Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. 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. Halitosis (bad breath) may also occur.
Periodontal disease typically arises from the development of plaque biofilm, which harbors harmful bacteria such as Porphyromonas gingivalis and Treponema denticola. These bacteria infect the gum tissue surrounding the teeth, leading to inflammation and, if left untreated, progressive damage to the teeth and gum tissue. Recent meta-analysis have shown that the composition of the oral microbiota and its response to periodontal disease differ between men and women. These differences are particularly notable in the advanced stages of periodontitis, suggesting that sex-specific factors may influence susceptibility and progression. Factors that increase the risk of disease include smoking, diabetes, HIV/AIDS, family history, high levels of homocysteine in the blood and certain medications. 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.