CausesBy Mayo Clinic staff
It's thought that periodontitis begins with plaque. This sticky film is composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth removes plaque. But plaque re-forms quickly, usually within 24 hours.
Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar makes plaque more difficult to remove and acts as a reservoir for bacteria. What's more, you usually can't get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.
The longer plaque and tartar remain on your teeth, the more damage they can do. Initially, they may simply irritate and inflame the gingiva, the part of your gum around the base of your teeth. This is called gingivitis, the mildest form of periodontal disease. But ongoing inflammation eventually causes pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. In time, these pockets become deeper and more bacteria accumulate, eventually advancing under your gum tissue. These deep infections cause a loss of tissue and bone. If too much bone is destroyed, you may lose one or more teeth.
- What is gum disease? Association of General Dentistry. http://www.knowyourteeth.com/infobites/abc/article/?abc=G&iid=324&aid=1251. Accessed Aug. 24, 2010.
- De Oliveira C, et al. Toothbrushing, inflammation and risk of cardiovascular disease: Results from Scottish Health Survey. British Medical Journal. 2010;340:2451. http://www.bmj.com/content/340/bmj.c2451.full.pdf. Accessed Aug. 23, 2010.
- Periodontal (gum) disease: Causes, symptoms and treatments. National Institute of Dental and Craniofacial Research. http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm. Accessed Aug. 24, 2010.
- Wilder RS, et al. Gingivitis and periodontitis in adults: Classification and dental treatment. http://www.uptodate.com. Accessed Aug. 27, 2010.
- How to keep a healthy smile for life. American Academy of Periodontology. http://www.perio.org/consumer/smileforlife.htm. Accessed Aug. 24, 2010.
- Gonsalves WC, et al. Common oral conditions in older persons. American Family Physician. 2008;78:845.
- Mouth-body connection. American Academy of Periodontology. http://www.perio.org/consumer/mbc.top2.htm. Accessed Aug. 23, 2010.
- Pocket depth reduction. American Academy of Periodontology. http://www.perio.org/consumer/pocket.htm. Accessed Aug. 24, 2010.
- Soft tissue grafts. American Academy of Periodontology. http://www.ada.org/2624.aspx. Accessed Aug 27, 2010.
- Cleaning your teeth and gums. American Dental Association. http://www.ada.org/2624.aspx. Accessed Aug. 27, 2010.
- Gum disease and diabetes. American Academy of Periodontology. http://www.perio.org/consumer/mbc.diabetes.htm. Accessed Aug. 31, 2010.
- Gum disease and respiratory diseases. American Academy of Periodontology. http://www.perio.org/consumer/mbc.respiratory.htm. Accessed Aug. 31, 2010.
- Esposito M, et al. Enamel matrix derivative (Emdogain) for periodontal tissue regeneration in intrabony defects. Cochrane Database of Systematic Reviews. 2010:CD003875.