Gum disease or Periodontal disease is an infection of the tissues that support teeth. The gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket: generally, the more severe the disease, the greater the depth of the pocket.
Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.
Some factors increase the risk of developing periodontal disease:
- Tobacco smoking or chewing
- Systemic diseases such as diabetes
- Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
- Bridges that no longer fit properly
- Crooked teeth
- Fillings that have become defective
- Pregnancy or use of oral contraceptives
Several warning signs that can signal a problem:
- Gums that bleed easily
- Red, swollen, tender gums
- Gums that have pulled away from the teeth
- Persistent bad breath or bad taste
- Permanent teeth that are loose or separating
- Any change in the way teeth fit together while biting.
- Any change in the fit of partial dentures
Types of gum disease
There are many forms and stages of periodontal disease. The most common are:
1. Gingivitis. The first stage of periodontal disease, gingivitis, is the mild inflammation of the gingival caused by plaque build up. Gingivitis is an inflammatory condition of the gingiva caused by factors including smoking, certain drugs and hormonal changes that occur in puberty and pregnancy. Gingival will be red, swollen, and tender, bleeding while brushing and flossing. This stage of gingivitis is reversible.
2. Mild Periodontitis. Inflammation will spread to the supporting alveolar bone. Minor bone loss and the formation of periodontal pockets, or food traps, may occur. Periodontitis follows with the destruction of the supporting structure of the teeth and is influenced by factors including the individual's immune and inflammatory response. It is initiated by microbial plaque. Periodontitis, if left untreated, can causes tooth loss, mouth odor, bad breath or halitosis.
3. Moderate Periodontitis. In this stage, there will be increased gingival recession, moderate to deep pockets, moderate to severe bone loss, and mobility of teeth due to the bone loss.
4. Severe Periodontitis. This is the most serious stage of periodontitis. Deep pockets, increased mobility of teeth, movement of teeth out of position, and visible fistulas (boils) will be present in this stage. Pus may develop; bone loss continues, and teeth may loosen or fall out.