Periodontal disease is a
chronic bacterial infection that affects the gums and the
bone supporting the teeth. This infection may be influenced
not only by oral health factors but also by other diseases
like diabetes or cardio-vascular diseases. Smoking, stress
and genetic factors may also support periodontal disease.
Sometimes, the association between periodontal disease and
other (systemic) diseases goes in both directions: this
means that not only periodontal disease can be influenced by
other diseases but that also periodontal disease might have
a strong impact on the course of systemic diseases.
If the plaque which contains the
bacteria is not regularly removed through good oral health
care and by professional means, an inflammation of the gums may be the
result. The patient and/or the dentist can see that the gums
are red, slightly swollen and bleed easily. This early form
of periodontal disease is called gingivitis.
Gingivitis can be reversed into a healthy state thanks to
professional tooth cleaning followed by improved oral home
care by the patient.
As gingivitis does usually not cause particular discomfort
for the patient, this condition does not cause him or her to
see a dentist. Also, bleeding gums are traditionally
considered as being quite "normal" and not recognized as the
symptom of the disease. In some cases, even dentists do not
diagnose gingivitis unless the patient complains about
If gingivitis is not treated, it
can advance to periodontitis. Plaque and its bacterial
population will go deeper and deeper down below the sulcus
area. The inflammatory response of the body will cause the
gums (and finally also the bone surrounding the teeth) to
retract and separate from the teeth. Spaces between the gums
and the teeth are formed, the so-called pockets. Even at
this time, the patient may just feel minor discomfort. Too
often, he or she will go and see the dentist only when the
bone around the teeth has so much decreased that one or
several teeth become loose.
Following conservative estimates,
more than 50% of the general population have gingivitis
which already should be treated by the dentist (professional
tooth cleaning). At least one third of the population
suffers from a mild or advanced form of periodontitis.
This means that the treatment need worldwide is enormous! It
goes without saying that
specialized periodontists play an
important role, especially in severe cases. However, in
order to give treatment to the very high number of people
concerned by moderate forms of periodontal disease
(including gingivitis), general practitioners and dental
hygienists are indispensable.