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Periodontal disease

Periodontal disease begins around the necks of the teeth, where they emerge through the gums.

Healthy gums are pink in color. The gum pocket formed where the teeth emerge through the gums is three millimeters deep or less. The attachment fibers connecting the gums to the teeth, and the teeth to the bone, are intact. The gums are resilient, and neither bleed nor hurt when being probed.

During meals, food debris accumulates. When mixed with mouth bacteria, and proteins from saliva, plaque and less-obvious biofilm are formed. Both are harmful to teeth and periodontal structures. Left in place on the teeth, bacterial plaque and biofilm begin to mineralize, forming hardened deposits called "calculus," which can only be removed with dental instruments.

In response to the increased bacteria, the body sends immune cells and healing cells to the area by way of the circulation. The increased blood flow produces red, enlarged and tender gum tissues – a reversible condition known as "gingivitis," in which the periodontal attachment fibers remain intact.

Continuous exposure to acids and enzymes from plaque bacteria and the body's immune response to them eventually causes the periodontal attachment to be lost – an irreversible condition known as "periodontitis."

The gum pocket increases to the point where the patient can no longer effectively remove plaque, leading to the destruction of tooth-supporting bone.

Smoking impairs blood flow, and can significantly interfere with the patient's ability to fight the bacterial infection.

Generalized periodontitis affects all of the teeth. They may loosen, appear unnaturally long and unattractive, and may ultimately be lost. When multiple back teeth are lost, the front teeth may be unable to support closing forces of the jaw muscles. They begin to tip and move. The cheeks begin to collapse inward where the back teeth are missing, and the lack of proper support for the jaw joints may cause them to ache, pop and click.

Periodontal bacteria can enter the body's circulatory system through leaky blood vessels. Once inside, the bacteria can lead to blood clots, and inflamed vessels – which constrict in diameter, leading to strokes, heart disease, heart attacks, and poor circulation in the extremities.