What is periodontal disease?

Periodontal (gum) disease is a serious bacterial infection in your mouth that destroys the gums and supporting bone around the teeth.

The CDC estimates that half of all adults 30 years or older have some form of periodontal disease. That equates to 64.7 million people in the United States.

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Periodontitis is a silent destroyer because pain is typically absent. Most cases of periodontitis are detected at routine exams with your general dentist, who will refer you to a periodontist like Dr. Schmalz to further evaluate your condition.

Periodontal diseases including Gingivitis and Periodontitis, left untreated can cause tooth loss, and affect your ability to eat, speak and smile.

The bacterial infection present will stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed by the inflammation. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed.

Signs and Symptoms

Signs and symptoms of periodontal disease include:

• Redness, swelling or tenderness of your gum tissue
• Bleeding while brushing, flossing or eating
• Loose teeth
• Persistent bad breath
• A rapid change in how your teeth fit together

Risk Factors

Risk factors of periodontal disease include:

• There is an increased risk for developing periodontal disease as we age
• Smoking and tobacco use also increases the risk for developing periodontal disease at an early age. Smoking also increases the severity of the periodontal disease and diminishes your response or limits the effectiveness to treatment.
• Certain medications can effect your mouth and gum tissues adversely. It is important to bring a complete list of your medications to your first appointment.
• Genetics can also contribute to the severity and onset of someone’s periodontal disease.
• Stress, clenching and grinding can also contribute to bone loss around your teeth and may speed the rate at which the supporting tissues of your teeth are lost.
• Systemic diseases and obesity can also predispose someone to developing periodontal disease

Should I be concerned with periodontal disease?

Take a quick assessment to see if you should be concerned with your periodontal health.

When to see a Periodontist?

All general dentists are educated and trained to diagnose and treat early forms of periodontal disease. Your dentist may have already begun an initial treatment of your periodontal disease. If your general dentist has a concern regarding your gums and the supporting bone around your teeth he or she may refer you to a periodontist. We will work in collaboration with your general dentist to treat your more advanced periodontal disease and bring you back to optimum health.

The Mouth-Body Connection

It is important to understand that periodontal disease in your mouth affects your entire body. Periodontal disease produces inflammation (bleeding of the gum tissue) that eventually breaks down the supporting gum tissue and bone surrounding your teeth. Research has shown that this inflammatory process is linked to other chronic inflammatory diseases, like, cardiovascular disease, diabetes and chronic lung diseases. Untreated chronic inflammation that occurs with untreated periodontal disease, can then be detrimental to other areas of the body.

Patients with poorly controlled diabetes are more at risk for developing periodontal disease. Periodontal disease can also have a more rapid progression in people with uncontrolled diabetes. Research has shown that with uncontrolled periodontal disease it is more difficult for patients to control their daily blood sugar levels. This in turn can lead to an increased risk for more diabetic complications.

Research has also shown that untreated periodontal disease can also contribute to complications with pregnancy, such as, pre-term deliveries and low birth weight babies.

Several studies have shown a link between periodontal disease and heart disease and that periodontal disease increases the risk of heart disease. This is likely due to the inflammation that occurs in periodontal disease adversely affecting our vascular system. Research has also looked at the increased risk of having a stroke with uncontrolled periodontal disease. Patients with an uncontrolled oral infection were more likely to have a stroke than those not affected by periodontal disease.

Patients with active periodontal disease are more at risk for developing lung infections, like pneumonia, from breathing in bacteria from their mouth.

There is also an increased risk for developing different cancers like, kidney cancer, pancreatic cancer and certain blood cancers with active periodontal disease is present.

Periodontal Disease in Women:

• Gingival changes in tissues can occur at different stages in a women’s life. During puberty there is an increase in hormones present in the circulation, which can lead to an increase in the inflammation of the gingival tissues.
• Gingival inflammation can also occur in pregnancy due to the increase in hormones. Active periodontal disease during pregnancy can also lead to complications associated with the birth, such as, low birth weight and pre-term delivery.
• As we age dry mouth can increase and cause burning sensations, altered taste or pain. In some women this can occur during menopause. Estrogen supplements can be used to relieve these symptoms in most cases.
• Osteoporosis has also been linked to bone loss in the jaw and that due to the lost in bone density the support of the teeth may be decreased, especially in patients with periodontal disease.

Periodontal Disease in Men:

• Periodontal disease has been linked with elevated levels of Prostate-specific antigen (PSA). Elevated PSA levels are seen when the prostate becomes inflamed and unhealthy so there may be a link between the inflammation present with periodontal disease and prostate health.
• Men with periodontal disease, who are either younger than 30 or older than 70, are at an increased risk for developing impotence again due to the active chronic inflammation associated with periodontal disease.

Prevention of Periodontal Disease

The best ways to initially prevent the start of periodontal disease is to routinely brush and floss your teeth twice daily. It is also important to have routine preventative exams and cleanings with your general dentist so they can detect any areas of concern early on in the disease process. Avoiding certain habits, like smoking, can also help lower your risk for developing periodontal disease.