Gingivitis, also called gum disease or periodontal disease, describes the events that begin with bacterial growth in your mouth and may end -- if not properly treated -- with tooth loss from destruction of the tissue that surrounds and supports your teeth. (Gingivitis and periodontitis are two distinct stages of gum disease.)
Gingivitis usually precedes periodontitis. However, it is important to know that not all gingivitis progresses to periodontitis.
In the early stage of gingivitis, bacteria in plaque build up and cause the gums to become inflamed (red and swollen) and often bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.
When gingivitis is left untreated, it can advance to periodontitis. In a person with periodontitis, the inner layer of the gum and bone pull away from the teeth (recede) and form pockets. These small spaces between teeth and gums collect debris and can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.
Toxins, or poisons, produced by the bacteria in plaque as well as the body’s “good” enzymes (involved in fighting infections), turn against the body and actually start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become looser, and tooth loss occurs. Gum disease, in fact, is the leading cause of tooth loss in adults.
Plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:
Periodontal disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. They include:
Even if you don’t notice any symptoms, you may still have some degree of gum disease. In some people, gum disease may affect only certain teeth, such as the molars. Only a dentist or a periodontist can recognize and determine the progression of gum disease.
During a periodontal exam, your dentist or periodontist typically checks:
The goals of periodontal treatment are to promote reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues.
Gingivitis can be reversed in nearly all cases when proper plaque control is practiced. Proper plaque control consists of professional cleanings at least twice a year and daily brushing and flossing. Brushing eliminates plaque from the surfaces of the teeth that can be reached; flossing removes food particles and plaque from in between the teeth and under the gum line.
Other health and lifestyle changes that will decrease the risk, the severity, and the speed of gum disease development include the following:
Recent studies show that some people may be genetically susceptible to gum disease, and may be at a higher risk to develop some form of gum disease. If anyone in your family has gum disease, it may mean that you are at greater risk as well. If you are more susceptible to gum disease, your dentist or periodontist may recommend more frequent check-ups, cleanings, and treatments to better manage the gum disease.
According to recent studies, researchers have uncovered potential links between periodontal disease and other serious health conditions. In people with healthy immune systems, the bacteria in the mouth that makes its way into the bloodstream is usually harmless. But under certain circumstances, these microorganisms are associated with health problems such as stroke and heart disease. Diabetes is not only a risk factor for periodontal disease, but the periodontal disease may make diabetes worse.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
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