have to remove them.
How to Prevent Gum Disease
Because the effects of periodontitis and severe stages of periodontal disease cannot be completely reversed, it's important to establish a preventative care routine before the disease progresses.
If you practice good oral hygiene by brushing and flossing your teeth daily and done correctly, this will remove the plaque from your teeth and prevent build-up. Also, interdental brushes and water flossers may be helpful to remove plaque from between the teeth. It is also recommended to visit your dentist every six months for a professional cleaning to remove plaque and tartar in places that are harder to reach. If you already have periodontal disease, your dentist or periodontist may recommend more frequent visits and implement a more aggressive treatment plan.
Knowing the following factors that can put you at risk for gum disease is important for prevention:
- Crooked or crowded teeth, braces, and bridges
- Grinding, gritting, or clenching teeth
- Tobacco use
- Poor nutrition
Symptoms of Periodontal Disease
Symptoms can be varied across the spectrum—from no symptoms in the beginning stages to extreme pain. Other warning signs of periodontal disease include:
- Red, swollen, tender, or bleeding gums
- Gums receding or pulling away from the tooth
- Abnormal tooth sensitivity, especially around the gumline
- Loose teeth or painful chewing
- Bad breath or a bad taste in the mouth
If you recognize any of these symptoms, make an appointment with a dental professional for an evaluation. They will examine your gums with a dental probe to look for infection. They also may take new X-rays to compare with older X-rays and identify any changes to your teeth or bones. If a referral to a specialist is needed, your dentist will refer you to a periodontist.
Periodontal Disease Treatment
If you are diagnosed with periodontal disease, treatments may vary depending on the severity of your case. Some of these treatments include:
- Scaling and root planing. For gingivitis or the early stages of gum disease, non-surgical treatments may be available to restore periodontal health. Scaling is a deep cleaning technique that carefully removes plaque and tartar from your teeth both above and below the gumline. Root planing removes plaque and tartar from the root surfaces, smoothing rough spots that trap and hold bacteria. Once the teeth are clean, the gum tissue can begin to heal.
- Periodontal gum surgery. A pocket reduction procedure may be an option if the periodontal pockets surrounding your teeth become so deep that they are difficult to clean with regular at-home oral hygiene and a professional care routine. During this procedure, the periodontist makes incisions in your gums to flap back the tissue, providing more access to the roots for more effective scaling and root planing below the gumline and cleaning out the bacterial infection. This will allow for the reattachment of the gum tissue to the teeth.
- Gum graft surgery. If periodontal disease progresses and gums begin to recede, the periodontist might recommend surgery to reshape gums or graft new tissue to cover exposed tooth roots. During this surgery, the periodontist takes gum tissue — usually from the roof of your mouth — to cover the root and protect your tooth from decay, bone loss, and further recession.
- Regenerative procedures. When periodontitis has destroyed the bone supporting your teeth, regenerative procedures may help reverse some of the damage. After the periodontist exposes the root and removes the bacteria, they may graft bone to the surrounding area of the tooth to encourage your body to regenerate the lost bone and tissue. In time—if adequate bone is present—you may then be a candidate for dental implants to replace teeth that have been lost.
- Extraction. In the worst cases of periodontitis, bone loss is so severe that the tooth cannot be saved and must be removed.
Other Health Implications of Periodontal Disease
Unfortunately, the impact of periodontal disease goes beyond your mouth, and researchers are finding more and more links between gum disease and your overall health. Some of these health problems include:
- Heart disease. Infection in your gums may increase the risk of clogged arteries and even worsen existing heart conditions.
- Stroke. Likewise, periodontal disease may increase the risk of stroke caused by blocked arteries.
- Respiratory disease. Bacteria from the mouth may spread to the lungs, causing lung infections or worsening existing lung conditions. Immunocompromised adults with gum disease may be at increased risk for severe pneumonia.
- Premature birth. Gum disease during pregnancy may increase the likelihood of delivering the baby too early and the possibility of low birth weight.
- Diabetes. Periodontal disease may make it more difficult for people with diabetes to control their blood sugar than those with healthy gums.
Don't ignore those tender or bleeding gums. The sooner periodontal disease gets diagnosed and treated, the faster you can return to a healthier mouth.