Signs and Symptoms of Periodontal Disease

There are well known warning signs of periodontal disease


There are well known warning signs of periodontal disease. However, periodontal disease can progress without any signs or symptoms. That is why it is very important to have regular dental check-ups and periodontal screenings.

Gingival inflammation and bone destruction are often painless, and many individuals experience little or no discomfort in the early stages of periodontal disease. Often the disease has progressed significantly before an individual realizes there is a problem or seeks treatment.

Do you suffer from any of the problems?

  • Red, swollen, or painful gums
  • Bleeding when brushing, flossing, or eating hard foods (such as apples)
  • Receding gums, resulting in teeth looking longer
  • Halitosis (bad breath) or a persistent metallic taste in the mouth
  • Loose or shifting teeth
  • Deep pockets between the teeth and gums
  • Pus between the teeth and gum tissues

Causes of Periodontal Disease

Poor Oral Hygiene

There are both genetic and environmental factors associated with the onset of periodontal (gum) disease. By becoming aware of these factors and by taking preventative measures to avoid gum disease you can significantly lower your risk of developing periodontal disease. The best way to prevent gum disease from starting is with good oral hygiene at home. Daily brushing and flossing removes plaque from the teeth and prevents the accumulation of bacteria and toxins. However, the teeth can accumulate a plaque biofilm below the gum line which is not cleansable by brushing and flossing alone. If the biofilm is allowed to accumulate for too long it will turn into a hard calculus which cannot be removed by the patient. Once calculus forms, only a dental professional can remove it. It is imperative that plaque biofilm be disrupted by a hygienist or dentist on a regular basis to prevent the onset of gum disease. Excellent home care, coupled with regular dental exams and professional cleanings, are the key to good oral health.

Genetic Predisposition

Despite excellent oral hygiene practices, research has shown that nearly 30% of the population may be genetically predisposed to developing gum disease. Regular dental screenings and early intervention are essential to maintaining a healthy oral cavity in these genetically susceptible individuals. Genetically predispositioned patients should see a periodontist every 2 to 3 months for biofilm removal.

Tobacco Use

Research has shown that smoking is one of the major factors contributing to the development and progression of gum disease.Not only are smokers more likely to suffer from calculus accumulation, deep periodontal pockets, and bone loss, smokers also have slower recovery and healing rates. During periodontal exams an oral cancer screening should be performed on tobacco users on a frequent basis because smokers are also much more likely to develop oral cancer than non smokers. Oral cancer, when caught very early, is highly treatable. Later stages of oral cancer have a poor 5 year survival rate.

Poor Nutrition

A poor diet lacking in nutrition can lower the body’s ability to fight infections and can negatively impact the health of the gum tissues. Diets high in refined carbohydrates and sugar have an adverse affect on overall gum tissue health. As individuals get older, vitamin supplements recommended by a periodontist can help to maintain good oral health.


Diabetes reduces the body’s resistance to infection, which increases the likelihood of the gums becoming infected. High glucose levels in the saliva of diabetics promote the growth of bacteria that cause gum disease. Bacterial infections in the gums are also more difficult to control. Furthermore, patients who develop periodontal disease may have more difficulty with glucose metabolism thereby making their diabetic condition worse.

Underlying Health Issues

Many other medical conditions can intensify or accelerate the onset and progression of gum disease. Examples include respiratory disease, heart disease, arthritis, and osteoporosis. New research suggests that inflamed and chronically bleeding gums place patients at a significantly higher risk for heart attacks, strokes, diabetes, respiratory complications and certain types of cancer.

Puberty, Pregnancy and Menopause

Hormonal changes that occur during puberty, pregnancy and menopause can cause the gingival tissue to be more sensitive and more susceptible to gum disease. It is EXTREMELY important for a pregnant woman to have excellent gum health. Some recent research suggests that poor periodontal (gum) health during pregnancy can adversely affect a developing fetus.

Chronic Stress

Stress weakens the immune system and lowers the body’s ability to fight infections. Many patients report bleeding gums or acute oral infections during high stress periods in their lives. Stress can contribute to Necrotizing Ulcerative Gingivitis (NUG), a very painful and destructive oral disease. Chronic stress can also contribute to clenching and grinding which can further damage the tissues that support the teeth.


Many medications affect the health of the teeth and gums, making them more susceptible to gum disease. Examples include oral contraceptives, heart medications, anti-depressants, seizure medications, and steroids. Antihypertensives and seizure medications (i.e. Dilantin) actually promote the overgrowth of the gingival tissue allowing bacteria to more easily colonize in the swollen gums. Furthermore, many medications cause dry mouth (xerostomia) which can compromise periodontal health. Patients suffering from dry mouth should see their dentist every 2 months for biofilm disruption and removal. Dry mouth can rapidly destroy teeth and gums leading to rampant cavities and tooth loss.

Clenching or Grinding Teeth

Clenching and/or grinding of teeth can damage the tissues that support the teeth. This can lead to the acceleration of gum disease along with the weakening and loosening of the teeth. Clenching and grinding may also precipitate TMD (temporomandibular joint disorder). If not treated early, TMD can be very painful and can cause additional physical and psychological health problems.