To view a detailed interactive video about Symptoms of Periodontal Disease.

It is extremely important to note that periodontal disease can progress without any signs or symptoms such as pain. This is why regular dental checkups are exceptionally important. Described below are some of the most common signs and symptoms of periodontal disease.

If you have any of these signs or symptoms, the advice of a general dentist or periodontist should be sought as soon as possible:

• Bleeding Gums.
  Bleeding (when brushing, flossing or eating food) is one of the most common symptoms of a periodontal infection. The toxins in plaque cause a bacterial infection that makes the tissues prone to bleeding. Gums should never bleed, even when you brush vigorously or use dental floss.
• Pain, redness or swelling.
  Plaque, calculus and bacteria irritate the gums and teeth. A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason. It is essential to halt the progression of the infection before the gum tissue and jawbone have been affected. It is also critical to treat the infection before it is carried into the bloodstream to other areas of the body. Gums should never be red or swollen.
• Receding Gums.
  New spacing between teeth or longer-looking teeth can be caused by periodontal disease due to gum recession and bone loss. The toxins produced by bacteria can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy”.
• Bad breath/halitosis.
  Although breath odor can originate from back of the tongue, the lungs and stomach, from the food we consume, or from tobacco use, bad breath may be caused by old food particles that sit between the teeth and underneath the gum line. The deeper gum pockets are able to house more debris and bacteria, causing a foul odor.
• Loose teeth or change in bite pattern.
  A sign of rapidly progressing periodontal disease is the loosening or shifting of the teeth in the affected area. As the bone tissue gets destroyed, or periodontal fibers weakened (fibers that support the tooth to the bone), teeth that were once firmly attached to the jawbone become loose or may shift in position.
• Pus.
  Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress. The pus is a result of the body trying to fight the bacterial infection.

Periodontal disease is diagnosed by your dentist during a periodontal examination. This type of exam should always be part of your regular dental check-up. A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper. Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will determine the type of periodontal disease you have.

To view a detailed interactive video about common causes of Periodontal Disease.

There are genetic and environmental factors involved in the onset of periodontal disease, and in many cases, the risk of developing periodontal disease can be significantly lowered by taking preventative measures.

Here are some of the most common causes of periodontal disease:

• Poor Dental Hygiene.
  Preventing dental disease starts at home with good oral hygiene and a balanced diet. Prevention also includes regular dental visits that include exams, cleanings and x-rays. A combination of excellent home care and professional dental care will ensure and preserve the natural dentition and supporting bony structures. If bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacteria toxin, that can cause gingivitis or periodontal disease, which can lead to tooth loss.
• Tobacco Use.
  Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss.
• Genetic Predisposition.
  Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
• Pregnancy and Menopause.
  During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
• Chronic Stress and Poor Diet.
  Stress lowers the ability of the immune system to fight off disease, which means bacterial infections may possibly beat the body’s defense system. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
• Diabetes and Underlying Medical Issues.
  Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body’s ability to utilize insulin, which makes the bacterial infection in the gums more difficult to control, and cure.
• Grinding Teeth.
  The clenching or grinding of the teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one’s teeth is usually associated with a "bad bite" or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
• Medication.
  Many drugs including oral contraceptive pills, heart medicines, anti-depressants and steroids affect the overall condition of teeth and gums; making them more susceptible to gum disease. Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.
• Lack of Selenium.
  A contributing cause may be low selenium in the diet. Studies have shown that selenium has the strongest association with gum disease, with low levels increasing the risk by 13 fold.

Daily oral hygiene measures to prevent periodontal disease include:

• Brushing. Brushing properly on a regular basis (at least twice daily), with the patient attempting to direct the toothbrush bristles underneath the gum-line, to help disrupt the bacterial growth and formation of subgingival plaque. To view a short informative video about brushing.
• Soft Toothbrush. Using a soft toothbrush to prevent damage to tooth enamel and sensitive gums.
• Flossing. Flossing daily and using interdental brushes (if there is a sufficiently large space between teeth), as well as cleaning behind the last tooth, the third molar, in each quarter. To view a short informative video about Flossing.
• Antiseptic Mouthwash. Chlorhexidine gluconate based mouthwash in combination with careful oral hygiene may cure gingivitis, although they cannot reverse any attachment loss due to periodontal disease.
• Medication. Using periodontal trays to maintain dentist-prescribed medications at the source of the disease. The use of trays allows the medication to stay in place long enough to penetrate the biofilms where the bacteria are found.
• Check-Ups. Regular dental check-ups and professional teeth cleaning at least 2-4 times per year. Dental check-ups serve to monitor the person’s oral hygiene methods and levels of attachment around teeth, identify any early signs of periodontal disease, and monitor response to treatment. To view a short informative video about what to expect during a new patient dental exam.