The mouth is an amazing microcosm of bacteria living among the oral tissues. Most of the time the bacteria work in benign harmony with the tissues of the mouth but sometimes that harmony is disrupted by the sour note that is periodontal disease.
Periodontal disease is a term that encompasses several different conditions that affect the areas around the teeth. The term comes from the Latin word “peri”, meaning around and the Greek word “odont”, meaning tooth. The term used to describe the study of the teeth and the supporting structures around them is called Periodotology. The dental specialty dedicated to the prevention and treatment of periodontal disease is called Periodontics.
The group of diseases that fall under periodontal disease all have the same end results, inflammation of the gums (gingivitis), destruction of the periodontal ligament , loss of bone support, and finally tooth loss. Of the people who develop gingivitis, 10-15% will develop more advanced periodontal disease. About 70% of the people who develop more advanced forms of periodontal disease will develop the chronic form of the disease that worsens as the patient ages. The other 30% will develop different forms and patterns of disease.
The body’s way of protecting itself against disease, the immune system is a key factor in the body’s defenses against the bacteria that causes periodontal disease. Inflammation, one of the major defensive responses of the immune system, is usually the first sign of periodontal disease. Inflammation is the body’s way of isolating the disease-causing bacteria to prevent the spread to other parts of the body. The immune system can be influenced by a number of factors, including heredity. Genes that predispose a person to periodontal disease and other inflammatory conditions can be passed down from previous generations. Stress can also impede the immune system by lowering resistance.
Periodontal disease is usually preceded by gingivitis. Gums become inflamed and bleed easily when brushing. If left untreated, gingivitis advances to periodontal disease. Pockets start to form when the inner layer of the gums pull away from the teeth. Debris collects in these small pockets between the teeth and gum and can become infected. As the plaque spreads and grows below the gum line, the immune system fights the bacteria. Bone and connective tissue that hold the teeth in place starts to break down as the interaction between infection fighting enzymes and the toxins produced by the bacteria interact. The teeth become loose and tooth loss occurs.
Early diagnosis and treatment is key to saving teeth and bone. Daily brushing and flossing keeps periodontal disease from recurring, but regular checkups with your dentist are necessary. It is advisable to have your teeth regularly cleaned and to quit smoking.