Understanding Gum disease

Causes and Stages of Periodontal Disease

What causes periodontal disease?

Bacteria are the initial cause of periodontal disease. Bacteria form in plaque, which is a sticky, almost invisible film that forms over the teeth and destroys bone. Plaque that is not removed by regular brushing and flossing hardens into tartar over time. You cannot remove tartar (or calculus) on your own. The only way to remove tartar is by a procedure called scaling, which is done by a dentist/hygienist.

What are the stages of periodontal disease?

Stage 1. Gingivitis

In this early stage, your gums may look normal but they also may be red, puffy, and bleed easily when you brush your teeth. You may also notice some mouth odor. This is because bacteria in plaque have caused infection.

Stage 2. Early Periodontitis

Early periodontitis occurs when the bacterial infection spreads from the gum to the bone that supports the teeth. High levels of bacteria initiate a release of tissue-destroying enzymes. The bacteria and enzymes then cause small spaces, or crevices, to form between the gums. These crevices are called pockets. They are deeper than normal spaces, which measure 1 to 3 mm deep. As the pocket deepens and the amount of bacteria and enzymes increases, the gums recede down the root of the tooth, increasing the pocket depth. Your dentist measures how deep your pocket is with an instrument called a periodontal probe, which is placed in the gum crevice.

Stage 3. Moderate Periodontitis

When the gum attachment progresses further down the root, it is called moderate periodontitis. In this stage, up to one-third of your bone has been lost.

Stage 4. Advanced Periodontitis

When half or more of the original bone holding the tooth has been lost, and pockets are very deep, it is called advanced periodontitis. The tooth may appear longer because the root is exposed, and the tooth may loosen and eventually fall out, or have to be removed by your dentist.