Periodontal Disease

What is periodontal disease?

Periodontal diseases are infections of the gums and bone that surround and support the teeth. In its early stage, called gingivitis, the gums can become swollen and red, and they may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or even fall out. Periodontal disease is mostly seen in adults. Periodontal disease and tooth decay are the two biggest threats to dental health.

Causes

Bacteria in the mouth infect tissue surrounding the tooth, causing inflammation around the tooth leading to periodontal disease. When bacteria stay on the teeth long enough, they form a film called plaque, which eventually hardens to tartar, also called calculus. Tartar build-up can spread below the gum line, which makes the teeth harder to clean. Then, only a dental health professional can remove the tartar and stop the periodontal disease process.

Warning signs

The following are warning signs of periodontal disease:

• Bad breath or bad taste that won't go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Gums that have pulled away from your teeth
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures

Risk factors

Certain factors increase the risk for periodontal disease:

• Smoking
• Diabetes
• Poor oral hygiene
• Stress
• Heredity
• Crooked teeth
• Underlying immuno-deficiencies—e.g., AIDS
• Fillings that have become defective
• Taking medications that cause dry mouth
• Bridges that no longer fit properly
• Female hormonal changes, such as with pregnancy or the use of oral contraceptives

Prevention and treatment

Gingivitis can be controlled and treated with good oral hygiene and regular professional cleaning. More severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. Such treatment might include deep cleaning of the tooth root surfaces below the gums, medications prescribed to take by mouth or placed directly under the gums, and sometimes corrective surgery.

To help prevent or control periodontal diseases, it is important to:

1. Brush and floss every day to remove the bacteria that cause gum disease.
2. See a dentist at least once a year for checkups, or more frequently if you have any of the warning signs or risk factors mentioned above.

If you can’t afford dental care, you may be able to find help through the following sources:

• The Health Resources and Services Administration supports a network of "safety net" clinics for people who qualify for reduced-cost care, and many have a dental clinic (toll free: 1-888-275-4772).
• Most dental schools* have a clinic staffed by the professors and students, where care is provided based on your ability to pay.
• Your state dental organization* may be able to refer you to dentists in your area who provide care at a reduced rate.

What is the CDC doing about periodontal disease?

The CDC is currently working with key partner organizations such as the American Academy of Periodontology and the American Dental Association to improve and sustain surveillance of periodontal disease in the adult U.S. population. The efforts of the CDC include (1) developing measures for use in surveillance of periodontal disease at the state and local levels, (2) improving the validity of prevalence estimates derived from the NHANES (National Health and Nutrition Examination Survey) by improving the accuracy of the clinical examination protocols used in this national survey, and (3) developing simple measures for screening for periodontal disease in clinical settings.

CDC collaborations related to periodontal disease and diabetes

The National Diabetes Education Program (NDEP) is a joint program of the CDC and the NIH (National Institutes of Health). The CDC regularly collaborates with a workgroup within NDEP called PPOD (Pharmacy, Podiatry, Optometry, and Dental Professionals). PPOD develops and promotes materials to educate patients and fellow dental professionals on the disease and how to prevent a major complication that often results from having diabetes—periodontal disease.

Available educational materials for dental professionals include:

• Working Together to Manage Diabetes: A Guide for Pharmacists, Podiatrists, Optometrists, and Dental Professionals, 2007
• Diabetes Medication Supplement, 2007
• Working Together Poster (English version)
• Working Together Poster (Spanish version)

Podcasts About Periodontal Disease and Diabetes

Listen to Summary: Periodontal Disease and Diabetes Podcast. Provides valuable information on the impact of periodontal disease and its link to diabetes (Length 1:36). View transcript.

Listen to Periodontal Disease and Diabetes Podcast. Informative interview of two dental professionals about periodontal disease, diabetes complications, and the influence of poor oral health on blood glucose control (Length 5:33). View transcript.

Additional Resources

Periodontal (Gum) Diseases: Causes, Symptoms and Treatment. (PDF–1.26 MB). National Institute of Dental and Craniofacial Research consumer brochure. Bethesda, MD. Reprinted January 2006.

Periodontal (Gum) Diseases*: American Dental Association consumer fact sheet.

American Academy of Periodontology*

Journal articles on periodontal disease

One or more documents on this Web page is available in Portable Document Format (PDF). You will need Acrobat Reader to view and print these documents.

* Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.