What is it?
Periodontitis is a serious gum infection that destroys the soft tissue and bone that support your teeth. Periodontitis can cause tooth loss or worse, an increased risk of heart attack or stroke and other serious health problems.
Periodontitis is common but largely preventable. Periodontitis is usually the result of poor oral hygiene. Daily brushing and flossing and regular professional dental cleanings can greatly reduce your chance of developing periodontitis.
Signs and symptoms of periodontitis can include:
- Swollen gums
- Bright red or purplish gums
- Gums that feel tender when touched
- Gums that pull away from your teeth (recede), making your teeth look longer than normal
- New spaces developing between your teeth
- Pus between your teeth and gums
- Bad breath
- Bad taste in your mouth
- Loose teeth
- A change in the way your teeth fit together when you bite
There are different types, or classes, of periodontitis. The most common class is chronic periodontitis — the typical type that most adults older than age 35 have. Periodontitis that begins in childhood or early adulthood is called aggressive periodontitis.
It's thought that periodontitis begins with plaque. This invisible, sticky film is composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth removes plaque. But plaque re-forms quickly, usually within 24 hours.
Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar makes plaque more difficult to remove and acts as a reservoir for bacteria. What's more, you usually can't get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.
The longer plaque and tartar remain on your teeth, the more damage they can do. Initially, they may simply irritate and inflame the gingiva, the part of your gum around the base of your teeth. This is gingivitis, the mildest form of periodontal disease. But ongoing inflammation eventually causes pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. In time, these pockets become deeper and more bacteria accumulate, eventually advancing under your gum tissue. These deep infections cause a loss of tissue and bone. If too much bone is destroyed, you may lose one or more teeth.
Not everyone with extensive plaque and tartar develop periodontitis, though. Some research suggests that periodontitis occurs not simply from plaque but when the type of bacteria in your mouth changes, becoming more destructive.
Factors that can increase your risk of periodontitis include:
- Poor oral health habits
- Tobacco use
- Older age
- Decreased immunity, such as that occurring with leukemia or HIV/AIDS
- Poor nutrition
- Certain medications
- Hormonal changes, such as those related to pregnancy
- Substance abuseIll-fitting dental restorations
- Lower socioeconomic status
Complications that periodontitis can cause or be associated with include:
- Tooth loss
- Coronary artery disease
- Low birth weight babies
- Poorly controlled diabetes
- Respiratory problems
Some of these complications may come as a surprise. But research suggests that the bacteria responsible for periodontitis can travel through your bloodstream, affecting many parts of your body. For instance, bacteria may travel to the arteries in your heart. There, they can trigger a cycle of inflammation and arterial narrowing that contributes to heart attacks.
Diagnosis of periodontitis is generally simple. Diagnosis is based on your description of symptoms and an exam of your mouth. Your dentist will look for plaque and tartar buildup and check for easy bleeding.
To check the health of your gum tissue, your dentist may use a metal probe to measure the depth of the gingival sulcus, the groove between your gums and your teeth. The probe is inserted beside your tooth beneath your gumline, usually at several sites throughout your mouth. The measurements can help determine how severe your periodontitis is.