Periodontal disease is a bacterial infection that damages your gums and the fibers that connect your gums to your teeth and tooth-supporting bone. It is also known as "gum disease." Without proper oral hygiene and treatment, it can cause your teeth to loosen and lead to missing teeth. In severe cases, it can also destroy the bone that supports your teeth.
Periodontal disease is caused by bacteria, and hundreds of different species may be involved. These bacteria release acids and enzymes that can directly break down tooth-supporting tissue and bone. They also trigger an immune response that produces tissue-destroying acids and enzymes, resulting in infection and inflammation characterized by redness, swelling, and tenderness.
While gum disease becomes more common as you get older, the disease can begin at any time. Periodontal disease can be localized or generalized. Localized disease is defined as less than 30% of your teeth are affected, while generalized disease means more than 30% of your teeth are affected.
According to the American Academy of Periodontology, there are many types of periodontal disease. The four most common are:
If your dentist diagnoses you with periodontal disease, they will assign and continuously reevaluate a "stage" and "grade" based on various factors.
Not everyone is equally susceptible to periodontal disease. In addition, periodontal disease progresses differently in different people. Your dentist will help you understand what treatment and maintenance strategy is right for you.
Research has revealed that periodontal disease may impact conditions such as respiratory disease, cardiovascular disease, arthritis, stroke, diabetes, pregnancy, and others. Research continues to emerge about the mouth-body connection.
In addition, research also shows that conditions like diabetes, HIV/AIDs, arthritis, cancer, and leukemia may increase a person's risk for developing periodontal disease. The conditions may also present challenges in the management of periodontal disease.
While the connections are not fully understood, these connections appear to exist because the bacterial infection from your mouth enters your bloodstream and produces an effect. That effect may be from inflammation caused by the infection or from the impact of or by-products from the bacteria itself. For example, the body produces a compound called C-Reactive Protein. Its levels can be monitored, and if it exceeds a certain level, the risk of inflammatory harm to the body is increased.
If you or a family member are diagnosed with periodontal disease, it is important to have it treated as soon as possible to reduce the effects of bacteria in the mouth. Early treatment, the use of antimicrobial agents, and ongoing maintenance can help avoid more expensive dental procedures. It can also help mitigate the effects on other conditions in your body.
Periodontal disease is typically caused by poor oral hygiene, which leads to the accumulation of plaque and bacteria on your teeth and gums. If you do not continually remove the plaque, gingivitis may develop. Gingivitis is reversible if treated properly. If untreated, gingivitis can progress into periodontal disease, as the gingival fibers attaching the gums to the teeth and tooth-supporting bone begin to break down.
Factors that increase your risk of developing periodontal disease include:
If you are diagnosed with periodontal disease, you have a better chance of preventing its progression if you begin treatment and management as soon as possible. At your initial visit, your dentist or hygienist will:
At this point, your dentist may begin treatment. One or more follow-up appointments may be required to treat your disease. Depending on the severity of your disease, your general dentist may refer you to a periodontist.
At the follow-up appointments, your dentist will:
The goal of periodontal disease treatment is controlling the infection in your mouth to slow the disease's progression and prevent additional damage that may negatively impact your overall health. Your dentist and hygienist can help you play an essential role in managing your periodontal disease through periodontal maintenance treatment, but the ultimate responsibility for preventing its progression in the vast majority of cases lies with you. There are several types of periodontal treatments. The types you need depend on the specific state of your disease. The types of treatments, and when you need them, also change as the disease improves, stabilizes, or progresses over time.
The most important factors in ensuring long-term success with periodontal disease are:
If your periodontal disease isn't severe, your treatment options are typically non-surgical and include:
After your periodontal disease is under control, other treatments or surgeries may be needed to help correct the damage it has caused. These may include:
Some of these treatments may result in receding gums, which may require additional treatment.
Tooth removal may be another option to consider. Periodontal disease will go away if the affected teeth are removed, although risk factors for future disease may remain. The infection does not remain in the bone once the affected teeth are gone. However, missing teeth can have significant consequences if they are not replaced.