Gingivitis and Periodontal Disease

Gingivitis, also generally called gum disease or periodontal disease, describes the events that begin with bacterial growth in your mouth and may end – if not properly treated – with tooth loss due to destruction of the tissue that surrounds your teeth.

What's the Difference Between Gingivitis and Periodontitis?

Gingivitis usually precedes Periodontitis. However, it is important to know that not all gingivitis progresses to Periodontitis.

In the early stage of gingivitis, bacteria in plaque buildup, causing the gums to become inflamed (red and swollen) and often easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.

When gingivitis is left untreated, it can advance to Periodontitis.

In a person with Periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line.

Toxins or poisons – produced by the bacteria in plaque as well as the body's "good" enzymes involved in fighting infections – start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become looser, and tooth loss occurs. Gum disease, in fact, is the leading cause of tooth loss in adults.

What Causes Periodontal Disease?

Plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:

• Hormonal changes such as those occurring during pregnancy, puberty, menopause, and monthly menstruation-make gums more sensitive, which makes it easier for gingivitis to develop.

• Hormonal changes such as those occurring during pregnancy, puberty, menopause, and monthly menstruation -- make gums more sensitive, which makes it easier for gingivitis to develop.

• Illnesses may affect the condition of your gums. This includes diseases such as cancer or HIV that interfere with the immune system. Because diabetes affects the body's ability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease.

• Medications can affect oral health because some lessen the flow of saliva, which has a protective effect on teeth and gums. Some drugs, such as the anticonvulsant medication Dilantin and the anti-angina drug Procardia and Adalat can cause abnormal growth of gum tissue.

• Bad habits such as smoking make it harder for gum tissue to repair itself.

• Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.

• Family history of dental disease can be a contributing factor for the development of gingivitis.

 What are the Symptoms of Periodontal Disease ?

Periodontal disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. They include:

• Gums that bleed during and after tooth brushing

• Red, swollen, or tender gums

• Persistent bad breath or bad taste in the mouth

• Receding gums

• Formation of deep pockets between teeth and gums

• Loose or shifting teeth

• Changes in the way teeth fit together upon biting down, or in the fit of partial dentures.

How does my Dentist diagnose Periodontal Disease ?

During a periodontal exam, your dentist or periodontist typically checks for these things:

Gum bleeding, swelling, firmness, and pockets (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease)

Teeth movement and sensitivity and proper teeth alignment

Your jawbone to help detect the breakdown of bone surrounding your teeth

How is Periodontal Disease Treated?

The goals of periodontal treatment are to promote reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues. A full description of the various treatment options is provided in Gum Disease Treatments.

Prevention of Periodontal disease:

• Stop smoking. Tobacco use is a significant risk factor for development of Periodontitis. Smokers are seven times more likely to get Periodontitis than nonsmokers, and smoking can lower the chances of success of some treatments.
• Reduce stress. Stress may make it difficult for your body's immune system to fight off infection.
• Maintain a well-balanced diet. Proper nutrition helps your immune system fight infection. Eating foods with antioxidant properties, for example, those containing vitamin E or vitamin C (vitamin E-containing foods include vegetable oils, nuts, green leafy vegetables; vitamin C-containing foods include citrus fruits, broccoli, potatoes) can help your body repair damaged tissue.
• Avoid clenching and grinding your teeth. These actions may put excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are destroyed.