What Is the Disease of the Periodontium?

The periodontium is the group of tissues that surround and support each tooth. It includes the gingiva (gums), periodontal ligament, cementum, and alveolar bone. Together, these structures keep your teeth stable and protect them from infection and trauma. When any part of this system becomes inflamed or damaged, it is referred to as a disease of the periodontium, commonly known as periodontal disease.

Periodontal disease is one of the most widespread oral health problems in adults. It ranges from mild gum inflammation to severe tissue and bone loss that can result in tooth loss if left untreated.

Understanding the Periodontium

To understand periodontal disease, it helps to know what makes up the periodontium:

• Gingiva: The gum tissue that surrounds the teeth and forms a seal to protect deeper structures.
• Periodontal ligament: A network of fibers that anchor each tooth to the bone and absorb chewing forces.
• Cementum: The hard tissue covering the tooth root that allows ligament fibers to attach.
• Alveolar bone: The part of the jawbone that holds and supports the tooth sockets.

All four components work together to maintain healthy, stable teeth. If infection or inflammation affects one part, the others can be damaged too.

What Is Periodontal Disease?

Periodontal disease refers to chronic bacterial infections that destroy the supporting tissues of the teeth. It usually begins with plaque accumulation along the gumline and can progress in stages if not controlled.

Types and Stages of Periodontal Disease

1. Gingivitis

This is the earliest stage. Plaque — a sticky film of bacteria — builds up around the gumline. The gums become red, swollen, and bleed easily during brushing or flossing. At this stage, the damage is reversible with proper oral hygiene and professional cleaning.

2. Periodontitis

If gingivitis is not treated, it can progress to periodontitis. The infection spreads deeper, attacking the periodontal ligament and alveolar bone. Gums begin to pull away from the teeth, forming periodontal pockets where more bacteria accumulate. The bone that supports the teeth starts to deteriorate, leading to loose teeth or even tooth loss.

3. Advanced Periodontitis

In severe cases, extensive bone destruction and tissue loss occur. Teeth may become mobile, shift out of position, or fall out. The infection can spread beyond the mouth, contributing to systemic inflammation and increasing risks for conditions such as diabetes, heart disease, and stroke.

Causes of Periodontal Disease

The primary cause is bacterial plaque.
However, several factors can increase susceptibility and worsen the disease:

• Poor oral hygiene (inadequate brushing and flossing)
• Smoking or tobacco use
• Hormonal changes (e.g., pregnancy or menopause)
• Diabetes or other systemic diseases
• Genetic predisposition
• Stress and weakened immune response
• Poor nutrition and vitamin deficiency
• Ill-fitting dental restorations or malaligned teeth trapping plaque

Symptoms of Periodontal Disease

Common warning signs include:

• Red, swollen, or tender gums
• Bleeding while brushing or flossing
• Receding gums or longer-looking teeth
• Persistent bad breath (halitosis)
• Loose or shifting teeth
• Pain when chewing
• Pus between teeth and gums
• Changes in bite or tooth alignment

Diagnosis

A dentist or periodontist diagnoses periodontal disease through:

• Visual examination of gums and plaque buildup
• Measuring pocket depth around teeth using a periodontal probe
• X-rays to evaluate bone loss
• Assessment of medical and dental history to identify risk factors

How Periodontal Disease Affects the Whole Body

Periodontal disease is not limited to the mouth. The chronic inflammation it causes can release bacteria and inflammatory molecules into the bloodstream. Research links untreated gum disease to:

• Heart disease and stroke
• Worsened diabetes control
• Respiratory infections
• Pregnancy complications such as premature birth or low birth weight
• Rheumatoid arthritis and systemic inflammation

Treatment of Periodontal Disease

1. Non-Surgical Treatment

• Scaling and root planing: Deep cleaning that removes plaque and tartar from beneath the gums and smooths the root surface to encourage reattachment of tissues.
• Antibacterial therapy: Local or systemic antibiotics may be used to reduce bacterial load.
• Improved oral hygiene: Consistent brushing, flossing, and antiseptic rinses are essential for healing and prevention.

2. Surgical Treatment

• Flap surgery: The gum is lifted to allow deep cleaning of infected areas and then sutured back in place.
• Bone grafts: Used to rebuild lost bone around teeth.
• Guided tissue regeneration: Membranes or growth factors help the body rebuild bone and ligament tissue.
• Soft tissue grafts: Cover exposed roots and strengthen the gumline.

Prevention of Periodontal Disease

• Brush teeth twice daily with a soft-bristled toothbrush.
• Floss once a day to remove plaque between teeth.
• Use an antimicrobial mouthwash as recommended by your dentist.
• Visit your dentist every six months for cleaning and checkups.
• Avoid tobacco and maintain a balanced diet rich in vitamins and minerals.
• Manage chronic conditions such as diabetes to reduce inflammation risk.

Frequently Asked Questions

1. Is periodontal disease reversible?
Gingivitis, the earliest stage, is reversible with good oral hygiene and professional care. Once bone loss occurs in periodontitis, the damage cannot be completely reversed, but further progression can be stopped.

2. Can you cure periodontitis permanently?
With proper treatment and maintenance, periodontitis can be controlled and stabilized, but the patient must maintain excellent hygiene and regular dental visits to prevent recurrence.

3. Is periodontal disease contagious?
The bacteria that cause it can transfer through saliva (e.g., kissing), but infection usually develops only when oral hygiene is poor or the immune system is compromised.

4. What’s the difference between gingivitis and periodontitis?
Gingivitis affects only the gums and is reversible. Periodontitis involves deeper tissues — ligament, cementum, and bone — and leads to permanent damage if untreated.

5. Can periodontal disease cause tooth loss?
Yes. In advanced stages, the supporting bone resorbs and teeth become loose, eventually falling out or requiring extraction.

Summary

The disease of the periodontium — known as periodontal disease — is a progressive condition that begins with gum inflammation and can lead to destruction of the tissues and bone that support your teeth. It is caused mainly by bacterial plaque, but lifestyle, systemic health, and genetics also play major roles. With early detection, proper cleaning, and ongoing maintenance, periodontal disease can be managed effectively, helping preserve your teeth and overall health.