While  you may think that some loss of teeth is inevitable with aging, it is  actually possible for all of your teeth to last a lifetime. One of the  ways you can achieve this goal is to avoid periodontal disease (“peri” –  around; “odont” – tooth), which is caused by bacteria that attack the  tissues around the teeth. Unfortunately, you may not even realize you  have gum disease as the signs and symptoms are not always as apparent to  you as they are to a dental professional.

Nearly all people who do not maintain good daily oral hygiene will  develop gingivitis. If left untreated, this bacterial gum infection can  progress from gingivitis (“gingival” – gum; “itis” – inflammation) to  periodontitis, which results in bone loss around your teeth. As the bone  tissue is lost, the gum tissues detach from the teeth and form little  pockets that provide an even better place for bacteria to live — where  your brush and floss can't reach. As periodontal disease advances  leading to more bone loss, tooth loss can result. Part of this has to do  with genetics, as periodontal disease tends to run in families. The  good news is that periodontal disease can be controlled, even at more  advanced stages.

It's important to understand that you can have periodontal disease  with no obvious symptoms, especially if you are a smoker (nicotine  reduces blood supply preventing bleeding and swelling of the gum  tissues). Still, there are some important things to look for:

• Bleeding gums — Some people think that when their  gums bleed, it simply means they're brushing too hard. While brushing  too hard is bad for the gums, it should not cause bleeding. Any bleeding  of the gums should be considered a warning sign of gum disease.
• Bad breath — It's very easy for plaque to collect  in the spaces between the teeth, creating the perfect living conditions  for bacteria that produce odorous, sulfur-containing compounds,  resulting in bad breath.
• Redness or swelling of gums — Inflammation of the gums is usually the first visible sign of periodontal disease.
• Receding gums — If you notice that your teeth look  longer than they used to, it may be that your gum tissue has receded  (away from the enamel), exposing some of your tooth roots.
• Sensitivity — If there is gum recession, the exposed roots may become sensitive to hot or cold.
• Periodontal abscess — Bacteria can become enclosed in a periodontal pocket and the area will fill with pus, becoming swollen and painful.
• Loose teeth — When periodontal disease results in  bone loss, teeth can become loose or migrate. Tooth loss can result and  may be accelerated if you are applying excessive biting forces from  clenching or grinding your teeth.

All periodontal therapy starts with the evaluation of your oral  hygiene techniques and instruction for improving them, followed by the  mechanical removal of plaque and any calcified deposits (tartar or  calculus) that are present on the root surfaces. This is accomplished  with a cleaning technique known as scaling, root planing or debridement  using hand instruments and/or ultrasonic (high frequency vibrational)  instruments. Locally applied antimicrobial products or antibiotics might  also be recommended during various parts of periodontal treatment to  assist in healing and pocket-depth reduction, hopefully eliminating the  need for periodontal surgery. Sometimes surgical procedures may be necessary to remove the deep  pockets that form between inflamed gum tissue and teeth. There are many  different types of surgery to handle a variety of problems. And many  times, combinations of procedures are used to attempt to reduce the  number of surgeries as well as the cost of treatment.

Periodontal disease occurs in your mouth but seems to be linked to  more serious conditions in other parts of the body, such as  cardio-vascular disease (CVD), diabetes and preterm births. While the  exact nature of the connection is unclear, it appears that moderate to  severe periodontal disease increases the level of systemic (bodily)  inflammation — a characteristic of all chronic inflammatory diseases.  Also, the same bacterial strains that are commonly found in periodontal  pockets surrounding diseased teeth have been found in blood vessel  plaques of individuals with CVD. Therefore, controlling periodontal  inflammation may help to reduce systemic inflammation.

The best way to prevent periodontal disease is to brush and floss  your teeth effectively every day. In fact, regular dental checkups and  professional cleanings every 3, 4 or 6 months (as recommended by your  dentist) are also an important part of maintaining periodontal health;  the instruments and techniques used in these cleanings can reach into  areas that your toothbrush and floss can't.

It is also possible to detect early forms of gum disease by  evaluating your gingival (gum) tissues, both visually and by examining  their attachment levels to the teeth. And the health of your  tooth-supporting bone can be assessed by taking dental radiographs  (x-rays pictures).

There are other steps you can take: Eating right, reducing stress in  your life, and giving up unhealthy habits like smoking will also help  ensure that you keep your teeth for a lifetime.