1. What is it? Gingivitis? Periodontitis?

Periodontal disease is a bacterial infection of the gums and bone supporting the teeth. As masses of bacteria called plaque, build up on tooth surfaces, at and below the gum line they cause inflammation of the gums called gingivitis. When the infection spreads to the fibers connecting the gums to the teeth and to the surrounding bone and tooth ligaments it is called periodontitis. This eventually causes gum abscesses and severe bone loss which results in loosening and tooth loss.

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2. What are the risk factors? Or who gets it?

One of the most significant risk factors for severe periodontal disease is smoking. It increases the severity of the disease, the number of teeth lost and the chance of failure of all treatments. There are genetic susceptibility factors that help to explain why some people do or do not develop periodontal disease. Genetic testing and the significance it brings to treatment options is still controversial. Those people who are under long term stress will also have more bone and tooth loss. Poor oral hygiene and the lack of routine cleanings and periodontal exams leads to breakdown and tooth loss as well.

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3. My teeth and gums don't hurt me,
how can I have severe periodontal disease?

Periodontal disease can progress without any warning signs, symptoms or pain. Bleeding gums for example may be a sign of a simple gingivitis (gum infection) or a severe periodontitis (bone infection with loss of supporting bone). In many cases the first sign of a problem may be looseness or drifting teeth. At this later stage the teeth may be nearly hopeless to save.

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4. I get check ups every six months. How can I have periodontal disease?

Routine examinations and even check up x-rays are not enough to detect the presence of gum disease. Only by a comprehensive periodontal evaluation can any existing damage or infection be uncovered. A comprehensive evaluation includes a probing of each tooth at six critical places, recording the results at each place.

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5. Can bacterial plaque that accumulates under the gum cause diseases more serious than periodontal disease and tooth loss?

Possibly. There is mounting evidence that bacterial gum infection may contribute to heart disease, diabetes, stroke, and premature births to mothers with gum disease. The fact is that the bacteria themselves can easily enter the bloodstream, lodging in blood vessels and possibly other organs. While the mechanisms of these changes is not fully understood research continues to determine how strong the relationship is to these diseases. Dr. Mayo the founder of the Mayo Clinic once stated that, "Daily plaque control can add ten years to your life". He may be right, especially when regular professional care is added to it.

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6. Is there a relationship between stress, periodontal disease and holistic health?

There is indeed a relationship. As stress increases so does the likelihood for continuing breakdown of the bone that supports the teeth. That is, an increase in the severity of periodontitis.

The changes in the central nervous system that come with stress, affect the pituitary gland and it in turn affects the adrenal glands. The release of stress hormones from the adrenal can reduce or modify the immune system and inflammation to increase gum disease activity.

Everyday stresses such as financial stress have been studied and those under this type of stress had more gum attachment loss and supporting bone loss than those that did not. But those people who had appropriate coping behavior to the stress, did not have these ill effects. In other words, if we can find healthy ways to cope with every day stresses, our periodontal health can remain in tact. Therefore, things like physical exercise, self relaxation, a positive attitude and meditation or yoga will help save our teeth as well as our mental emotional health.

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