About Gum Disease

About Gum Disease

Facts about Gum Disease

About Gum DiseaseGum disease is essentially a chronic inflammation of the gums and surrounding tissues, caused by an overgrowth of certain bacteria in the mouth. Gum disease can range from simple gum inflammation (gingivitis) to a more serious condition (periodontitis) where there is damage to the supporting bone and connective tissues that hold your teeth stably in your mouth. Gingivitis literally means “inflammation of the gums” and periodontitis means “inflammation of the structures surrounding teeth”. Gum disease is also known as “periodontal disease”.

Gum disease, especially when it progresses to advanced stages, is the primary cause of tooth loss in adults in the United States.

As a periodontist, Dr. Feldman is a highly skilled specialist in the diagnosis, treatment and prevention of gum disease. Using the latest in dental technology, Dr. Feldman can restore your oral health by removing the disease-causing bacteria with minimally invasive procedures. His objective is to heal your gums, save your teeth and maintain your dental health.

The health effects of gum disease

According to the U.S. Surgeon General, approximately 80 percent of American adults have some form of gum disease. Gum disease is an insidious condition because it often shows little or no symptoms in its early stages. Since the disease can progress without pain or discomfort until it becomes severe, it often goes untreated until it has reached the advanced stages where tooth loss, bone loss and gum recession occur.

Additionally, while gum disease may be confined to the mouth, its effect may not be. While research is still not entirely conclusive, gum disease has also been linked to serious health conditions such as diabetes, cardiovascular disease, respiratory disease, osteoporosis and cancer.

The way in which Gum Disease progresses

Our mouth is home to many types of bacteria. Most types of oral bacteria are harmless, while others play a beneficial role in protecting our teeth and gums or play an important part in the digestive process.

Trouble starts when certain harmful types of bacteria accumulate on the teeth in the sticky substance known as plaque. Plaque emits toxins that irritate the gums, causing inflammation. This is the beginning stage of gum disease. If this accumulation of bacteria is not removed, the disease progresses in severity as the plaque deposits grow and start reaching below the gumline. This causes the gum to begin to detach from the tooth and a gum “pocket” to form.

The plaque in the pocket hardens into a crust called tartar or calculus. This tartar serves as an ideal base for further bacterial accumulation. The pocket continues to deepen, and the deeper it becomes, the more aggressive are the types of bacteria that are able to grow there. The inflammation progressively worsens and the bacteria start eating away the connective tissue that connects the teeth with the supporting bone. When the bacterial infection reaches even deeper and reaches the bone tissues, the supporting bone is lost.


Gingivitis is the earliest stage of gum disease. It consists of inflammation of the gums without any damage to the surrounding bone or connective tissues. Gingivitis is caused by the buildup of plaque, which produces toxins that irritate the gums, causing redness, swelling and bleeding.

The good news is that the damage caused by gingivitis can be reversed with professional cleaning and good home oral care.

The bad news is that untreated gingivitis can advance to periodontitis, which means the infection has started to affect the surrounding connective tissues and bone.


Toxins produced by the bacteria in the plaque irritate the gums, causing chronic inflammation. Gums separate from the teeth, forming pockets that become infected.

Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance even further under the gum tissue, reaching and eating away the connective tissues and bone tissues. Eventually, if too much bone and connective tissue is lost, the teeth will become loose and may need to be extracted.

Stages of Periodontitis

Your bone and gum tissue should fit snugly around your teeth with the gum tissue attaching to your teeth at about 3mm below the visible gumline. Gingivitis can exist at up to 3 mm depth, but there is no loss of bone and no loss of ligament (the connective tissue that firmly connects the teeth to the surrounding bone).

Periodontitis sets in when that point of attachment is 3 mm deep or more and there are signs of ligament damage and bone loss. Periodontitis progresses in three stages: mild, moderate and severe.

Mild Periodontitis

If gingivitis is left untreated, it can advance to beginning (mild) periodontitis. In the early stages, the disease is starting to attack the bone and ligament tissues that support the teeth. Pocket depth at this stage is between and 3 and 5 mm.

Moderate Periodontitis

The destruction of the supporting bone and connective tissue has continued and the gum continues to separate from the tooth. Dr. Feldman usually finds moderate gum disease to have pocket depths of 6 to 7 mm.

Advanced Periodontitis

In advanced periodontitis there is extensive bone loss and damage to the connective tissues. The depth of the gum pockets is 8 mm or above. Teeth often start to shift or become loose, and they may have to be removed. The depth of a tooth root is only 10-12 mm, so at this stage of the disease, the tooth is very unstable.

Gum disease warning signs

About Gum DiseaseIt is important to keep in mind that gum disease can progress without pain or discomfort in its early stages. If you have noticed any of the following symptoms, please call our office so Dr. Feldman can give you a full examination.

  • Gums bleed while brushing or flossing
  • Gums are red, swollen or tender to the touch
  • Gums have pulled away from your teeth
  • Gums have receded or teeth that appear longer than normal
  • Persistent bad breath
  • An unpleasant taste in your mouth
  • Teeth have become more sensitive
  • Teeth have shifted position
  • Teeth have become loose

Contributing factors to gum disease

The accumulation of bacterial plaque in the mouth s the principal cause of gum disease. However, there are other factors that can contribute to gum disease and make the disease progress faster.

Smoking: Smoking has been found to be a contributing factor to gum disease. A recent study indicates that the most damaging types of bacteria for gum health are found in the mouths of people who smoke.

Genetics: It is estimated 50% of the population is genetically predisposed to gum disease. But that doesn’t mean gum disease is inevitable. Good oral care can prevent or control the disease.

Misaligned or crowded teeth: If it is difficult to get at certain areas with a toothbrush or dental floss, then it is likely that there will be more plaque and tartar accumulation in those areas. The more plaque and tartar you have, the greater your chances of developing gum disease.

Poor quality dental work: If bridges or crowns have not been properly placed, bacteria can accumulate beneath them.

Poor diet: A lack of adequate nutrition may result on certain chronic health conditions, including gum disease. A healthy diet with plenty of fresh fruits and vegetables can boost your immune system and help it to fight off gum infections.

Systemic health problems: Certain systemic health problems (health problems that affect the entire body), such as diabetes, respiratory disease, heart disease, and autoimmune disorders may contribute to gum disease.

Female hormonal changes: Hormonal changes can sometimes result in increased sensitivity of the gum tissues and make them more susceptible to gum disease.

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