What Causes Periodontitis?

Periodontitis is the end result of a complex interaction between the bacteria (or plaque) that accumulates on tooth surfaces and your own body's efforts to fight this bacterial infection. Everyone has bacteria in their mouth; if you follow normal oral hygiene procedures and see your dentist regularly, under most circumstances these bacteria live in balance with your body's defense mechanisms. However, if the bacteria build up on the tooth near the gums, and particularly if your body's defense mechanisms are compromised, then an imbalance can arise and your gums will become red and inflamed. This inflammation, if left untreated, eventually results in damage to the ligaments and bone which hold your teeth in place, and in the worst cases can cause the teeth to become loose or to be lost.

The Progression of Gum Disease

In its earliest stages, gum disease is referred to as gingivitis inflammation of the gums. Every day a clear sticky film called plaque builds up on the surface of the tooth. Plaque is made up of bacteria and their secretions, and it is easily removed by proper home care. However, if plaque is allowed to build up, then eventually the gum tissue in contact with the plaque becomes red and inflamed. You may have observed that sometimes your gums bleed when you brush your teeth. This is because of the inflammation, and is often the first sign that you have the earliest stages of periodontal disease.

If the plaque is not removed, it hardens into deposits called tartar or calculus, which cannot be removed by just brushing and flossing. These deposits and their associated bacteria can cause a more severe form of inflammation as your body tries to fight the infection. One of the most important tools your body has to fight infection are white blood cells, which are loaded with substances designed to help the white cell get out of the bloodstream and pass through the gum tissue to then kill the bacteria. Some of these substances, known as enzymes, have an unfortunate side effect they can attack your body's own tissues.

In the case of gum disease, the long-term, chronic nature of the infection means that these tissue-destroying enzymes build up. Eventually they start to eat at the ligaments and bone which support your teeth. First, a small "pocket" forms between the tooth and the gum where food can be lodged and bacteria can live. If left undisturbed, the bacteria will continue to cause inflammation and tissue destruction, and they will gradually move down the tooth surface. This results in tooth pockets that get deeper and deeper. The depth of the pocket is a good measure of the severity of your disease. If pockets are deep and bone loss is evident, this stage of gum disease is known as periodontitis.

Eventually, if left untreated, the disease progresses to the point where the bone loss is so severe that the tooth becomes loose, and in the worst case, is lost. However, don't despair. If your condition is treated early and aggressively by our office, it is possible to slow the progression of the disease.