Periodontal Disease

Periodontal disease is gum disease that is a result of bacteria forming into plaque and calculus on teeth and gums, causing bone loss around the teeth, gum swelling and irritation, or gum recession. Periodontal disease is a common disease and leading cause of tooth loss in people aged 35 and older. Since it affects so many people, it is important to understand exactly what periodontal disease is. For starters, it is commonly known as gum disease.

Plaque is a film on your teeth that is largely composed of bacteria and is constantly forming. If the plaque is not removed, gums can become irritated and start to swell. Calculus is then formed once plaque starts to build up and harden. The plaque will continue to build up even with the presence of calculus, which will increase the irritation and swelling of gums. As this occurs, periodontal fibers that allow the gums to be a strong foundation for the roots of teeth will begin to break down (bone loss). When these fibers break down, the gums lose their support around the tooth leaving space for bacteria to grow. These spaces are called periodontal pockets. Once periodontal pockets are formed, bacteria continues to build and deepen the pockets. This results in severe bad breath and can result in pockets becoming so deep that the bone can no longer support the tooth and the tooth is lost.

Proper oral care, including brushing and flossing multiple times a day and visiting the dentist for regular oral hygiene visits, can minimize the plaque buildup before calculus is formed which can prevent periodontal pockets from forming.

There are various stages of periodontal disease. Routine visits to your dentist including hygiene visits can help prevent periodontal disease as well as spot it and treat it early. Treating it early can prevent the degree of periodontal disease from worsening and minimize the chances of tooth loss.

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1. Healthy gums will have strong supportive tissue and a solid foundation of gums will surround the roots of a tooth. Periodontal pockets are not present at this stage.

2. The first and typically mild stage of periodontal disease is usually developed at an earlier age and is known as gingivitis. At this stage, plaque and calculus are present but there is no bone loss. Periodontal pockets may be present but with proper care, periodontal disease can be reversed. Sore, bleeding gums are common at this stage.

3. Periodontitis is the next stage. At this time, calculus is found below the gumline and pockets are beginning to deepen. This will lead to the loosening of teeth and the shrinking/receding of gums. Red, bleeding gums are found in this stage as well, however, redness and bleeding is typically more extensive with periodontitis compared to gingivitis.

4. Advanced periodontitis is, as the name suggests, the most advanced stage of periodontal disease. This is when teeth fall out or need to be removed due to the extent of bone loss caused by the deep periodontal pockets. The pockets may also fill with pus, and the gums will be swollen, especially near the root of the tooth due to the bacteria and bone loss.

If your gums are red, swollen, sore, bleeding, or has pus between the gums and teeth, visit your dentist. These are indicators to the development or presence of periodontal disease. If you notice permanent teeth being to feel loose, consult with your dentist. They can examine your oral health and detect periodontal disease. For further examination or treatment, they may refer you to a periodontist (specialist in gum treatment).

A periodontist is a specialist that treats periodontal disease. They can perform more extensive exams to detect periodontal disease as well as determine the extent of the disease. One of the ways they can determine what stage your gums are at is by periodontal probing. A small ruler-like probe is inserted in the space between your gums and teeth to determine the severity of the bone loss. The deeper the pockets, the more severe periodontal disease is. There are various treatments to remove periodontal pockets if necessary.

Periodontal disease can go unnoticed by patients for quite some time, especially in the early stages. This is why proper at-home oral care and regular visits to the dentist are essential to the prevention and detection of periodontal disease.