Periodontal Disease

Periodontal disease is the loss bone and connective tissue supporting the tooth due to inflammation induced by plaque bacteria.

The bacteria don't directly cause the damage. Most of the damage is caused by the immune response to the bacteria.

This immune attack isn't just in the mouth. Horomones are released into the bloodstream that can have effects in the brain, heart and circulatory system.

Stages of Gum Disease

  1. Healthy gums are pink and firm. They rarely bleed and don't hurt when cleaned
  2. Gingivitis- plaque inflames the gum tissues, causing them to bleed easily.
  3. Periodontitis- inflammation progresses deeper. Bone supporting the tooth begins to disappear. Spaces develop between the gums and tooth as bone recedes, called periodontal pockets. Pockets trap more food and bacteria, worsening the inflammation. If sufficient bone is lost, gums no longer have support and recession occurs, exposing the root.
  4. In late stages, enough bone is lost and the tooth becomes loose. Pockets are colonised with more aggressive types of bacteria. At this stage teeth may be lost.
fig 1. Periodontal Disease Process
fig 1. Periodontal Disease Process

Important Facts about Periodontal Disease

-It's the most common cause of tooth loss after 40. The signs of periodontal disease are bleeding, red, swollen or receding gums and loosening of the teeth.

-It usually starts with poor oral hygiene. Accumulation of plaque and food debris allows pathogens to multiply in the mouth. It can be easily prevented with regular, thorough cleaning. Periodontal disease is painless until the late stages. By the time it hurts it may be too late to fix.

-It is chronic inflammation caused by your immune response to plaque bacteria. This inflammation causes the destruction of connective tissue and bone. People with autoimmune disease, diabetes, certain genetic diseases and smokers have exaggerated inflammatory responses and accelerated rate of disease.

-22.9% of Australians have moderate or severe periodontal disease.

-Treatment involves the removal of plaque bacteria through mechanical and chemical means, and rarely  gum surgery.

-Prevention requires good dental hygiene including thorough and regular tooth brushing and inter dental cleaning. Some people may benefit from antibacterial toothpastes and rinses.

-Healthy gums will not be sore or bleed when cleaned.

- A strong link exists between uncontrolled periodontal disease and heart disease/stroke. This is because inflammatory hormones enter the blood from the gums and travel to distant organs.