Understanding Periodontal Disease: Causes, Treatment & Prevention

Periodontal disease is the term dentists use to describe gum disease. It’s a common condition that affects the gums, which surround and support your teeth.

Periodontal disease usually starts as minor inflammation but can quickly progress. If you don’t treat periodontal disease it can lead to significant damage, up to and including tooth loss.

There are two main stages of periodontal disease: gingivitis and periodontitis.

• Gingivitis is the first stage of periodontal disease. It causes red, swollen gums that can be painful or sensitive when you brush or floss. It may cause bleeding from your gums near or around your teeth. Gingivitis is usually reversible and treated with good oral hygiene and a professional cleaning at the dentist during your regular checkup.
• Periodontitis occurs if gingivitis progresses untreated. The gums start to pull away from the teeth, which create pockets that bacteria can accumulate in and get trapped. Over time, this leads to bone loss and can result in the loss of teeth.

When it comes to periodontal disease, the key is to recognize it early and treat it with minor changes to oral habits before it becomes serious. If it has progressed too far, treatment may involve more complicated dental procedures like scaling or root planing, medication, or even surgical procedures if the structure of your teeth is compromised.

Recognizing the Signs and Symptoms

Symptoms of periodontal disease are easy to spot, and you’ll almost certainly feel them as you see them. Early signs and symptoms include:

• Bleeding gums, particularly when you brush or floss your teeth
• Bad breath, even very soon after you’ve brushed your teeth
• Gum recession, where you can visibly see the gums pulling back from your teeth.

Later, more severe symptoms might include:

• Loose or shifting teeth, as gums pull away and fail to support your teeth
• Pain when chewing, especially if your teeth are shifting
• Pus or ‘gunk’ in between your teeth that doesn’t resemble normal plaque buildup
• Changes in your bite, as your teeth move

If you experience even mild symptoms of periodontitis, contact your dentist for an appointment as soon as possible.

Bleeding gums

Your gums may bleed for a variety of reasons, and it is a symptom that is often one of the first signs that you’re experiencing gum disease. It’s important to note that gums can bleed for a number of reasons.

Gingivitis is the most common cause, and is an early form of periodontal disease, but they may also be prone to bleeding if you’re brushing too hard, using the wrong type of toothbrush, practicing poor oral hygiene (brushing infrequently), or experiencing changes in your hormones caused by pregnancy, medications, or other health conditions.

Mind cases of bleeding gums usually are treated with a professional cleaning at a dentist office and improved oral hygeine at home. It can often be reversed without fuss, but don’t ignore bleeding gums - early care can prevent big problems later.

Bad Breath

Bad breath - the bane of garlic connoisseurs, bleary-eyed alarm clock haters suffering from morning breath, and sufferers of periodontal disease. Dentists refer to bad breath as halitosis, and it can be embarrassing to have bad breath!

Sometimes bad breath is caused by what we eat - a tuna fish sandwich or a garlic-heavy pasta might send your date running for the hills rather than leaning in for a goodnight kiss. Other times, halitosis is a symptom of poor oral hygiene and/or gum disease.

Common causes of bad breath:

• Bacteria buildup on your teeth or in your mouth - your tongue can be a major culprit!
• Gum disease
• Dry mouth
• Smoking and tobacco use
• Strong-smelling food or medication

To prevent bad breath, maintain your hygiene. Brush twice a day, floss and rinse daily, and make sure to clean your tongue when you address your teeth. Avoid tobacco use, stay hydrated (with water!), and limit strong-smelling food. Using mouthwash to kill bacteria in your whole mouth can be very beneficial.

If better oral habits don’t solve your problem, it’s time to consult professionals - schedule an appointment with your dentist today. Persistent bad breath may be a sign of more significant gum disease.

Gum Recession

Gum recession is how we describe gum tissue pulling away from the teeth. It can make your teeth look longer, increase the sensitivity as new sections of your tooth are exposed, and create risk of decay as elements of your teeth that shouldn’t be exposed to contaminants are laid bare.

Signs to look our for are increased tooth sensitivity, notches or grooves in your teeth near the gumline, and roots or gaps between teeth that you can see in the mirror. As for why you may be experiencing gum recession? It could be gum disease, or things like brushing too hard, grinding your teeth, or misaligned teeth.

To treat receding gums, dentists usually start with hygiene. If that doesn’t work, you may need to discuss options like root planing or gum graft surgery. Early intervention is preferred.

Stages of Periodontal Disease

Luckily, periodontal disease progresses in predictable ways from mild to moderate to severe.

• Later Stage: Moderate Periodontitis. Damage is getting worse, and this is where tooth movement may start to happen. Dentists will categorize someone with moderate vs mild periodontitis based on factors like the depth of the pockets in the gums.
• Latest Stage: Severe Periodontitis. At this stage, teeth can be in trouble. You’re probably experiencing severe gum loss, and probably bone loss as well. Your teeth may start to move, and you may see pus between teeth or feel pain consistently.

Gingivitis

This stage is the only one that is fully reversible. You’ll notice red, swollen gums and bleeding when brushing or flossing.

Treatment: Improved dental hygiene plus professional routine dental cleaning

Slight/Early Periodontitis

Gum disease has progressed and you’re seeing effects below the gumline. You’ll see slight gum recession, and may see pockets around the gum develop.

Treatment: Scaling and root planing (deep cleaning), plus the improved dental hygiene recommended for gingivitis.

Moderate Periodontitis

Damage is getting worse, and this is where tooth movement may start to happen. Dentists will categorize someone with moderate vs mild periodontitis based on factors like the depth of the pockets in the gums.

Treatment: More intensive treatment like deep cleaning, antibiotics or localized dental surgery may be necessary.

Advanced Periodontitis

At this stage, teeth can be in trouble. You’re probably experiencing severe gum loss, and probably bone loss as well. Your teeth may start to move, and you may see pus between teeth or feel pain consistently.

Treatment: Advanced periodontitis may require more significant surgical intervention (like flap surgery, bone grafting, or tooth replacement options). It is a last resort and patients only usually get to this stage after significant neglect or damage has already been done.

Primary Causes of Periodontal Disease

Periodontal disease starts when things take up residence in your mouth that shouldn’t be there. Plaque and bacteria are the primary culprits. Plaque is a sticky film of bacteria that constantly forms on your teeth (ever notice your teeth feel grainy after a long day or when you wake up in the morning? Plaque is to blame!) If plaque isn’t removed, it will build up and harden into tartar, which irritates the gums.

The body responds to bacteria with inflammation and tenderness. Your gums may become red, swollen, and may bleed.

But there are other reasons you can develop periodontal disease: smoking & tobacco, hormonal changes, health conditions, or simply genetic predisposition.

How to treat gum disease?

As with many things dentistry related, an ounce of prevention is worth a pound of the cure. Good oral hygiene is the most practical prevention strategy, which means:

• Brush twice a day
• Rinse and floss once a day

If you’ve developed periodontal disease already, however, gingivitis may be fully reversible with improved oral hygiene, a simple professional cleaning, and several weeks of time. More advanced periodontal disease may not be ‘cured’ but can be managed. Your dentist may turn to scaling and root planing, antibiotics, or surgical interventions.

FAQs About Periodontal Disease

How long can you keep your teeth with periodontal disease?

With proper early detection and effective treatment, many people can be treated for periodontal disease but nevertheless keep their teeth white over time.

Can periodontal disease affect overall health?

Your teeth are an important indicator for the rest of your body, and periodontal disease can have an impact on overall health. Left untreated, gum disease is associated with increased risk of heart attacks, diabetes complications, and pregnancy issues like low fetal birth weight.

What are the best practices for maintaining gum health?

The best practice for maintaining gum health is to brush properly (twice per day with an appropriate toothbrush), floss daily, and use antibacterial mouthwash. In addition, stay on schedule for routine clearings, avoid tobacco, and eat healthy, gum friendly food.

Are there specific foods that promote gum health?

Yes - there are foods that prompt gum health. Generally, we’ll be looking for food to reduce inflammation, strengthen gums, and support both your dental and general health goals.

Think leafy greens (kale, romaine, etc.), fruits and vegetables that are firm and limited in sugar (apples, carrots, celery), dairy (for calcium!), fatty fish, nuts or seeds.