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Understanding Gum (Periodontal) Disease

Periodontal disease affects millions of Americans. Are you one of them?

By Dr. Max A. Listgarten


The Immune System: Balance is Key

The immune system is the body's way of protecting itself against disease. It is made up of a complex recognition and response system to bacteria or other pathogenic (disease-causing) organisms. Specific antibodies to these organisms enhance the effectiveness of the body's defenses against these bacteria.

One of the major defensive responses mediated by the immune system is inflammation of the gums, usually the first tell tale sign of periodontal disease to be observed. This inflammation is actually the immune system at work, trying to isolate the disease-causing bacteria and prevent spread to other parts of the body. Defense cells get rid of the offending bacteria and promote the repair of damaged tissues.

Certain groups of people carry genes that may predispose them to periodontal and other inflammatory disease.

Unfortunately, the body's immune system can be influenced by a number of factors, heredity being one of the most critical. Certain groups of people carry genes that may predispose them to periodontal and other inflammatory diseases. Family history of periodontal disease may be an important clue, since we inherit our genes from previous generations. Genetic testing has recently been developed that helps identify such people.

Another impediment to the immune system is stress, brought on by physical illness or severe emotional distress. Stress can affect the immune system by lowering resistance, which impedes the ability of the immune system to fight periodontal disease.

Signs and Symptoms of Periodontal Disease

As mentioned before, the first signs of periodontal disease usually begin with gingivitis; the gums appear reddened at the margins, slightly swollen and bleed when gently provoked by tooth brushing or flossing. It is often thought that brushing too hard causes bleeding gums — however, bleeding from the gum tissues is not normal and should be taken as a warning sign.

Bad breath and taste are also commonly associated with periodontal disease. As the disease progresses the gum tissues begin to recede, exposing root surfaces which may cause tooth sensitivity to temperature and pressure change. Gum tissues may start to lose their normally tight attachment to the tooth causing pocket formation, detectable by a dentist during periodontal probing. As pocket formation progresses, supporting bone loss may be noted around the teeth.

Abscess formation, the collection of pus pockets denoted by pain, swelling and discharge from the gum tissues is a later sign of disease. Ultimately looseness and drifting of teeth occur as bone is lost in more advanced degrees of disease and may also be apparent as eating becomes more difficult or uncomfortable.


Early periodontal disease can be detected by your general dentist during routine and regular dental checkups. He or she can physically and visually evaluate the gingival tissues, probe to determine whether the attachment levels to the teeth are normal or abnormal, and evaluate bone health through dental radiographs (x-rays).

Depending on the findings, your dentist may also refer you to a periodontist, a dentist specializing in the diagnosis and treatment of periodontal diseases. A periodontist will interact with a general dentist and other dental specialists in planning and treating periodontal and bite problems to achieve optimum periodontal health and a functional and esthetic result.