What is a healthy periodontium?
In health, the roots of the teeth are embedded in the jaw bone. The gum overlies the bone and wraps around the teeth forming a collar around the neck of the teeth. The gum at the neck of the teeth is pale pink and firm.
What are periodontal (gum) diseases?
Periodontal diseases are chronic infections that affect the gums and the underlying bone supporting the teeth. These infections are caused by bacteria.
Bacteria are always present in the mouth and accumulate on the tooth surfaces after meals or drinks. They form a soft, sticky mass called "plaque". Plaque is usually removed through regular tooth cleaning (brushing and cleaning between the teeth). However, if some plaque remains near the gum margin, inflammation of the gums may result (gingivitis). If not treated, this inflammation can progress to periodontal disease.
Where periodontal disease occurs, the bacteria grow down below the gum margin along the root surface. The gums detach from the tooth and form so called "pockets". As a result, the bone surrounding the teeth will retract away from the source of infection. With increasing bone destruction the tooth will loose its support. If this is left untreated it can lead to tooth loss.
Are there other factors contributing to periodontal (gum) disease?
Smoking is the most important risk factor for periodontal disease. Patients with periodontal disease who smoke tend to have higher numbers of deep gum pockets and loose more teeth than non-smokers. Stress, uncontrolled diabetes and genetics factors may also play a role in periodontal disease.
Also, increasing evidence supports an association between periodontal disease and other (systemic) diseases or complications, e.g. cardio-vascular diseases, pre-term low birth weight delivery. Treatment of periodontal disease could be beneficial in this respect.
How can you notice periodontal (gum) disease?
Periodontal disease can go on for years without pain and without detection unless specific examination procedures are performed. Patients can sometimes see that the gums are red, possibly swollen and bleed easily. Often however, only minor discomfort can be noted and the condition may remain "silent" for many years. Too often, patients notice the problem only when the bone loss around the teeth is so extensive that teeth become loose or when the gums start to recede.
The disease is diagnosed by assessing the gum in several sites around each tooth together with detailed x-ray images.
Can it be treated successfully?
Yes, if the disease is diagnosed early enough or there is sufficient supporting bone left. However, to succeed with the treatment, an optimal level of good daily oral hygiene is essential in order to keep away harmful bacteria. In addition, particular risk factors (such as smoking) need to be controlled.