Gum disease is an infection of the tissues that support your teeth. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket: generally, the more severe the disease, the greater the depth of the pocket.

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

Gingivitis

The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called “gingivitis.” In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.

Periodontitis

When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth.”) In periodontitis, gums pull away from the teeth and form “pockets” that are infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Some factors increase the risk of developing gum disease:

• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
• Bridges that no longer fit properly
• Crooked teeth
• Fillings that have become defective
• Pregnancy or use of oral contraceptives.