Periodontal Disease

Learn the basics of periodontal (gum) disease. Most people don’t even know they have it.

Periodontal disease is another term for gum disease. About half of Americans over age 30 have it, and 70% of those over age 65 suffer from it as well1. Most people who have periodontal disease don’t know it.

  • Gum disease is caused by 10 to 20 different strains of bacteria in the mouth.
  • It is worsened by poor dental hygiene.
  • These bacteria build up into plaque. They then harden into tartar. This causes inflammation of the gums, which is called gingivitis.

Gingivitis is a mild form of gum disease. It can get better with daily brushing and flossing, as well as regular professional cleanings. If left untreated, gingivitis can become periodontitis.

  • Periodontitis is when the gums are damaged and detach from the teeth. They form pockets behind the teeth that become infected with bacteria.
  • Bacteria toxins and enzymes released as the body’s natural response to infection further irritate the gums.
  • As plaque and tartar spread below the gum line, the immune system’s inflammatory response grows larger.
  • In advanced stages, gums, bones, and other tissues that support the teeth are slowly destroyed.
  • Teeth may become loose and have to be removed. About one in four Americans over age 75 have lost all their natural teeth, and this is largely from periodontal disease.

If you don’t brush and floss regularly, you’re likely to get gum disease. The extent of gum disease depends on many factors, including:

  • Your oral hygiene
  • Genetics
  • How well your immune system responds

Brushing alone can’t remove bacteria in tartar, in pockets, or below the gum line. This is why flossing and professional cleanings are necessary. Often a deep-cleaning method called “scaling and root planing” is needed. This is when tartar is scraped off at and below the gum line.

Other major risk factors for periodontal disease include:

  • Tobacco and chemicals in the smoke (or liquid from chewing tobacco) harm the gums and teeth
  • A poor diet, especially one high in sugars or sticky carbohydrates (like dried fruit or caramel)
  • Certain medications and oral contraceptives
  • Hormonal changes (as such, women are sometimes more likely to get gingivitis during puberty, pregnancy, menstruation, and menopause)
  • Anything that decreases the production of saliva (it helps wash away the bacterial toxins)
  • People with diabetes and other chronic diseases

Treatment for periodontal disease depends on the stage of the disease. You may need:

  • A prescription mouth rinse
  • Oral irrigation with an antibiotic solution
  • General antibiotic treatments
  • More thorough removal of tartar below the gum line
  • Surgery

If you have periodontal disease, your regular dentist will probably refer you to a periodontist. A wide range of treatments are now available.

Healthy gums, healthy heart?

In recent years, observational studies have found that people with gum disease are at increased risk for heart disease This has led some dentists to suggest that good oral hygiene can help protect the heart.

Research has also linked gum disease to disorder such as diabetes, certain cancers, and respiratory and kidney disease. But these links are more shaky. The decline of oral health often follows a more general age-related slump in health.

The idea that dental disease can play a role in disorders is biologically plausible. Take heart disease, for example:

  • Oral bacteria can enter the bloodstream and affect the heart and arteries.
  • Inflammation involved in gum disease could trigger the inflammation that plays an important role in atherosclerosis.

The American College of Cardiology has concluded there may be a small link between gum disease and heart disease. But more study is still needed.



  1. Centers for Disease Control and Prevention