Periodontal (gum) disease is an infection. It affects the tissues and bone that support the teeth.
Healthy gum tissue fits like a cuff around each tooth. When someone has periodontal disease, the gum tissue pulls away from the tooth. As the disease gets worse, the tissue and bone that support the tooth are damaged. Over time, teeth may fall out or need to be removed. Treating periodontal disease in the early stages can help prevent tooth loss.
Periodontal disease has been linked to some other diseases. People with diabetes or heart disease are more likely to get periodontal disease. Strokes and high stress also may be related to periodontal disease. Researchers are still studying these links.
If you notice any of the signs below, see your dentist. However, you can have periodontal disease and not notice any of these warning signs. That is why regular checkups are very important.
Periodontal disease is caused by plaque, a sticky film that is always forming on your teeth. Plaque contains bacteria that can irritate and inflame the gums.
Inflamed gums can pull away from the teeth and form spaces called "pockets." These pockets collect more bacteria. If the infected pockets are not treated, the gum disease can get worse.
If the disease is caught very early (when it is gingivitis), you may simply need a professional cleaning. The dental team can give you advice for improving your daily oral hygiene.
Some patients develop more severe disease that must be treated. This usually involves a special cleaning called scaling and root-planing. The dentist carefully removes plaque and tartar down to the bottom of each periodontal pocket. The tooth's root surfaces are also cleaned and smoothed. This helps the gum tissue to heal and reattach to the tooth. This treatment is sometimes called "periodontal cleaning" or "deep cleaning" and may take more than one visit.
At followup visits, the dentist or hygienist measures the pocket depths to see if scaling and root-planing has been successful. If the periodontal pockets have deepened and the supporting bone is lost, more treatment may be necessary. You may be referred to a periodontist.
If the pockets do not heal enough after scaling and root-planing, periodontal surgery may be needed. Surgery allows the dentist to remove plaque and tartar from hard-to-reach areas. Then the gums are stitched into place to hug the teeth tightly. Surgery can reduce pocket depth and make it easier to keep teeth clean.
If bone has been damaged by periodontal disease, surgery may be needed to rebuild or reshape the bone. Splints, bite guards or other appliances may be used to hold loose teeth in place and to help tissues heal. If too much gum or bone tissue has been lost, the dentist may do a gum or bone graft.
The dentist may place a membrane layer at the surgical area to help the gums stay in place while the tooth root reattaches to the supporting ligament. This is called guided tissue regeneration. After surgery, the dentist may apply a protective dressing over teeth and gums and recommend or prescribe a special mouth rinse. Your dentist also may prescribe an antibiotic and a pain-reliever.