Periodontology – Periodontitis

Periodontitis, or gum disease, is a serious infection of the gums which can cause damage to the soft tissue inside the mouth. When the infection remains untreated, the disease is able to destroy the bone which exists to support the teeth. In more severe cases, periodontitis can cause the teeth to become loose or even result in tooth loss.

While the disease is very common, it can also be prevented. In most cases, periodontitis is due to poor oral hygiene practices and neglect. Good oral hygiene practices include twice daily brushing, daily flossing and getting regular dental checkups. These practices aid in both the prevention and treatment of periodontitis.

Signs & Symptoms

In the early stages of periodontitis, there are very limited symptoms. In most cases, the disease progresses significantly before patients pursue treatment.

Some of the most common symptoms associated with periodontitis include:

  • Swollen, puffy gums which bleed easily when brushing or flossing
  • Gums which are red or purplish in color
  • Tender gums
  • Bad breath or halitosis
  • Presence of pus between the teeth and gums
  • Loose teeth or the complete loss of the tooth
  • Chewing pain
  • Development of spaces between the teeth
  • Gums start pulling away from the teeth
  • Change in bite

It is important for patients to understand that bone destruction and gingival inflammation do not always result in pain. It is common for patients to assume that bleeding without any associated pain can be ignored. However, this should raise concern as it can be an early sign of periodontitis.

Some of the risk factors associated with periodontitis include:

  • Gingivitis
  • Poor oral hygiene and neglect
  • Use of tobacco
  • Hormonal changes, such as menopause or pregnancy
  • Recreational drug use
  • Obesity and poor nutrition
  • Genetics
  • Certain medications
  • Conditions such as leukemia, HIV/AIDS and cancer treatment which lower the immune system
  • Diseases including diabetes, rheumatoid arthritis and Crohn's disease


Periodontitis typically begins with the collection of plaque. When it is not properly removed from the teeth, plaque can progress to periodontitis as outlined below:

  • Plaque forms on the teeth from the interaction of starches and sugars found in food with bacteria in the mouth. While brushing and flossing aids in the removal of plaque, it can quickly form and collect on the teeth.
  • Plaque hardens below the gumline and becomes tartar or calculus. Tartar is quite difficult to remove and is filled with bacteria. Unremoved, plaque and tartar can cause serious damage to the teeth. Tartar cannot be removed with regular brushing and flossing. In order to properly remove it, a professional dental cleaning is necessary.
  • Plaque can also cause gingivitis, a more mild form of gum disease. Gingivitis includes the inflammation and irritation of the gum tissue surrounding the teeth. Through professional treatment and improved oral hygiene, gingivitis is reversible.
  • The ongoing inflammation of the gums can ultimately lead to periodontitis. This eventually results in pockets between the teeth and gums. Pockets which eventually fill with plaque, tartar and bacteria and continue to grow deeper. When it remains untreated, the chronic infection can cause the loss of tissue, bone and ultimately the loss of teeth. Chronic inflammation also places a strain on the body’s immune system.
  • The optimal method for preventing periodontitis is being disciplined and practicing good oral hygiene. Good oral care should start at a young age and the patient should remain consistent to ensure they maintain good oral health.
  • Good oral hygiene includes twice daily brushing and regular flossing. A good oral hygiene regimen aids in preventing an environment filled with bacteria which is a breeding ground for periodontal disease. It is also important to regularly visit the dentist for an exam and professional cleaning.