I am Fran Sánchez-Alcaraz, periodontist at Vélez y Lozano. If your answer is yes to any of these questions, this article will be of interest to you, because we will review what it consists of, and what its most frequent manifestations are.

What is periodontal disease?

Periodontal disease is the medical term for gum disease. The first stage is gingivitis, which is a milder form, which if left untreated progresses to the more serious pathology of periodontitis, which can lead to gum pain, infection and even tooth loss.

Periodontal disease is one of the ten most common diseases affecting humans and the leading cause of tooth loss among adults, so it is important to be aware of the disease and how it can develop. 

The gum disease often does not hurt or cause discomfort, but instead presents as redness, swelling, bleeding or receding gums. This often causes us to overlook it and not seek help as quickly as we should.

What are the causes?

Gum disease or periodontal disease is caused by the action of bacteria that normally live in equilibrium in the mouth. On some occasions, due to incorrect oral hygiene, an overgrowth of these bacteria occurs in spaces that are difficult to access, such as the space between gums and teeth, or between tooth and tooth.

In addition to hygiene, there are other factors that aggravate the disease:

  • Tobacco, increases the risk of periodontitis by a factor of three.
  • Stress.
  • Systemic diseasessuch as diabetes.
  • Low defences.
  • Hormonal changessuch as those that occur during pregnancy or menopause.
  • Genetic factors.

What are the symptoms of periodontitis?

I mentioned before that the symptoms are not always very noticeable, and it does not usually hurt very much, so it is important to go to our dentist if we find any of the following discomforts:

  • Bleeding gumsspontaneous or during brushing, and redness. 
  • Bad breath.
  • Hypersensitivity to cold.
  • Loss of gum or perception of longer teeth.
  • Mobility or separation of teeth.
  • Development of abscesses or phlegmons in the gum.

However, in smokers, the disease is usually diagnosed later, as smoking reduces blood flow, so bleeding gums sometimes do not appear until later stages of the disease. Smokers should therefore pay special attention to the health of their gums, in addition to trying to quit smoking.

What complications can this entail?

Periodontitis also affects general health, as there is scientific evidence that periodontitis is associated with increased vascular risk, decompensation of diabetes, respiratory infections and even premature birth.

  • DiabetesDiabetes and periodontitis have an important bidirectional relationship and if not managed together, can be counterproductive to good health and a better life. Like any other infectious pathology, periodontitis alters the metabolic-endocrine status of people. Thus, diabetic patients are more at risk of suffering from periodontitis and periodontitis can initiate or increase insulin resistance, as shown by multiple scientific studies, complicating or hindering glycaemic control. 
  • Cardiovascular diseasePeriodontitis is a risk factor for the development of arteriosclerotic cardiovascular disease. Atherosclerosis is a fundamentally inflammatory disease and it has been shown that uncontrolled infectious or inflammatory foci, such as those caused by periodontitis, cause it to progress and may even trigger more acute processes, such as severe coronary syndromes. Some of the germs that cause periodontal disease have been found to be present in the atheromatous plaques in blood vessels. This is because, in untreated periodontitis, bacteria, toxins and other inflammatory elements can be released into the bloodstream and can cause problems in other parts of the body. The presence of these elements in the coronary arteries triggers a clogging process, increasing the risk of heart attack.

Although periodontitis is a chronic and progressive disease, the good news is that it can be treated, and above all prevented. We will talk about this in my next article.