Gum (Periodontal) Disease

Periodontal (gum) disease is an infection of the tissues that hold teeth in place.  It’s typically caused by poor brushing and flossing habits that allow plaque—a sticky film of bacteria—to build up on the teeth and harden.  In advanced stages, periodontal disease can lead to sore, bleeding gums; painful chewing problems; and even tooth loss.

Symptoms

Symptoms are often not noticeable until the disease is advanced. They include:

• Bad breath that won't go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth

Any of these symptoms may signal a serious problem, which should be checked by a dentist.

Causes

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless "plaque" on teeth. Brushing and flossing help get rid of plaque.  Plaque that is not removed can harden and form bacteria-harboring "tartar" that brushing doesn't clean.  Only a professional cleaning by a dentist or dental hygienist can remove tartar.

Gingivitis

The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called "gingivitis."  In gingivitis, the gums become red, swollen and can bleed easily.  Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.

Periodontitis

When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth.")  In periodontitis, gums pull away from the teeth and form "pockets" that are infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed.  The teeth may eventually become loose and have to be removed.

Risk Factors 

• Smoking.  Smoking is one of the most significant risk factors associated with the development of periodontitis.  Additionally, smoking can lower the chances of success of some treatments.
• Hormonal changes in girls/women.  These changes can make gums more sensitive and make it easier for gingivitis to develop.
• Diabetes.  People with diabetes are at higher risk for developing infections, including periodontal disease.
• Stress.  Research shows that stress can make it more difficult for our bodies to fight infection, including periodontal disease.
• Medications.  Some drugs, such as antidepressants and some heart medicines, can affect oral health because they lessen the flow of saliva.  (Saliva has a protective effect on teeth and gums.)
• Illnesses.  Diseases like cancer or AIDS and their treatments can also affect the health of gums.
• Genetic susceptibility.  Some people are more prone to severe periodontal disease than others.

Reference:

National Institute of Dental and Craniofacial Research, USA.