The main etiological agent of periodontal disease in humans is the bacterial plaque.

However, habits such as smoking, or systemic conditions such as uncontrolled diabetes may also contribute to its development, influencing the severity and the speed of its expression and the responsiveness to its treatment.

The most common form of periodontal disease is gingivitis, which is characterized by a reversible inflammatory process of the gingiva. Gingivitis is caused by the accumulation of plaque and tartar around the teeth. In this situation, the gingiva is reddish (erythematous, rather than the traditional light pink appearance), with its increased volume (edematous gingival margin) and bleeding after touching (during brushing or after using the interproximal brush).

Untreated gingivitis allows its evolution to periodontitis, with involvement of the alveolar bone and irreversible progressive loss of dental support due to decreased clinical adherence. Clinically, periodontitis is characterized by bone resorption with possible development of gingival recessions, periodontal pockets, tooth mobility and persistent gingival haemorrhage after touching (pus and bad breath may even be present in some cases).

Treatment of early periodontal disease may be limited to mechanical removal of tartar and plaque, motivation and care instruction in your oral hygiene at home. In more advanced cases, with bone loss already associated, therapy may involve the need to surgically access deeper sites for them to be instrumented. Regenerative procedures may also be promoted to try to recover lost dental support.

Failure to treat the most severe cases will result in dental loss. Once the disease is treated in its active phase, the patient will move to a stable, supportive phase in which the disease can be controlled by keeping the characteristic inflammatory signs away.