Overview of Periodontal (Gum) Disease

Periodontal means "around the tooth," so all periodontal diseases involve the gums. They are caused by bacteria and inflammation the gums and connective tissues. Common symptoms of periodontal disease, also called periodontitis, include: red, swollen gums; bleeding gums; persistent bad breath (halitosis); receding gum line; pus between teeth or coming out of gums; pockets in the gums, shifting or movement in teeth; loose teeth; and loss of teeth.

Most commonly caused by plaque and bacteria below the gums, periodontitis is sometimes caused by a systemic disease or autoimmune illness. The resulting gum disease symptoms are similar, but the underlying cause is different. Research has found that the relationship between periodontal disease and systemic diseases is bilateral, meaning that each disease can contribute to the symptoms of the other.

Gingivitis is the mildest form of periodontal disease.

After gingivitis has gone untreated, it can lead to chronic periodontitis. Smoking cigarettes can contribute to the progression of the disease as well. Chronic periodontitis will generally require more intense cleanings from a dental professional and possibly antibiotic treatment.

Aggressive periodontitis develops rapidly and is more severe than chronic periodontitis. Smoking is thought to be a factor in developing this form as well.

Necrotizing periodontitis develops in individuals with compromised immune systems, such as HIV, lupus, rheumatoid arthritis, or other autoimmune diseases.

Periodontitis caused by systemic disease generally develops in children who have other health conditions, such as diabetes or autoimmune diseases.

Individuals are at increased risk of developing periodontal diseases if they smoke cigarettes, use smokeless tobacco, don't floss, don't get professional teeth cleanings, or have a compromised autoimmune system.

The complications of the different types periodontitis are similar; sometimes they merely vary in severity.Plaque growth above and below the gum line is often present in all forms of periodontitis except for necrotizing.
Common symptoms of periodontal disease are: teeth shifting, loose teeth, receding gums, pus in gum pockets, loss of bone mass in jaw bone, bleeding gums, dentures no longer fitting properly, and systemic inflammation.

Adequate oral hygiene is the best prevention for gum disease. At the minimum, brush at least twice and floss once daily. Flossing gets rid of bacteria and plaque both above and below the gum line, which reduces the inflammation that leads to periodontal problems. Regular professional cleanings gets rid of plaque and tartar that are missed with regular brushing and flossing. X-rays can show signs of gum disease that may not be apparent with only probing and visual examinations.