Periodontal disease is an infection of the tissue that supports your teeth. The connection between your teeth and the gums is not as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Bacteria that cause periodontal disease can attach just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissue to break down. As the tissues are damaged, the sulcus develops into a pocket. The more severe the disease, the greater the depth of the pocket. Periodontal (gum) disease is a leading cause of tooth loss and may be associated with other chronic diseases, including diabetes, heart disease and pregnancy problems. According to the American Dental Association, most adults have some form of gum disease and do not even realize it.
The sticky film that constantly forms on your teeth is called plaque, and it is mostly made of bacteria. Some of these bacteria produce by-products (called toxins or enzymes) that can irritate the tissues that support your teeth. These by-products can damage the attachment of the gums, periodontal ligament and bone to your teeth.
Gingivitis is the mildest form of periodontal disease. It causes the gums to become red and swollen and to bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care. Factors that may contribute to gingivitis include: diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection and certain medication use.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen, and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.