Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Periodontal Disease
When to See a Periodontist
Periodontal treatment may be sought in several ways. Your general dentist or a hygienist may recommend a consultation with a periodontist if they find signs of periodontal disease through the course of a checkup or other dental care appointment. You may also decide to see a periodontist on your own, as a referral is not necessary to be seen at our office.
In fact, if you experience any of these symptoms, we encourage you to schedule an appointment at our office without delay:
- Unexplained bleeding while performing regular cleaning or consuming food is the most common sign of a periodontal infection.
- Ongoing halitosis (bad breath), which continues despite rigorous oral cleaning, can point to periodontitis, gingivitis or the beginnings of a gum infection.
- Longer-looking and loose-feeling teeth can indicate recession of the gums and/or bone loss as a result of periodontal disease.
Patients with heart disease, diabetes, osteopenia or osteoporosis are often diagnosed with correlating periodontal infections. The bacterial infection can spread through the blood stream, affecting other areas of the body.
- Bleeding while brushing or eating normal foods
- Bad breath
- Loose teeth and gum recession
- Related health concerns
What is Periodontal Disease?
Periodontal disease is a chronic infection of the periodontal or gum tissue. This infection is caused by the presence of a bacterial film, which is called dental plaque, that forms on the teeth surfaces. Bacteria that found in dental plaque produce toxins which irritate the gums. They may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. With periodontal disease, bleeding, redness and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum and jawbone of more than 80% of Americans by age 45. Each case is looked at individually, because in addition to plaque there are co-factors such as genetics, smoking, and overall health, which contribute to disease severity. Once periodontal disease is detected, our goal as therapists is to provide information and treatment necessary to control/ or arrest the active infection, and help keep the disease in an inactive or controlled state.
However, don’t be fooled!
With periodontal disease, bleeding, redness and swelling do not have to be present. The periodontal disease symptoms of inflammation may only be evident with sub gingival probing. Further, pain is usually not associated with periodontal disease.
Diabetes is a group of chronic inflammatory diseases that affect the body's ability to process sugar. If you have diabetes, it is particularly important to maintain excellent oral health. That's because diabetics are more prone to oral infections such as periodontal (gum) disease, which can result in tooth loss if left untreated. Conversely, the presence of gum disease can make it harder for people with diabetes to control their blood sugar levels.
Periodontal disease is a chronic ailment that is also associated with an elevated level of systemic (whole-body) inflammation. Like diabetes, it may have wide-ranging consequences outside the mouth — possibly increasing a person's chance of experiencing major cardiovascular events (such as heart attack or stroke) or adverse pregnancy outcomes (low birth weight and pre-term delivery). So perhaps it's not surprising that a growing body of evidence suggests the two diseases are related.
Two Diseases With A Lot In Common
It has long been recognized that having diabetes is a risk factor likely to increase the severity of periodontal disease. That's because diabetes reduces the body's resistance to infection, making diabetics more susceptible to both bacterial and fungal infections. Likewise, evidence shows that having serious gum disease (periodontitis) is likely to result in worsening blood glucose control in diabetics; it can also increase the risk of diabetic complications. So, what's the connection?
While no one is sure at present, the two diseases seem to share some common pathways and disease-causing mechanisms. Both are associated with the process of inflammation and the immune response. Inflammation itself — often signaled by pain, heat and redness — is evidence of the body's immune system at work, attempting to fight disease, repair its effects, and prevent it from spreading. Chronic or prolonged inflammation, however, can lead to serious problems in different parts of the body and a decline in overall health.
What does this mean to you? According to one large study, if you're diabetic, your risk of dying from heart attack is over twice as great if you also have severe periodontitis — and for kidney disease, your risk is 8.5 times higher! Plus, uncontrolled periodontal disease makes it six times more likely that your ability to control blood sugar levels will get worse over time. So not only can having one condition put you at risk for worsening the other — having both can cause a significant deterioration in your overall health.
A Two-Way Street
While diabetes can't be cured, it's possible to manage the disease on a long-term basis. And here's some good news: Clinical studies show that diabetics who get effective treatment for their periodontal disease also receive some significant benefits in their general health. Many exhibit better blood glucose control and improved metabolic functioning after periodontal treatment.
What kinds of treatments might be needed? While much depends on the individual situation, some typical procedures might include: scaling and root planing (a deep cleaning that removes plaque bacteria from teeth, both above and below the gum line); antibiotic therapy; and oral hygiene self-care instruction.
Likewise, if you're at risk for diabetes but haven't yet developed the disease, there are some things you can do to forestall it. While there is a significant genetic component, a major risk factor for diabetes is being overweight — so keeping your weight under control will better your chances of avoiding it. High levels of triglycerides or low levels of HDL (good) cholesterol are also risk factors. These may respond to changes in your diet — like cutting out sugary drinks and eating healthier foods. Also, high blood pressure coupled with an inactive lifestyle puts you at greater risk. Here, moderate exercise can help.
When you come to our office, be sure to let us know if you're being treated for, or are at risk of developing diabetes. And if you are managing the disease, remember that it's more important than ever to maintain good oral health.
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