Periodontal Disease
Periodontal disease is an infection of the teeth, gums, and the bone that surrounds the teeth. Most people who have periodontal
disease aren’t even aware of it, because it’s rarely painful, especially in the early stages.

What causes periodontal disease?
The main cause of periodontal disease is the accumulation of plaque. Plaque is the sticky film of food and bacteria that forms constantly on your teeth. If all of the plaque isn’t removed each day, it builds up and mineralizes to become tartar, also called calculus.

If tartar isn’t removed, it begins to accumulate on the root surfaces. Bacteria that cause periodontal disease thrive in tartar. These bacteria produce toxins, and it’s these toxins, combined with your body’s response to them, that destroy bone around your teeth. Professional help is required to remove tartar, because there’s no way to remove it at home. A toothbrush or floss won’t even budge it.

What are the warning signs?
While many people with periodontal disease experience no symptoms, others do experience warning signs that include:
• persistent bad breath
• bleeding of the gums when brushing or flossing
• soft, swollen, or tender gums
• gums shrinking away from the teeth
• loose teeth
• changes in the spaces between teeth, which may reflect changes in the underlying bone

Periodontal disease	Scaling and root planing

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Periodontal Disease & Smoking
It’s common knowledge that smoking has been linked to both lung and heart disease. To add to this, recent studies have shown that
tobacco use is likely one of the most significant risk factors in the development and progression of periodontal (gum) disease. Smokers
are more likely to have a buildup of tartar on their teeth, where disease-causing bacteria thrive.

Periodontal disease — a chronic infection
Periodontal disease is an infection that attacks the bone, gums and other soft tissues surrounding the teeth. It’s caused by plaque, a sticky, colorless film of food and bacteria that forms constantly on teeth. If it’s not removed, plaque hardens to become tartar (also called calculus) in as little as 24 hours. Your body responds to the bacteria in plaque and tartar by sending white blood cells (the body’s natural defense) to the infected area. When these white blood cells reach your gums, they release enzymes to attack the infection. Unfortunately, these protective enzymes also attack and break down the bone and soft tissue surrounding your teeth.

Left untreated, periodontal disease will worsen, causing pockets to develop between your teeth and gums. The harmful bacteria reproduce rapidly in these pockets, causing them to deepen as more bone and soft tissue are destroyed. Your teeth may become loose, painful, and may even fall out. Smoking worsens the problem by damaging the natural processes your body uses to fight the periodontal infection; it reduces saliva levels, restricts blood flow, and damages your immune system.

There is no good news
There are over 4000 chemicals in cigarette smoke, including formaldehyde, carbon monoxide, ammonia and arsenic. These and other
chemicals in tobacco can slow down the healing process and make periodontal treatment less effective. Other tobacco products, including cigars, pipes and smokeless tobacco, contain similar toxins and produce almost exactly the same results. Smokers are four times more likely to have advanced periodontal disease. The Center for Disease Control and Prevention reports that 41.3 percent of daily smokers over age 65 are toothless, compared to 20 percent of non-smokers. Tobacco users also suffer from a far greater
incidence of bad breath, mouth sores, tooth staining, and oral cancer.

Infected gums	Dental problems related to smoking	Over 4,000 chemicals

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What Is Gingivitis?
Gingivitis is the earliest, most common form of gum disease. There is usually no pain or discomfort associated with it; in fact, 75 percent of adults in the U.S. have gingivitis, and many aren’t even aware of it. Luckily, the effects of gingivitis are reversible, but this isn’t the case if it goes untreated. Gingivitis can be the gateway to periodontal disease, a much more serious condition that can lead to irreversible bone loss and ultimately, tooth loss.

Plaque is the culprit
The main cause of both gingivitis and periodontal disease is the accumulation of plaque, the sticky film of food and bacteria that forms
constantly on your teeth. You must remove all of the plaque each day, or it builds up and mineralizes to become tartar. Bacteria that thrive in tartar produce toxins; it’s these toxins, combined with your body’s reaction to them that destroy bone around your teeth. Once bone has been lost, it never grows back.

When too much bone is lost, there’s little support for the teeth. They get loose and have to be removed. That’s why it’s vital that we treat gingivitis early, before it can progress and cause irreversible damage.

The symptoms of gingivitis
Though most people aren’t aware that they have gingivitis, the warning signs are redness where the gums meet the teeth, swollen gums, bleeding when brushing and flossing, and persistent bad breath. To determine whether or not you have gingivitis, we’ll perform a thorough examination. We’ll look for any changes in the shape, color or contour of your gums, and we’ll determine if any bleeding occurs when we gently probe them.

Treating gingivitis
If we determine that you do have gingivitis, treatment will always include a professional cleaning, which removes plaque from teeth. We'll also get you started on an effective, consistent homecare regime, and a revisit schedule. In some cases, additional steps are required, which could include using a disclosing solution to determine where the plaque is, a review of the proper use of floss as well as a manual or electric toothbrush, and using an antibacterial rinse to help kill destructive bacteria.

Most common form of gum disease	Plaque stained red	The perio probe

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