Periodontal disease begins in the "gingival sulcus," a cuff of soft tissue around the
necks of the teeth
where they emerge through the gums.
Healthy gingiva are pink in color
and the sulcus depth ranges from zero to
three millimeters - measured from the tip of
the gingival margin to the base of the
sulcus.
The attachment fibers connecting the
gums to the teeth, and the teeth to the bone
are intact.
The gums are resilient, and neither
bleed nor hurt when being probed.
During meals, food debris accumulates in
the sulcus.
When mixed with mouth bacteria, and
proteins from saliva,
plaque and less-obvious biofilm are formed.
Both are harmful to teeth and periodontal
structures.
Left in place on the teeth, bacterial
plaque and biofilm begin to mineralize,
forming hardened deposits called
"calculus" - which can only be removed with
dental instruments.
In response to the increased bacteria adjacent to the soft gingiva, the body sends
immune cells and healing cells to the
area by way of the circulation.
The increased blood flow to the gingiva produces red, enlarged and tender
gum tissues - a reversible condition known
as "gingivitis," in which the
periodontal attachment fibers remain
intact.
Continuous exposure to acids and enzymes
from plaque bacteria and the body's
immune response to them eventually
causes the periodontal attachment to be
lost -
an irreversible condition known as
"periodontitis."
The sulcus depth increases to the point
where the patient can no longer
effectively remove plaque - leading to the
destruction of tooth-supporting bone.
Smoking impairs blood flow,
and can significantly interfere with the
patients' ability to fight the bacterial
infection.
Other factors may be involved.
Generalized periodontitis affects all of
the teeth.
They may loosen, appear unnaturally long
an unattractive, and may ultimately be lost.
When multiple back teeth are lost, the
front teeth may be unable to support
closing forces of the jaw muscles.
They begin to tip and move.
The cheeks begin to collapse inward
where the back teeth are missing, and the
lack of proper support for the jaw
joints may cause them to ache, pop and click.
Periodontal bacteria can enter the body's
circulatory system
through leaky blood vessels.
Once inside, the bacteria can lead to
blood clots,
and inflamed vessels - which constrict in
diameter,
leading to strokes, heart disease, heart
attacks, and poor circulation in the
extremities.
