Periodontal disease is a common infection of the tissues that surround and support the teeth. It is caused by dental plaque and tartar. The two main types of periodontal disease are: “gum disease”, or gingivitis, and “pyorrhea”, or periodontitis.

Plaque and tartar:
There are millions of germs or bacteria that are present in the mouth of every individual. Each day these bacteria form a sticky, invisible film that covers the tooth surface. If this film, called dental plaque, is not adequately removed, the bacteria quickly calcify and turn into a hard, chalky substance known as tartar, or dental calculus (See Exhibit 1). Bacterial plaque is directly responsible for the dental problems of tooth decay and gum disease.

Gingivitis (gum disease):
Bacterial plaque forms on the teeth every 24 hours. If not removed each day, the plaque build up worsens, tartar deposits form, and the condition known as gum disease or gingivitis begins to develop. This will occur in every individual in as little as three weeks. The gums may become red, swollen and soft, and may begin to bleed during meals or brushing. Although gingivitis may not be painful, bad breath or tastes in the mouth may be noticed. (See Exhibit 2)

Excess plaque and tartar alone will cause gingivitis. However, the severity of the gum disease may be worsened by several factors, including rough edges on fillings or caps and certain medical or hormonal conditions. Diabetes and pregnancy are two conditions that may cause gingivitis to become more severe.

Periodontitis (pyorrhea):
Gingivitis is an infection that is limited to the gums that surround the teeth. In certain susceptible individuals, this condition can progress and the gums will begin to pull away from the teeth. Once this has occurred, deep infected gum or pus pockets develop (See Exhibit 3) and the bone that supports the teeth is lost (See Exhibit 4). Gum disease has now progressed to what is called “pyorrhea” or periodontitis.

Signs and symptoms of periodontitis may include:

1. Bad breath or foul tastes
2. Loosening of teeth
3. Spaces developing between the teeth
4. Sudden large gum swellings, or abscesses
5. Mild or dull pain in the teeth or gums
6. Increased tooth sensitivity to temperatures or pressure

If untreated, the loss of the bone that supports the natural teeth may be so extensive that the teeth themselves are lost. In extreme cases, this destruction of the jawbones may be so severe that false teeth may not be able to be worn comfortably or securely.