Periodontal disease is an inflammatory disease affecting the soft tissue and hard structures supporting the teeth. It also is the leading cause of tooth loss in adults.

Periodontal disease, also called gum disease, begins with plaque accumulation. Plaque is a sticky bacterial substance that results when sugars and starches interact with already present bacteria in your mouth. Proper brushing and flossing may remove accumulated plaque, but when left on teeth for more than three days, it can turn into tartar, or calculus, which can only be removed by a dental hygienist.

Toxins secreted by plaque and tartar accumulation initially trigger gum inflammation, also known as gingivitis. Gingivitis is the mildest form of periodontal disease. If this inflammation is left untreated, it will eventually cause pockets where plaque, tartar and bacteria collect between the teeth and gums. The bacteria in the plaque destroys the tooth’s supporting root structure, and toxins contribute to additional inflammation, which causes pockets to become deeper. This stage is called periodontitis, or periodontal disease. Eventually, enough tissue and bone loss can occur that the patient begins to lose teeth, and supporting bone deteriorates.

Risk factors of gum disease include:

  • Smoking – inhibits healing process.
  • Pregnancy – gums are more sensitive and prone to gingivitis during hormonal fluctuations such as those that occur when women are pregnant. We advise pregnant women to have cleanings every three to four months during their pregnancy.
  • Diabetes – patients suffering from diabetes are at higher risk for developing infections like gum disease.
  • Medications – certain medications can affect the flow of saliva, which protects your mouth from decay by lowering its pH.
  • Genetic susceptibility – some patients are more prone to developing gum disease than others.
  • Poor oral hygiene – contributes to plaque accumulation.

Signs that you may have gum disease include:

  • Chronic bad breath
  • Red, swollen gums
  • Bleeding gums
  • Loose teeth
  • Sensitive teeth
  • Receding gum line (teeth may appear longer)


The main goal of periodontal treatment is to control the infection. This often begins with scaling and root planing, which is a deep-cleaning method used to physically remove bacteria and tartar that contribute to the periodontitis. Scaling refers to scraping away tartar from above and below the gum line. Root planing is the process of inserting an instrument below the gum line to smooth rough spots on tooth roots where bacteria and germs gather.

Antibiotics, antiseptic chips (inserted below gum line) or an antimicrobial mouth rinse are prescribed following the deep cleaning to prevent infection while the gums heal. Patients must adhere to a strict home oral care regimen to protect their at-risk gums, and will likely need to schedule checkups every three to four months so their condition can be monitored.

If you have lost your teeth due to periodontal disease, you may be a candidate for implants. Dr. Rob Allen is a Raleigh dentist who collaborates with an experienced team to determine the best treatment option. If dental implants are recommended, he can restore them once the implants have integrated themselves into the jawbone.

Periodontitis is a serious disease that puts more than your teeth at risk. Other risks associated with periodontal disease include low birth weight in babies, heart disease and stroke. Schedule a checkup today if you are showing signs of periodontal disease.