Periodontal disease is a condition that attacks the gums and bone supporting the teeth. It can be present throughout the mouth or in localized areas. It is caused when a buildup of plaque and calculus (tartar) are left on the teeth for a long period of time. This buildup begins to spread underneath the gums. It harbors bacteria that release toxins. These toxins cause destruction of the bone and gums around the teeth. The longer it is left untreated, the worse this damage becomes.

This disease is the top culprit for tooth loss. It has also been linked to problems in overall health. These include conditions such as: strokes, cardiovascular disease, diabetes, pneumonia, and pregnancy complications. Research on these associations is ongoing and researchers will likely find even more associations in the future.

Signs of periodontal disease include:

  • Gums that bleed when you brush or floss.
  • Shifting of the teeth.
  • Loosening of the teeth.
  • Bad breath that does not go away with proper brushing and flossing.
  • Red, puffy, sore gums.
  • Pus around the teeth.

Periodontal disease is typically not very painful so it often goes unnoticed until it is severe. It is important to have regular dental check-ups so that any gum issues can be diagnosed and treated as soon as possible.

In a word, inflammation, or swelling. Scientists know that it leads to hardened arteries, also called atherosclerosis. That’s a condition that makes it hard for blood to flow to your heart. It puts you at greater risk for heart attack and stroke.

Inflammation is also a sure sign of gum disease. Sore, swollen gums are the main symptom. There are two main types: gingivitis, which causes red, painful, tender gums, and periodontitis, which leads to infected pockets of germy pus. That’s the type that raises the worry for heart problems. It allows bacteria and other toxins to spread below the gum line.

Gingivitis, which causes red, painful, tender gums, and periodontitis, which leads to infected pockets of germy pus.

Did you know.

Your gums are very vascular, meaning they’re full of blood vessels. And, your mouth is full of bacteria. If you disrupt the gum layer even a little bit, you’re going to get bacteria in your bloodstream, which can go anywhere and trigger inflammation throughout the body, “Inflammation is one of the main things that cause damage to blood vessels, including those of the heart.”

Studies show that the bacteria found in periodontal disease — including Streptococcus sanguis, which plays a role in strokes– spreads to the heart. “The two appear to go hand-in-hand,” Merritt says. “In the absence of gum disease, there is significantly less of these bacteria in the heart.

Periodontal disease (gum disease) is diagnosed by your dentist during a periodontal examination. This is done as a part of your initial exam and your regular dental check-ups.

During this exam, a periodontal probe (small blunt instrument) is placed into the space between the gum and the tooth. The depth of this pocket is measured around each tooth. When the gums are healthy, these measurements are typically 3 millimeters or less. Healthy gums also do not bleed easily.

If these pockets are deeper than 3 millimeters, you cannot adequately clean them with regular brushing and flossing. This leads to the buildup of bacteria and plaque beneath the gums. These bacteria can produce toxins that destroy bone and irritate tissue.

Your dentist will use these pocket depths, along with other factors such as amount of bleeding, inflammation of the gums, bone levels seen on x-ray, to determine the health of your gums. This diagnosis can be:


Healthy gums have pocket depths of 3 millimeters or less. They do not bleed easily. The tissue appears firm and pink.


Gingivitis is a condition where the gums are inflamed, but the bone supporting the teeth is intact. There will typically be some pockets deeper than 3 millimeters, and areas of bleeding. The teeth often have a lot of plaque and calculus (tartar) buildup. The gums may be tender and irritated. If left untreated, this condition can progress to periodontal disease. With proper treatment, it can be reversed.


Peridontitis is a condition where structures that support the teeth (bone and gums) become damaged. Pocket depths are typically more than 3 millimeters, the gums are inflamed and bleed easily. The bone and gum tissue supporting the teeth become lost. This disease is progressive, and the amount of bone loss increases the longer it is left untreated. If enough bone and gum tissue is lost, the teeth can become loose and infected. They may need to be removed.

Treatment of periodontal disease depends on the type and severity of the disease. Your dentist will recommend and explain the appropriate treatment for your condition.

In its early stages, periodontal disease can be treated using periodontal scaling and root planing (deep cleaning). Your gums will be numbed so that you are comfortable, and your hygienist will remove the plaque and calculus from your teeth. Toxins embedded in the roots of your teeth will also be removed. This is done using special dental instruments that can reach to the bottom of the pockets between the gums and the teeth.

When these deposits are removed, your body will begin to heal and shrink the pockets. When this happens, some tissue grows up from the bottom of these pockets, and the tissue around the gums shrinks slightly. The root surface can become exposed, and you may experience some sensitivity. This typically goes away on its own over time. When the healing is complete, and the pockets are restored to a smaller depth, you will be able to properly clean them with regular brushing and flossing.

If periodontal disease is severe and deep pockets remain after this procedure, periodontal surgery may be recommended. This procedure is typically done by a specialist called a Periodontist. This surgery will further reduce the pockets so that they can be cleaned properly at home.

Once your periodontal disease is under control, you will be placed on an appropriate maintenance regimen. This involves proper brushing and flossing at home. It is typically recommended that you have your teeth cleaned 3-4 times a year. This is because periodontal disease can recur and the bacteria that are responsible must be removed often.

At these visits, your hygienist will check your pocket depths and remove any plaque and calculus from above and below the gums. Any areas of reoccurrence will be brought to the attention of the dentist and appropriate treatment will be recommended. Occasionally it is necessary to place antibiotics in the pockets or perform another scaling and root planing (deep cleaning) in these areas.

With regular dental check-ups and cleanings, periodontal disease can be maintained and the bone and teeth supporting the teeth can be kept stable. Any problem areas can be brought to your attention and addressed quickly.