Periodontal disease

Periodontal disease
Other names	Gum disease, pyorrhea, periodontitis
Radiograph showing bone loss between the two roots of a tooth (black region). The spongy bone has receded due to infection under tooth, reducing the bony support for the tooth.
Pronunciation	Periodontitis ⫽ˌpɛrioʊdɒnˈtaɪtɪs⫽, pyorrhea ⫽ˌpaɪəˈriːə⫽
Specialty	Dentistry
Symptoms	Red, swollen, painful, bleeding gums, loose teeth, bad breath[1]
Complications	Tooth loss, gum abscess[1][2]
Usual onset	Getting gingivitis[3]
Causes	Bacteria related plaque build up[1]
Risk factors	Smoking,[4] diabetes, HIV/AIDS, certain medications[1]
Diagnostic method	Dental examination, X-rays[1]
Treatment	Good oral hygiene, regular professional cleaning[5]
Frequency	538 million (2015)[6]

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth.^[5] In its early stage, called gingivitis, the gums become swollen and red and may bleed.^[5] It is considered the main cause of tooth loss for adults worldwide.^[7][8] In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out.^[5] Halitosis (bad breath) may also occur.^[1]

Periodontal disease is generally due to bacteria in the mouth infecting the tissue around the teeth.^[5] Factors that increase the risk of disease include smoking,^[4] diabetes, HIV/AIDS, family history, high levels of homocysteine in the blood and certain medications.^[1] Diagnosis is by inspecting the gum tissue around the teeth both visually and with a probe and X-rays looking for bone loss around the teeth.^[1][9]

Treatment involves good oral hygiene and regular professional teeth cleaning.^[5] Recommended oral hygiene include daily brushing and flossing.^[5] In certain cases antibiotics or dental surgery may be recommended.^[10] Clinical investigations demonstrate that quitting smoking and making dietary changes enhance periodontal health.^[11][12] Globally, 538 million people were estimated to be affected in 2015 and has been known to affect 10–15% of the population generally.^[7][8][6] In the United States, nearly half of those over the age of 30 are affected to some degree and about 70% of those over 65 have the condition.^[5] Males are affected more often than females.^[5]