Chronic Inflammatory Periodontal Disease

Over the last 15 years, it has become abundantly clear that gum disease is a risk factor for cardiovascular disease, heart attack, and stroke. The intensity of inflammation that occurs in moderate to severe chronic untreated gum disease is sufficient to induce a systemic full body response.  This response can be easily measured in the blood sample that reveals elevated inflammatory mediators, like C reactive proteins, and at least six other verifiable increased serum levels.

The presence of chronic oral cavity inflammation enhances atherosclerosis, with bloodstream bacteria having direct contact with arterial walls, increasing inflammation.

The prevalence of periodontal (gum) disease continues to be an important public health problem in the United States as two in five adults are affected by some form of this disease and as high as 70 percent of American adults over 65. Smoking remains a major risk factor for periodontitis.

The table for the Centers for Disease Control and Prevention (CDC) defines the stages of gum disease:

Per CDC severe periodontitis is defined as having 2 or more sites with clinical attachment loss/ recession (CAL/R)  6 mm or greater and 1 or more sites with periodontal probing depth (PPD) 5 mm or greater.

Nonsevere periodontitis is comprised of the two less severe categories of disease (moderate and mild periodontitis). Moderate periodontitis is defined as 2 or more sites with 4 mm or greater or 2 or more sites with PPD 5 mm or greater mild periodontitis is defined as 2 or more sites with CAL 3 mm or greater and 2 or more sites with PPD 4 mm or greater or 1 or more sites with 5 mm or more.

Finally, total periodontitis is defined as the combination of mild, moderate, and severe periodontitis.


Prevalence of periodontitis classified by the CDC

  • Overall, 43%  of adults 30 years or older in the United States have total periodontitis, consisting of 7.8% with severe periodontitis and 34.4 percent with moderate  periodontitis.
  • The prevalence of  mild or moderate and of total—but not of severe—periodontitis increases significantly with age.
  • The prevalence of total periodontitis was greatest among men (50.2%), Mexican Americans (59.7%), current smokers (62.4%), and those who have diabetes (59.9%).  The prevalence increased with increasing number of teeth already missing 

In the early stage of gum disease, one gets gingivitis, bacteria in plaque build up, causing the gums to become inflamed and to easily bleed during brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.  This can be easily controlled by regular cleanings at your dentist in Woodland Hills, CA.

When you forget to brush and floss,  a sticky film of bacteria and food called plaque builds up around your teeth. The gunk releases acids that attack your teeth’s outer enamel and cause decay. After 72 hours, plaque hardens into tartar, which forms along the gum line and makes it hard to clean your teeth and gums completely. Over time, this buildup irritates and inflames your gums, causing gingivitis.  Most people can easily feel this buildup along their gum line. 

When gum disease progresses to periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and eventually will become infected. The body’s immune system fights the bacteria as plaque spreads and grows below the gum line. This also enters the circulatory system and can cause inflammation.

Toxins or poisons, produced by the bacteria in plaque as well as the body’s “good” enzymes involved in fighting infections,  start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen, leading to the destruction of more gum tissue and bone. When this happens, teeth are no longer anchored in place, so they become loose or become more prone to falling out. Gum disease is the leading cause of tooth loss in adults, which leads to its own set of complications. 

The causes of gum disease: 

  • Number one cause is lack of proper regular dental hygiene visits and not getting plaque and calculus removed every four to six months.
  • Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, which makes it easier for gingivitis to develop.
  • Illnesses may affect the condition of your gums.  Patients who have diabetes, this will  affect the body’s ability to use blood sugar, patients with this disease are at much higher risk of developing infections, including periodontal disease and cavities and tooth loss.
  • Medications can affect oral health, because some lessen the flow of saliva, which has a protective effect on teeth and gums.  
  • Bad habits such as smoking or chewable tobacco are very hard on gum tissue.
  • Poor oral hygiene habits such as not brushing and flossing on a daily basis. 
  • Family history of dental disease can be a contributing factor for the development of gingivitis.

We encourage patients to visit our Woodland Hills dentist on a regular schedule.  Your dental and overall health depends on it!