Periodontal Inflammation

Periodontal (or gum) inflammation is a response of the body to the onslaught of bacterial toxins and acids underneath the gums. Various factors such as diabetes, smoking, genetics, etc. can change the severity of the body’s response to these bacterial products. Inflammation results in redness and swelling of the gums. The body will send a lot of immune cells to try to remove the irritating substances that are residing in the gums. This immune response is essential for the body to ward off infections, however, in a situation where the oral hygiene is not good, the inflammatory response becomes chronic and the body is not able to return to normal health. This causes the eventual breakdown of the bone that holds the teeth in place. Symptoms of periodontal inflammation include bleeding and red gums. More advanced cases lead to loosening of the teeth and pus exuding from the gums. The by-products of inflammation eventually overtake the body’s system of repair resulting in permanent damage. The only way to break this cycle is by performing meticulous oral hygiene (simple brushing and flossing) on a daily basis.

Bleeding Gums

If you ever notice blood on your tooth brush after brushing your teeth, chances are that there is gum disease present. There should not be one drop of blood present on a brush or floss after use. These warning signs should be heeded earlier as opposed with later. Before you run to the dentist with bleeding gums, it is best to try a regimen of good oral hygiene first. Just simple but thorough brushing and flossing a couple of times a day can go a long way in stopping bleeding gums. I have actually had patients who have told me that they purposely did not floss because every time that they did, it made their gums bleed. What they didn’t realize was that by not flossing, it left the bacterial plaque behind that is the cause of the bleeding in the first place. The patients were thinking that the mechanical cleaning with the floss was what was causing the bleeding to occur, whereas, it was actually the gum disease itself that caused the problem. It may still take a trip to the dentist for a professional cleaning for the bleeding to subside. But by doing the good home care ahead of time, it can be the first step toward eliminating gum disease in your mouth.


Periodontitis is a disease of the gums and causes a majority of the tooth loss in adults. The sad part is that over 90% of the cases are preventable. Periodontitis is caused by an interaction of bacteria which reside on the teeth and the body’s immune system. The bacteria adhere to the teeth by a sticky substance called dental plaque. The plaque protects the bacteria from antibodies in saliva, thus allowing the disease to progress. Simply by removing the dental plaque everyday would stop the disease dead in its tracks. Mild periodontitis is the first step past gingivitis, a reddening of the gums. It is marked by easily bleeding gums, especially when brushing the teeth. If good oral hygiene measures are initiated, many times the disease process can be reversed. Moderate periodontitis is accompanied by some bone loss. If caught at this time a procedure called scaling and root planing can be helpful in stopping the disease progression. From this point on, any bone damage is irreversible, so it is best to catch things as early as possible. Severe periodontitis is the point where the teeth will loosen and tooth loss can occur. These cases usually require surgery to give the sufferer access to all of the affected areas for the purposes of oral hygiene. Due to the irreversibility of the bone loss, it is always best to put the disease in check by daily home care and frequent professional checkups.

Scaling and Root Planing

A gum procedure called scaling and root planing has saved millions of teeth. Periodontitis (gum disease) attacks the bone that holds the teeth in place. If left unchecked, it will eventually lead to tooth loss. If the disease is detected in its early stage, scaling and root planing can be a big help in altering the course of the disease. Periodontitis is caused by an interaction between bacteria that reside on the teeth and the body’s immune system. If the bacteria is removed on a daily basis by brushing and flossing, the disease usually does not occur. However, if the home care is not good, the bacteria will wreak havoc.

Over time, the bacteria will calcify into a material called calculus (tartar). The calculus is very porous giving a safe haven to new bacteria, so even if flossing is started, it will not clean away the bacteria residing in the tartar. Scaling will remove these deposits from the teeth.

Root planing will smooth the roots and remove diseased cementum (the live covering on the root surface). Scaling and root planing will allow the body to heal the gums and give someone a fresh start. However, the disease will return if the daily home care is not done.

Gum Disease and Heart Disease

It is becoming more and more apparent that there’s is a link between gum disease and heart disease. The link appears to have to do with inflammation. Chronic diseases such as diabetes, cardiovascular disease, Alzheimer’s disease and periodontal (gum) disease all have an inflammatory component. The general feeling at this time is that inflammatory components of gum disease can worsen plaque buildup in the arteries leading to the heart. The plaque buildup narrows the inside of those arteries, thus, restricting the blood flow.

Another theory is that bacteria that is present in periodontal (gum) pockets gets into the blood stream and attaches to the coronary arterial plaques. This theory says that that could contribute to clot formation. Studies have shown that people with periodontal disease are more than twice as likely to have coronary artery disease.

Even though theses theories haven’t been thoroughly proven, it is still a good idea to make sure that you are free of gum disease. A thorough periodontal exam by a dentist is necessary to be certain that gum disease is not present. This is because symptoms are not usually present until the later stages of the disease when irreversible bone damage occurs and the teeth start loosening.

Gum Disease and Diabetes

There is a connection between periodontal (gum) disease and controlling a diabetic’s blood sugar. A 1997 study of Pima Indians found that when gum disease was eradicated in diabetics, their blood sugar management improved. It is much easier for gum disease to gain a foothold because diabetics are more prone to infection. Thus, the two diseases feed off each other.

It has been found that diabetics who have gum disease are more prone to high blood sugar levels. Due to the fact that this relationship exists, it becomes extremely important for a diabetic to perform very meticulous home care. They should get regular dental examinations at least twice a year along with a thorough professional cleaning. Some diabetics require even more frequent cleanings, maybe up to 4 times per year, accompanied occasionally by scaling and root planing (a very deep cleaning usually done with a local anesthetic). This can be very helpful in managing blood sugar levels in a diabetic.