Periodontal Disease

What is periodontal disease?

Periodontal diseases are mainly the result of infections and inflammation of the gums and bone that surround and support the teeth. In its early stage, called gingivitis, the gums can become swollen and red, and they may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out. Periodontal disease is mostly seen in adults. Periodontal disease and tooth decay are the two biggest threats to dental health.

A recent CDC report¹ provides the following data related to prevalence of periodontitis in the U.S.:

• 47.2% of adults aged 30 years and older have some form of periodontal disease.
• Periodontal disease increases with age, 70.1% of adults 65 years and older have periodontal disease.

This condition is more common in men than women (56.4% vs 38.4%), those living below the federal poverty level (65.4%), those with less than a high school education (66.9%), and current smokers (64.2%)

Causes

Bacteria in the mouth infect tissue surrounding the tooth, causing inflammation around the tooth leading to periodontal disease. When bacteria stay on the teeth long enough, they form a film called plaque, which eventually hardens to tartar, also called calculus. Tartar build-up can spread below the gum line, which makes the teeth harder to clean. Then, only a dental health professional can remove the tartar and stop the periodontal disease process.

Warning signs

The following are warning signs of periodontal disease:

• Bad breath or bad taste that won't go away
  
• Red or swollen gums
  
• Tender or bleeding gums
  
• Painful chewing
  
• Loose teeth
  
• Sensitive teeth
  
• Gums that have pulled away from your teeth
  
• Any change in the way your teeth fit together when you bite
  
• Any change in the fit of partial dentures

Risk factors

Certain factors increase the risk for periodontal disease:

• Smoking
  
• Diabetes
  
• Poor oral hygiene
  
• Stress
  
• Heredity
  
• Crooked teeth
  
• Underlying immuno-deficiencies—e.g., AIDS
  
• Fillings that have become defective
  
• Taking medications that cause dry mouth
  
• Bridges that no longer fit properly
  
• Female hormonal changes, such as with pregnancy or the use of oral contraceptives

Prevention and treatment

Gingivitis can be controlled and treated with good oral hygiene and regular professional cleaning. More severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. Such treatment might include deep cleaning of the tooth root surfaces below the gums, medications prescribed to take by mouth or placed directly under the gums, and sometimes corrective surgery.

To help prevent or control periodontal diseases, it is important to:

1. Brush and floss every day to remove the bacteria that cause gum disease.
   
2. See a dentist at least once a year for checkups, or more frequently if you have any of the warning signs or risk factors mentioned above.

If you can't afford dental care, you may be able to find help through the following sources:

• The Health Resources and Services Administration supports a network of "safety net" clinics for people who qualify for reduced-cost care, and many have a dental clinic (toll free: 1-888-275-4772).
  
• Most dental schools have a clinic staffed by the professors and students, where care is provided based on your ability to pay.
  
• Your state dental organization may be able to refer you to dentists in your area who provide care at a reduced rate.

What is the CDC doing about periodontal disease?

The CDC is currently working with key partner organizations such as the American Academy of Periodontology and the American Dental Association to improve and sustain surveillance of periodontal disease in the adult U.S. population. The efforts of the CDC include (1) developing measures for use in surveillance of periodontal disease at the state and local levels, (2) improving the validity of prevalence estimates derived from the NHANES (National Health and Nutrition Examination Survey) by improving the accuracy of the clinical examination protocols used in this national survey, and (3) developing simple measures for screening for periodontal disease in clinical settings.

For additional background related to CDC activities, please click on the links listed:

Eke PI, Thornton-Evans G, Dye BA, Genco R. Advances in Surveillance of Periodontitis: The Centers for Disease Control and Prevention Periodontal Disease Surveillance Project. J Periodontol 11 February 2012: 1–9. View full text.

Eke PI, Page PC, Wei L, Thornton-Evans G, Genco RJ. Update of the Case Definitions for Population-Based Surveillance of Periodontitis. J Periodontol 16 March 2012:1–9. View full text.

Eke PI, Thornton-Evans G, Wei L, Borgnakke WS, Dye BA. Accuracy of NHANES Periodontal Examination Protocols. J Dent Res 2010;89(11): 1208–1213. View abstract.
 

Podcasts About Periodontal Disease and Diabetes

Listen to Summary: Periodontal Disease and Diabetes Podcast. Provides valuable information on the impact of periodontal disease and its link to diabetes (Length 1:36). View transcript.

Listen to Periodontal Disease and Diabetes Podcast. Informative interview of two dental professionals about periodontal disease, diabetes complications, and the influence of poor oral health on blood glucose control (Length 5:33). View transcript.

Additional Resources

Periodontal (Gum) Diseases: Causes, Symptoms and Treatment. [PDF–1.26 M]. National Institute of Dental and Craniofacial Research consumer brochure. Bethesda, MD. Reprinted January 2006.

American Academy of Periodontology

Journal articles on periodontal disease

Reference

¹Eke PI, Dye B, Wei L, Thornton-Evans G, Genco R. Prevalence of Periodontitis in Adults in the United States: 2009 and 2010. J Dent Res. Published online 30 August 2012:1–7. View full text.

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