Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Periodontal Disease
When to See a Periodontist
Periodontal treatment may be sought in several ways. Your general dentist or a hygienist may recommend a consultation with a periodontist if they find signs of periodontal disease through the course of a checkup or other dental care appointment. You may also decide to see a periodontist on your own, as a referral is not necessary to be seen at our office.
In fact, if you experience any of these symptoms, we encourage you to schedule an appointment at our office without delay:
- Unexplained bleeding while performing regular cleaning or consuming food is the most common sign of a periodontal infection.
- Ongoing halitosis (bad breath), which continues despite rigorous oral cleaning, can point to periodontitis, gingivitis or the beginnings of a gum infection.
- Longer-looking and loose-feeling teeth can indicate recession of the gums and/or bone loss as a result of periodontal disease.
Patients with heart disease, diabetes, osteopenia or osteoporosis are often diagnosed with correlating periodontal infections. The bacterial infection can spread through the blood stream, affecting other areas of the body.
- Bleeding while brushing or eating normal foods
- Bad breath
- Loose teeth and gum recession
- Related health concerns
What is Periodontal Disease?
Periodontal disease is a chronic infection of the periodontal or gum tissue. This infection is caused by the presence of a bacterial film, which is called dental plaque, that forms on the teeth surfaces. Bacteria that found in dental plaque produce toxins which irritate the gums. They may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. With periodontal disease, bleeding, redness and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum and jawbone of more than 80% of Americans by age 45. Each case is looked at individually, because in addition to plaque there are co-factors such as genetics, smoking, and overall health, which contribute to disease severity. Once periodontal disease is detected, our goal as therapists is to provide information and treatment necessary to control/ or arrest the active infection, and help keep the disease in an inactive or controlled state.
However, don’t be fooled!
With periodontal disease, bleeding, redness and swelling do not have to be present. The periodontal disease symptoms of inflammation may only be evident with sub gingival probing. Further, pain is usually not associated with periodontal disease.
Maintaining good oral health has many rewards: A sparkling smile, fresh breath, and healthy gums. But recent scientific evidence suggests that it may have an even greater benefit to your overall health: Specifically, it could potentially reduce your risk for a number of systemic (whole-body) diseases, including cardiovascular disease (CVD), diabetes, and rheumatoid arthritis — even premature birth.
Periodontal (gum) disease is estimated to affect nearly half of all Americans, and is the major cause of adult tooth loss. Numerous studies have shown that patients with severe periodontal disease are at increased risk for developing cardiovascular disease. Periodontitis may also increase the chance that diabetes will develop or progress, and research suggests an association between gum disease and adverse pregnancy outcomes as well.
Inflammation: Friend and Foe
What's the link between diseases of the mouth — like gum disease — and those of the body? They are connected by the body's natural reaction to harmful stimuli, which we call the inflammatory response. Often characterized by pain, redness and swelling, inflammation is a process by which your immune system responds to damage or disease in your tissues. Inflammation can help the body heal — or, if it becomes chronic, it can lead to more serious problems.
Gum disease (periodontitis), CVD, diabetes and rheumatoid arthritis are all associated with the same type of inflammatory response. Studies have found that moderate to severe periodontitis tends to increase the level of systemic inflammation — a condition that may smolder in the background, awaiting the right conditions to flare into a more serious disease. It has also been shown that the same strains of bacteria that are found in inflamed gum tissue may also appear in the arterial plaques of individuals suffering from CVD.
How Does It Work?
While there is intriguing evidence of a link between gum disease and other systemic diseases, further studies will be needed to prove whether one causes the other. At present, however, several mechanisms have been proposed to explain how the connection works. One suggestion is that oral bacteria themselves may enter the bloodstream, form into clumps, and trigger systemic inflammation. The inflammatory response can cause swelling of cells and tissues, which narrow the arteries and increase the risk of blood clots.
Another possibility is that byproducts of oral bacteria released into the bloodstream could trigger the production of substances called CRPs (C-reactive proteins) in the liver. These proteins tend to inflame blood vessels and promote the formation of clots, possibly leading to clogged arteries, heart disease and stroke. Elevated CRP levels, according to some studies, are a stronger predictor of heart attack than cholesterol levels.
What You Can Do
Since chronic inflammation is a systemic problem, the best way to begin controlling it is via a whole-body approach. Maintaining a healthy weight, getting moderate exercise (and, if you use tobacco, quitting the habit) will help with this. So will bringing untreated inflammatory diseases, such as periodontitis, under control.
There are a number of effective treatments for periodontal disease, including nonsurgical procedures such as root cleaning and the local application of antimicrobials. For more serious conditions, conventional or laser gum surgery is an option. Finally, to keep your gums healthy between office visits, you need to develop an effective oral hygiene routine you can practice at home.
Although it's too early to say that periodontal disease causes heart disease or other systemic conditions, they seem to have a connection. And while medicine and dentistry can't change genetics, together we can control external factors like excess weight, tobacco use… and gum disease. Maintaining good oral hygiene is the best way to avoid periodontal problems. But if problems occur, don't wait: The sooner you have treatment, the better your chances for controlling gum disease — and perhaps systemic diseases too.
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