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Periodontal Disease


What is Periodontal Disease?

Periodontal disease, also known as gum disease, is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed.

In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care. In a recent study of Americans aged 30 years and older, half exhibited gingival bleeding at one or more site.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins 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. 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. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

More than one in three people over age 30 have periodontitis. And, by a conservative estimate, 35.7 million people in the United States have periodontitis.

Warning Signs

Periodontal disease is often silent, meaning symptoms may not appear until an advanced stage of the disease. However, signs of periodontal disease include:

  • Red, swollen or tender gums
  • Bleeding while brushing or flossing
  • Gums that pull away from the teeth 
  • Loose or separating teeth
  • Pus between the gum and the tooth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite 
  • A change in the fit of partial dentures

Risk Factors

Plaque causes periodontal disease, which means that without proper at-home oral hygiene and regular dental visits, the risk of developing periodontal disease clearly increases. However, even perfect oral hygiene isn't enough to ward off periodontal disease in everyone. Other risk factors that are thought to increase the risk, severity and speed of development of periodontal disease include tobacco use, general health conditions, medications, stress, genetics, hormonal changes and poor nutrition.

Facts about Periodontal Disease

  • Prevalence and extent of periodontal disease is often measured by attachment loss and/or probing depth. Attachment loss is the places where disease has caused damage to the roots of the teeth and gum tissue loss. Probing depth is depth of a periodontal pocket.
  • Periodontal disease affects the mass of tissue in the oral cavity, which is equivalent in size to the skin on an arm that extends from the wrist to the elbow.
  • Smoking may be responsible for more than half of the cases of periodontal disease among adults in this country.
  • People with diabetes, leukemia, or AIDS/HIV are at increased risk for developing periodontal disease.
  • Stress can affect periodontal disease and can make the infection more severe and harder to fight. A recent study found high levels of financial stress and poor coping abilities increase twofold the likelihood of developing periodontal disease.
  • Periodontal disease is major cause of tooth loss in adults.
  • A growing body of research links periodontal disease to heart disease, diabetes, preterm and low birth weight babies, and respiratory disease.

About the Academy

The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association. For more information, contact the AAP Public Affairs Department at 312/573-3244 or 312/573-3242.

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