Periodontitis is a form of gum disease. It is a chronic infection of the gums which is characterized by a gradual loss of attachment between the tooth and the jawbone. It is the leading cause of tooth loss among adults in the United States.

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Periodontitis begins in the shallow pocket where the tooth and gum meets, usually as a milder form of gum infection known as gingivitis. Dental plaque is the primary cause of gum disease in genetically susceptible individuals. Bacteria found in plaque produce toxins which can irritate the gums. This can lead to inflammation which may manifest itself as red, swollen, bleeding gums. If the bacterial plaque persists, the gums can separate from the teeth leading to pocket formation. Plaque can also harden into a rough, pourous substance known as tartar (calculus).

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If periodontal disease progresses, the supporting gum tissue and bone that hold the teeth in place deteriorates, eventually leading to tooth loss. Bacteria can grow in this pocket, usually due to inadequate oral hygiene. The gum begins to pull away from the tooth deepening the pocket, making it harder to clean and encouraging the formation of tenacious tartar deposits below the gum line.

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Periodontal disease does not always have physical manifestations such as bleeding, swelling, or pain. It is primarily detected by a routine dental exam and x-rays by your dentist.

Gingivitis

Xray

The mobility of all teeth is checked and the bite is evaluated. X-rays of all teeth are needed to evaluate the condition of the bone around each tooth and show calculus deposits below the gumline.

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PERIODONTAL DISEASE AND SYSTEMIC HEALTH

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Periodontal Disease and Smoking

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You are probably familiar with the links between tobacco use and lung disease, cancer, and heart disease. Current studies have now linked periodontal disease with tobacco usage. Tobacco users have a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth, as well as greater loss of the bone and fibers that hold the teeth in your mouth. In addition, the chance of developing oral cancer increases with the use of smokeless tobacco. Chemicals in tobacco, such as nicotine and tar, slow down healing and the predictability of success following periodontal treatment. Problems caused by tobacco include the following: Lung disease, heart disease, cancer, mouth sores, gum recession, loss of bone and teeth, bad breath, tooth staining, less success with periodontal treatment and with dental implants. Quitting tobacco usage will reduce the chance of developing the aforementioned problems.

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Diabetes and Oral Health

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Individuals suffering from diabetes, especially uncontrolled diabetes, have a higher risk of developing bacterial infections in the mouth. These infections may impair your ability to process insulin, resulting in greater difficulty in controlling your diabetes. Periodontal disease will be more severe than those of a non-diabetic, and this may make treatment more difficult. Steps to prevent periodontal disease include daily brushing and flossing to remove plaque from your teeth and gums, regular dental visits for professional cleaning, and regular periodontal evaluation. Your health professional must also be told of your history of diabetes and the current status of your condition. Finally, you can help resist periodontal infection by maintaining control of your blood sugar levels.

WOMEN AND PERIODONTAL HEALTH

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Throughout a woman’s life, hormonal changes affect tissue throughout the body. Fluctuations in hormonal levels occur during puberty, pregnancy, and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral health. 

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Puberty

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During puberty, there is increased production of sex hormones. These higher levels increase gum sensitivity and lead to greater irritations from plaque and food particles. The gums can become swollen and red and feel tender. 

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Menstruation

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Similar symptoms occasionally appear several days before menstruation. There can be bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek. The symptoms often clear up once the period has started. As the amount of sex hormones decreases, so do these problems. 

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Pregnancy

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Your gums and teeth are also affected during pregnancy. Between the second and eighth month, your gums may also swell, bleed and become red or tender. Large lumps may appear as a reaction to local irritants. However, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear after pregnancy. Periodontal health should be part of your prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk. The best way to prevent periodontal infections is to begin with healthy gums and continue to maintain your oral health with proper home care and careful periodontal monitoring. 

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Oral Contraceptives

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Swelling, bleeding, and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones. You must mention any prescriptions you are taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate risk of drug interactions, such as antibiotics with oral contraceptives where the effectiveness of the contraceptive can be lessened. 

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Menopause

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Changes in the look and feel of your mouth may occur if you are menopausal or post-menopausal. They include feeling pain and burning sensation in your gum tissue and salty, peppery, or sour tastes. Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of "dry mouth." 

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PREVENTION

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Adults over the age of thirty-five lose more teeth to gum disease than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and Periodontal Disease is by good tooth brushing and flossing techniques performed daily and regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people can still develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progression. 

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Other important factors affecting the health of your gums include: 

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1. Tobacco usage

2. Diabetes

3. Stress

4. Clenching and grinding teeth

5. Medication

6. Poor nutrition