What Causes Periodontal Disease
The mouth has different types of flora and bacteria. Certain types of bacteria in the mouth can lead to periodontal disease. Systemic inflammation from disease progression or poor nutritional status can also lead to inflammation of the gums. The buildup of bacteria can lead to plaque.
If plaque is not removed, it hardens into calculus. Calculus makes it harder to keep the teeth clean. Calculus can spread below the gumline, leading to periodontal disease (State of Illinois, 2020). Infection can spread below the gum line and cause the gums to pull away from the teeth, creating pockets where more bacteria can get trapped. This leads to further infection of the bone and creates a shift in the teeth.
Who Is At Risk
Age and Mobility
If you are 30 years or older, you carry an increased risk of periodontal disease. Weakness or handicaps in the hands, even arthritis, can increase your risk. Decline in mobility of the hands make it difficult to make the movements needed for proper teeth brushing and flossing to assist with adequate oral hygiene (Gasner & Schure, 2025).
Socioeconomic Factors
The lack of education regarding the importance of oral care contributes to inadequate oral health. You simply may not recognize the importance of having good oral hygiene. In some instances, you may not be able to obtain supplies to perform oral care, such as a toothbrush or dental floss.
Disease Process
If you have chronic health conditions, you are at risk for periodontal disease. These health conditions include poor nutrition (decrease in vitamins C, D, and CoQ10) and general health problems (Barnawi et al., 2023). If you have Alzheimer’s disease and/or diabetes, you are at a higher-than-average risk for developing periodontal disease. Chronic diseases and conditions affect the overall health of the body, including oral health.
Health Habits
Smoking increases the risk of periodontal disease. Other poor health habits that may lead to periodontal disease include poor eating habits, such as excessive candy and soda intake. Hormonal changes related to pregnancy or the use of birth control can affect periodontal health as well.
What Are the Symptoms
Early Symptoms
Often, periodontal disease has no symptoms. Early symptoms are swelling, irritation, and bleeding of the gums. This is called gingivitis and is reversible. Other early signs include bad breath or bad taste in the mouth that doesn’t go away, sensitive teeth, and painful chewing.
Later Symptoms
Once the symptoms have progressed to periodontal disease, the bone has become involved. Periodontal disease is not reversible. The body’s immune response begins to break down connective tissue and bone, leading to symptoms of loose and missing teeth and further affecting the bony structure of the mouth.
How Is Periodontal Disease Diagnosed
Radiographic Bone Loss
If you suspect periodontal disease, you should see a dentist. Dental X-rays can be obtained in the dentist’s office. X-rays will reveal bone loss and shifting teeth. This confirmation is diagnostic of periodontal disease (Gasner & Schure, 2025).
Dental Probing
A probe is used during the dental exam to determine the space between the gums and teeth. If periodontal disease is present, there will be bleeding on probing (BOP). You will also have periodontal pockets greater than 4mm on probing. A periodontal pocket is a deep, unhealthy space between the teeth and gum tissue where the gum has pulled away from the tooth. A pocket depth starting at 3mm can trap bacteria and break down the supporting bone and tissue of the jaw, resulting in tooth loss (Gasner & Schure, 2025).
How Is Periodontal Disease Treated With Regenerative Therapies
Ozone Therapy
Ozone therapy to help treat periodontal disease uses oxygen-ozone gas, ozonated water, or ozonated oils to eliminate bacteria in periodontal pockets. This method decreases inflammation and promotes tissue healing. It is performed with scaling and root planing (SRP). Scaling and root planing is basically just a deep teeth cleaning with more specialized equipment than the standard dental office. A study of ozone therapy conducted with 13 randomized controlled trials (RCTs) resulted in a significant reduction of probing depth (Liu et al., 2025).
Probiotics
Probiotics are known for restoring healthy flora in the GI system. New studies are recognizing how probiotics can do the same for the mouth. They restore healthy flora, improving oral health and decreasing risk for periodontal disease. A study of 19 meta-analyses with 67 data sets determined that the use of oral probiotics can significantly decrease the bleeding on probing associated with periodontal disease (Tan et al., 2026).
Platelet Rich Fibrin
Periodontal disease is showing improvement with the use of platelet-rich fibrin (PRF) therapy. Platelet-rich fibrin consists of platelets, leukocytes, and growth factors. It is known to increase the healing process, regenerate bone loss, and promote soft tissue repair. It is applied during periodontal surgeries (Silva et al., 2024).
Vitamin Administration
Vitamin D is important to strengthen bones and is associated with decreasing inflammation. Vitamin C assists with collagen formation, forms a protective barrier on periodontal tissue, and decreases inflammation as well. Vitamin CoQ10 helps to “shield cells from oxidative damage”
. You could understand why a decrease in any or all of these vitamins could lead to periodontal disease. Administration of the vitamins by mouth will improve oral health and decrease risks for periodontal disease. More research is needed on an adequate dosage for achieving ideal outcomes (Barnawi et al., 2023).
What Are Possible Complications
Infection
Infection occurs when bacteria in the mouth enter the bloodstream and cause sepsis. Another complication is infective endocarditis, when the bacteria migrate to the heart and valves. These types of complications can lead to death.
Inflammation
Inflammation associated with periodontal disease imposes additional stress on the body. This stress can cause problems such as uncontrolled blood sugar in diabetic patients. Diabetics with periodontal disease have a higher mortality rate (Gasner & Schure, 2025). The pain from inflammation can cause you to stop eating, which leads to malnutrition. Remember, you need proper nutrition to manage and improve chronic disease processes and overall health.
Bone and Tooth Loss
As periodontal disease progresses, you will begin to experience shifting teeth and bone loss. This can create a loss of support and result in tooth loss. The worst-case scenario would be the need to have a full mouth extraction (FME) due to periodontal disease, followed by a lifetime of wearing dentures. In my experience, patients who develop the need for a FME can face unexpected difficulties, such as improper denture fitting and pain at extraction sites.
Can Periodontal Disease Be Prevented
In most cases, periodontal disease can be prevented. The exception to preventing periodontal disease would be if you have genetic factors that cause periodontal disease. When you are educated at an early age to brush your teeth two times a day and floss daily, a strong oral health foundation is set up. Practicing good oral hygiene and keeping preventive dental screenings for both you and your children will decrease the risk of periodontal disease.
If you smoke or have a poor diet, recognizing the need for change (stop smoking & improve diet) is important to preventing periodontal disease. Understanding how your overall health can lead to periodontal disease- and how periodontal disease affects existing conditions- helps motivate good oral health. When unhealthy habits are recognized and changed early in life, long-term consequences are avoided.
Takeaway
Periodontal disease can affect many body systems and is associated with various disease processes. Occasionally, it’s the disease process that worsens the periodontal disease- such as Alzheimer’s- Alzheimer’s causes individuals to forget to eat or brush teeth. Cognitive decline interferes with self-care, leading to poor oral hygiene and gum disease. Prevention and early interventions are important for maintaining oral health.
In my professional experience, many people simply are not aware of the risks associated with poor oral care until significant damage has already occurred. If you are experiencing symptoms such as bleeding gums, persistent bad breath, or gum tenderness, take action and be proactive. Learning about periodontal disease, improving daily oral care habits, and having a complete dental evaluation can help slow progression and protect your teeth. Overall, this will support better long-term oral and general health.
