February 7, 2023

Periodontitis, or gum disease, is a common infection that damages the soft tissue and bone supporting the teeth. Without treatment, the alveolar bone around the teeth will gradually erode.
Periodontitis means inflammation in the supporting structures around the tooth. Bacteria and other microorganisms stick to the surface of the tooth and in the pockets surrounding the tooth. As they multiply, the immune system reacts, leading to inflammation.
Untreated periodontitis will eventually result in tooth loss and may increase the risk of stroke, heart attack, and other health problems.
Periodontitis is a chronic or long-term inflammatory disease. Good oral hygiene practices can help manage or prevent it.
In this article, find out why periodontitis happens, who is at risk, and how to treat and prevent it.
The signs and symptoms of periodontitis include:
Symptoms may not appear until a person is in their 40s or 50s. By this time, periodontitis may be advanced, and the person may have irreversible damage.
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Treatment aims to clean out bacteria from the pockets around the teeth and prevent further destruction of bone and tissue.
Good oral hygiene can help reduce the risk of periodontitis.
Tips include:
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Removing plaque and calculus can help restore periodontal health.
This involves:
How often a person needs treatment will depend on how much plaque and tartar accumulate.
A number of medicated mouthwashes and other treatments are available.
They include:
If other treatments do not help, a dentist may recommend periodontal surgery.
Surgery can:
A dentist may carry out one or all of these procedures under local anesthetic. They will close the gums with stitches after the procedure.
Home treatment is essential for managing plaque buildup and reducing the risk of gum disease.
The American Dental Association (ADA) gives the following advice:
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People should not share brushes, as bacteria can pass between individuals in this way.
A dentist can also advise on:
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Other prevention tips include:
How can people remove plaque and tartar at home?
Gingivitis occurs before periodontitis. It usually refers to gum inflammation, while periodontitis refers to gum disease and the destruction of tissue, bone, or both.
Around 90% of adults have gingivitis, where bacterial plaque accumulates on the surface of the tooth.
With gingivitis:
Untreated gingivitis can progress to periodontitis.
With periodontitis:
The immune system attacks bacteria as the plaque spreads below the gum line into the pockets. This leads to an immune reaction, which involves the release of toxins and inflammation.
Bone and connective tissues that hold the tooth start to break down. Teeth can become loose and fall out. The changes may be irreversible.
A person should see a doctor or dentist if they have:
These symptoms may indicate a need for urgent treatment or further investigation to rule out other causes, such as mouth cancer or an abscess.
To diagnose periodontitis, a dentist will likely:
Complications and consequences of periodontitis include:
One study of people with chronic coronary artery disease, lasting 3.7 years, found that for every five teeth lost, there was a 17% higher risk of cardiovascular death, a 16% higher risk of all-cause death, and a 14% higher risk of stroke.
It is unclear why this happens, but it may be that bacteria from periodontitis infect the coronary arteries, triggering a wider immune response.
One study found that females who develop periodontal disease after menopause may be more likely to develop breast cancer, particularly if they have a history of smoking.
Bacterial plaque, a sticky, colorless membrane that develops over the surface of teeth, is the most common cause of periodontal disease.
Brushing teeth removes plaque, but it will build up again after a day or so.
Plaque that remains will harden into tartar, also known as calculus. Tartar is harder to remove than plaque. A person cannot remove tartar at home. It needs professional treatment.
Plaque and tartar can progressively damage teeth and surrounding tissue.
At first, gingivitis may develop. This is a reversible inflammation of the gums around the base of the teeth.
If gingivitis persists, pockets can develop between the teeth and gums. These pockets fill up with bacteria.
As the immune system responds to the buildup of tartar, bacterial toxins start destroying the bone and connective tissue that hold teeth in place. Eventually, the teeth start becoming loose, and they may fall out.
Below is an interactive 3-D model of periodontal disease.
Explore the model using your mouse pad or touchscreen to understand more about periodontal disease.
Factors that increase the risk include:
Here are the answers to some questions people often ask about periodontal disease.
In the early stages, called gingivitis, good oral hygiene can reverse some changes and prevent further deterioration. As the disease progresses, however, irreversible damage may occur. Often, symptoms of periodontitis do not appear until a later stage. For this reason, it is better to prevent it by practicing good oral hygiene and avoiding smoking.
Inadequate oral hygiene is the main cause, but smoking can also play a key role. Other individual risk factors include genetic features, a weakened immune system, and other health conditions.
It can lead to discomfort, tooth loss, and bad breath. Scientists have also found links with other diseases, such as diabetes, heart disease, and pregnancy complications.
Periodontitis is a type of gum disease.
It can happen if a person does not follow regular hygiene practices such as daily brushing and flossing. In the early stages, it is reversible. As it progresses, however, irreversible damage may occur. Often, a person does not realize this damage is present until it is too late to fix completely.
Periodontitis can lead to tooth loss, gum discomfort, and bad breath but may also increase the risk of heart disease and other complications.
To avoid periodontitis, people should brush their teeth twice a day, floss daily, and see a dentist at least once a year. A diet that favors whole foods and fresh fruits and vegetables over processed carbs can also help.
Last medically reviewed on June 26, 2022
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