Many people have gum disease (periodontitis) and do not even realize it. Periodontal disease is usually not painful, especially in its early stages. It's an infection in the gums caused by the bacteria in plaque. More specifically, it’s an oral condition which involves the breakdown of the structures (periodontal fibers and bone) which support the teeth and anchor them to the gums. Current research supports the view that periodontitis (gum disease) is determined by the body’s response to infection caused by bacteria in plaque.

    Diagnosis. Healthy gums fit tightly against your teeth. If you have periodontal disease, your gums will slowly begin to pull away from your teeth in response to the bacterial infection. The space between healthy teeth and gums (called a sulcus) is anywhere from 1 to 3 millimeters in depth. During an examination, your dentist will use a special calibrated instrument called a periodontal probe to measure the pocket depths (sulcus) around your teeth.  When bacteria and plaque build up in the sulcus and are not removed, your body mounts an immune response. The longer the bacteria and plaque remain in the sulcus, the more the gums recede. When your gums recede, so too does the bone underneath. Unfortunately, when you start losing bone, you run the risk of losing teeth. Periodontal disease clinically begins once your periodontal pockets are greater than 3mm deep. Once a pocket extends beyond 3mm, it's no longer cleansable by the bristles of a toothbrush; it can only be cleaned professionally. In general, the deeper the pocket, the greater the spread of periodontal disease.

Your dentist will also note any bleeding as he/she measures your periodontal pockets. Bleeding gums are a sign of periodontal disease; healthy gums do not bleed.

Your dentist will probably take x-rays of your mouth to determine whether there has been any bone loss around your teeth. This is another indicator of periodontal disease. In a healthy mouth, the bone comes up high around the necks of the teeth. However, in cases of periodontal disease, the constant irritation of bacteria and plaque causes the bone to resorb. The longer the condition goes untreated, the more bone is lost. Unfortunately, the condition is irreversible - once bone is lost, it never grows back. With regular checkups, your dentist will be able to make an early diagnosis and prevent bone and possible tooth loss.

While there are a wide variety of bacteria found in the mouth, certain bacteria have been identified in association with periodontitis as being particularly destructive.

• Porphyromonas Gingivalis
• Actinobacillus Actinomycetemcomitams

Periodontal Disease Risks

Left untreated, periodontal disease may:

• Spread around the root of a tooth causing it to die
• Cause the supporting bone to become so weakened that the tooth falls out
• Lead to systemic infections
• “You may be infecting your partner” Adults with periodontal disease may be a potential source of infection for their family members. The bacteria causing periodontal disease can be passed between people through kissing. It can also be spread in much the same way as the flu or a cold.

Signs and Symptoms of Gum Disease

• Gums which bleed upon brushing
• Loose teeth
• Persistent bad breath
• Bad taste in your mouth
• A change in the fit of your partial denture
• Pus coming from the sulcus between your teeth and gums

Treatment of Gum Disease

Treating periodontal disease is much more difficult than treating gingivitis. Improved oral home care is often sufficient at returning gums to health in cases of gingivitis. However, in cases of periodontitis, your dentist may initially try non-surgical methods such as scaling and root planing. Occasionally, in localized cases all that is needed may be to recontour or replace an existing restoration; in conjunction with antibiotics and good oral hygiene, the infection may be eliminated. However, if non-surgical treatments prove unsuccessful, surgical treatments such as periodontal flap surgery and gingivectomy may become necessary.

Prevention

Practice better oral hygiene by brushing and flossing regularly (after meals and before going to bed). By reducing the amount of plaque on your teeth, you can reduce the amount of bacteria in your mouth. Regular dental checkups (every 6 months) can alert you to potential problems.

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