What is periodontal disease?
Periodontal disease is an infection of the tissues that support your teeth

What causes periodontal disease?
The sticky film that constantly forms on your teeth is called plaque, and is made mostly of bacteria. Some of these bacteria produce byproducts (called toxins or enzymes) that can irritate the tissues that support your teeth. These byproducts can damage the attachment of the gums, periodontal ligament, and bone to your teeth.
You can remove plaque with good oral hygiene - brushing your teeth twice a day and cleaning between them once a day with floss or another interdental cleaner. When plaque is not removed through good oral hygiene, it builds up along the gum line and increases the risk of developing periodontal disease.
Plaque that is not removed regularly can harden into a rough porous deposit called calculus, or tartar. Tartar itself does not seem to cause the disease, but it may make it more difficult for you to remove plague so it should be removed regularly. Tartar only can be removed when your teeth are professionally cleaned in the dental office.

Do some factors increase the risk of developing periodontal disease?
Yes. Some factors can increase the risk of developing periodontal disease. If one or more of the following apply to you, it is especially important that you practice good oral hygiene and follow your dentist's advice to maintain healthy teeth and gums.

• People who smoke or chew tobacco are more likely to have periodontal disease. And it's more likely to be more severe than in those who do not use any tobacco products.

• Some systemic diseases, such as diabetes, can lower your body's resistance to infection, making periodontal diseases more severe.

• Many medications, such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives can affect the gums. In addition, medications that reduce your salivary flow can result in a chronically dry mouth, which can irritate your oral soft tissues. Let your dentist know about your medications and update your medical history files at the dental office when any changes occur.

• Bridges that no longer fit properly, crooked teeth or fillings that have become defective can contribute to plaque retention and increase the risk of developing periodontal disease.

• Pregnancy or use of oral contraceptives increases hormone levels that can cause gum tissue to be more sensitive to the toxins and enzymes produced by plaque and can accelerate growth of some bacteria. The gums are more likely to become red, tender and swollen, and bleed easily.

How would I know if I have periodontal disease?
It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important.
However, several warning signs can signal that you have a problem with periodontal disease. If you notice any of the following, see your dentist.

• Gums that bleed easily;

• Red, swollen, or tender gums;

• Gums that have pulled away from the teeth;

• Pus between the teeth when the gums are pressed;

• 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
  

Types of periodontal diseases
Periodontal diseases are classified according to the severity of the disease. The two major stages of the disease are gingivitis and periodontitis.

Healthy Tooth

Gingivitis
Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. It develops as toxins in plaque that irritate gums, making them red, tender, swollen, and likely to bleed easily. It can usually be eliminated by daily brushing, cleaning between your teeth, and regular dental cleanings.

Periodontitis
Gingivitis may lead to more serious, destructive forms of periodontal disease, called periodontitis. there are several forms of periodontitis, with the most common being chronic adult periodontitis.
Periodontiits occurs when toxins, enzymes, and other plaque byproducts destroy the tissues that anchor teeth into the bone. The gum line recedes, which can expose the tooth's root. Exposed roots can become susceptible to decay and sensitive to cold and touch.
As we mentioned earlier, the sulcus deepens into a pocket in the early stage of periodontal disease. Plaque that collects in these pockets can be difficult to remove during regular brushing and interdental cleaning. Byproducts from the plaque that collect in these pockets can continue to damage the gums, periodontal ligament, and bone. In some cases, so much ligament and bone are destroyed that the tooth becomes loose. Usually, your dentist can still treat the disease at this point.

In the worst of cases, a loose tooth may need to be extracted or may fall out on it's own.

How can I prevent periodontal disease?
Daily good oral hygiene can help reduce your risk of developing periodontal diseases.

Brush your teeth twice a day, with proper brushing, you can remove plaque from the inner, outer and chewing surfaces of each tooth. Your dentist or dental hygienist can show you a proper brushing technique.

Carefully clean between your teeth once a day with dental floss or another interdental cleaner to remove plaque from areas your toothbrush can't reach. It only takes a few minutes each day and is just as important in maintaining oral health as brushing your teeth.

if you need extra help controlling gingivitis and plaque that forms above the gum line, your dentist may recommend using an ADA-accepted antimicrobial mouthrinse or other oral hygiene aids as an effective addition to your daily oral hygiene routine.

When choosing dental care products, look for those that display the American Dental Association's Seal of Acceptance - your assurance that they have met ADA standards of safety and effectiveness.

Eat a balanced diet for good general health

Visit your dentist regularly.

How do I prevent periodontal disease form recurring?
Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. Your dentist also will want to see you at regular intervals. You may need to schedule more frequent visits than you have in the past.