Two terms need to be differentiated to understand gum disease. Gingivitis is a disease of the gums only—it is inflammation caused by plaque, the white, soft sticky substance that adheres to teeth and consists of bacteria, saliva, and bits of food. Gingivitis is perhaps the most common disease in the world and it is totally reversible through professional cleaning and proper home care.

Periodontal disease can be understood as a progression from gingivitis to an irreversibly damaged state. In periodontal disease, not only the gums are affected, but the ligaments and bone surrounding teeth are also damaged. These tissues cannot grow back, and once they are compromised, the gum pocket around a tooth tends to become deep and difficult to clean. The progression of periodontal disease is helped by several factors, including grinding, poor hygiene, poor dental restorations, tobacco use, etc., but ultimately it is also a disease caused by plaque. When plaque is not cleaned properly, it can harden, accumulate, and become a major problem called tartar or calculus—hard, scaly deposits that are found within gum pockets and attached to teeth.

Gum disease, or periodontal disease, has been linked to many serious health conditions, including heart disease, respiratory disease, chronic kidney disease, diabetes, stroke, low birth weight babies, and other adverse pregnancy outcomes. While it was once thought that the link was bacteria, studies now show that systemic inflammation is the common denominator. In any case, treatment of periodontal disease has been shown to improve general health as well as oral health.