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Mechanism of Periodontal Disease [Periodontal Disease]

Periodontal disease is caused by bacteria in plaque that accumulates around the gum-line (between the teeth and gums). If it is in the stage of “gingivitis”, which is inflammation of the gums, the gums can be reversed to a healthy state by removing plaque or tartar.

points to note
  • Your mouth condition or lifestyle habits can make your gums more susceptible to periodontal disease. In order to prevent and reverse periodontal disease, it is important to review your lifestyle habits, as well as your oral environment, to keep yourself fit.

Causes of Periodontal Disease

There is a shallow groove called the “gingival sulcus” between a tooth and the gums. Bacteria in plaque that accumulate there may cause periodontal disease.
In addition, risk factors that indirectly cause or advance periodontal disease, are hidden in your “oral environment” and “lifestyle habits”.

Two Risk Factors

1. Oral Environment (Local Risk Factor)

The following are included among the risk factors that increase plaque or cause inflammation of the gums.


Among the forms of tartar, there is supragingival tartar, which forms above the gums, and subgingival tartar, which forms between the enamel and gums.

If calcium or phosphoric acid in saliva is deposited into plaque, tartar forms. Since plaque easily accumulates on tartar, a vicious cycle begins, aggravating inflammation.

Teeth alignment

Misaligned teeth are often difficult to brush sufficiently, which can easily lead up to a buildup of plaque and inflammation.

Misaligned teeth are often difficult to brush sufficiently, which can easily lead up to a buildup of plaque and inflammation.

Ill-fitting crowns, etc.
Plaque easily builds up around dental crowns or other dental fixtures that do not fit teeth.
  • Bad habits
    Bad habits performed daily, such as mouth breathing or teeth grinding, aggravate periodontal disease.
    • Mouth breathing: if you have a habit of breathing through your mouth, your mouth will become dry and create an environment in which plaque easily accumulates. In addition, the resistance of your gums will be reduced, making the gums prone to inflammation.
    • Teeth grinding: strong force applied when grinding teeth will burden the periodontal tissue, making the gums prone to inflammation.

2. Lifestyle Habits (Systemic Risk Factor)

In order to prevent and improve periodontal disease, it is important to review your lifestyle habits, as well as your oral environment, to keep yourself fit.

Smoking narrows your blood vessels, causing poor blood circulation in your gums. This reduces their resistance to periodontal disease, which aggravates symptoms.
When you have diabetes, your resistance to bacterial infection is reduced, often resulting in worsening periodontal disease. In addition, recent studies have revealed that treatment of periodontal disease improves blood sugar levels.
A decrease in your body’s resistance due to psychological stress or changes in lifestyle habits (brushing, smoking, diet, etc.) creates an environment where periodontal disease easily worsens.
Dietary habits
The habit of eating just sweets or soft food in large quantities increases plaque and causes it to easily accumulate on your teeth. In addition, irregular eating patterns and a nutritionally imbalanced diet negatively affect your general health.

Stages of Periodontal Disease Progression

Periodontal disease is divided into “gingivitis” and “periodontitis”, depending on the condition. If plaque that has accumulated in the gingival sulcus remains, it will cause inflammation of the gums, which is a stage called “gingivitis”. Moreover, if gingivitis is left untreated, the inflammation will spread to the alveolar bone. This stage is called “periodontitis”.

Changes in Symptoms (Healthy Gums - Gingivitis - Periodontitis)

The color and texture of the gums change with the worsening of the symptoms.

Healthy gums
Healthy gums are light pink in color and fill each interdental space. They are elastic and tight. [Conditions of the gums]
Color - light pink
Texture - tight and elastic
Appearance - filling each interdental space
Bleeding - none
At the stage of gingivitis, plaque has accumulated between the enamel and gums. The gums appear red-tinged, and the tips of the gums between teeth are rounded and plump. The gums are inflamed due to the toxins produced by periodontic bacteria
The alveolar bone has not yet been destroyed
Gums are red and swollen due to engorged vessels
[Condition of the gums]
Color - red-tinged
Texture - Swollen and flabby
Appearance - rounded and plump
Bleeding - easily bleed with light stimulus
《points to note》
Caution is required if your mouth feels pasty when you wake up or your gums bleed easily when you brush your teeth. At this stage, you can repair your gums by reviewing your lifestyle habits and continuing with careful brushing.
At the stage of periodontitis, tartar and plaque accumulate between the enamel and gums, and the periodontal pockets have deepened.The gums appear red-purple and flabby, and are starting to recess. Periodontic bacteria continues to grow, producing more toxins. Toxins start destroying the alveolar bone, promoting the progression of periodontal disease. The teeth start becoming loose, and the gums bleed often
[Condition of the gums]
Color - red-purple
Texture/appearance - the gums have recessed, making the teeth appear elongated
Other conditions - the teeth become loose, and blood and pus begin coming out of the gums. Breath odor worsens. Food easily becomes stuck between the teeth.
《points to note》
It is necessary to consult with a dentist and begin treatment as soon as possible, in addition to learning to brush your teeth correctly.