Introduction 
Signs and Symptoms 
Periodontal & Systemic Disease Interrelationships 
Risk Factors 
Stages of Periodontal Disease
Gingivitis
Mild Periodontitis 
Advanced Periodontitis    

Introduction  
Periodontal disease is an infection of your gums (the soft tissue) around your teeth.  It is most often caused by the bacteria and toxins found in the plaque and tartar that builds up around teeth.  When plaque is not adequately removed by brushing and flossing, the gum tissue can initially become irritated and inflamed.  This beginning stage is termed Gingivitis, and is a reversible process.  If left untreated, the gum tissue and bone that support the teeth will begin to withdraw from the infection in a process called Mild Periodontitis.  When the infection is allowed to continue long enough, the disease can progress into the Advanced Periodontitis stage, and the support of the teeth can become severely compromised. 

Signs and Symptoms  
The signs and symptoms of gum disease are not always easily noticed and can be painless.  However, several warning signs that can signal a problem include:  

• Gums that bleed easily
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath or bad taste
• Permanent teeth that are loose or separating
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures

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Periodontal & Systemic Disease Interrelationships  
Tooth loss is not the only potential problem associated with periodontal disease.  Research has suggested that there may be a link between periodontal diseases and other health concerns such as diabetes, cardiovascular disease, stroke, bacterial pneumonia, and increased risk during pregnancy.  Studies seem to indicate that oral health and periodontal disease can exasperate these diseases.  Additionally, it has been shown that diabetes can affect periodontal disease as well.  Therefore, it is important to ensure good oral hygiene, particularly when you are already diagnosed with one of these diseases.  Regular brushing, flossing, a balanced diet, and regular dental cleanings and checkups  can provide a lifetime of benefits.   

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Risk Factors  
Some factors increase the risk of developing periodontal disease. These include:  

• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
• Bridges that no longer fit properly
• Crooked teeth
• Fillings that have become defective
• Pregnancy or use of oral contraceptives  

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Stages of Periodontal Disease  
While there are many types of periodontal disease, there are 3 major forms:  Gingivitis, Mild Periodontitis, and Advanced Periodontitis.   

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Gingivitis  
This is the first stage of gum disease, and is reversible.  It is the localized inflammation of gum tissue.  Your gums may appear a deeper red than normal, and they may feel tender and swollen.  You may also notice some bleeding, especially when you brush or floss.  A good professional cleaning with subsequent proper brushing and flossing at home can reverse gingivitis.  

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Mild Periodontitis  
At this stage of gum disease, the gum tissue and bone begin to pull away from your teeth.  While symptoms are not always noticeable, they can include:   

• Gums that bleed easily
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath or bad taste

With mild periodontitis, it is necessary to perform a deeper cleaning in order to get rid of the plaque, tartar and bacteria that have accumulated between your teeth and gum tissue.  This type of cleaning is often referred to as scaling and root planning.   

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Advanced Periodontitis  
Advanced forms of periodontitis can include what the American Academy of Periodontology terms moderate and severe periodontitis.  In this stage, significant amounts of the periodontal ligament and bone structure that hold the teeth in place can be destroyed.  This can cause your teeth to shift or loosen, and can affect your bite.   

Various treatment options are available, depending on how far advanced the disease is.  Sometimes deeper cleanings with special medicaments are adequate to remove the disease and stop it from progressing.  However, if the disease is advanced enough, treatment options such as bone grafts, pocket reduction surgeries, or even extractions may need to be considered.    

In advanced cases like these, Dr. Victor works with specially trained and board certified Periodontists in order to ensure the best treatment is provided.  

For more information, download the American Dental Association's brochure on Treating Periodontal Disease.

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