[Skip to Navigation]
Sign In
JAMA Patient Page
February 6, 2008

Periodontal Disease

JAMA. 2008;299(5):598. doi:10.1001/jama.299.5.598

Periodontal disease (unhealthy gums and teeth) often reflects serious health risks. Mild inflammation of the gums (gingivitis) can be prevented by regularly brushing and flossing teeth to remove plaque (buildup of a film on the teeth). This stops the development of tartar (hardened accumulation of plaque at the gum line), which can only be removed by dental cleaning. More serious infection, called periodontitis, can cause not only disease of the gums, but loss of teeth and the bone structures that support the teeth. Periodontitis may be associated with heart disease, stroke, and systemic (whole body) infections. There is also evidence that premature births happen more often to women who have gum disease before or during their pregnancies. The February 6, 2008, issue of JAMA includes an article about an association between periodontal disease and smoking marijuana.


  • Poor dental hygiene—not brushing your teeth or using dental floss regularly—allows the buildup of plaque and tartar, making the gum tissue unhealthy.

  • Smoking causes decreased oxygen delivery to the gum tissue and makes it easier for bacteria to invade the gums.

  • Some medications may cause gingival hyperplasia (overgrowth of gum tissue) or receding gums.

  • Viral or fungal infection

  • Poor nutrition, especially vitamin and mineral deficiencies, may cause gum disease or loss of teeth.

  • Chronic medical conditions, including diabetes, may lead to greater risk of infections or poor healing in the gums as well as in other body tissues.

Signs and symptoms

  • Receding or puffy, swollen gums

  • Painful gums

  • Bleeding when you brush your teeth

  • Tooth loss or loose teeth in adults

  • Pus draining from the gums

  • Bad breath that is not related to food and does not go away

Prevention and treatment

  • Brush your teeth at least twice a day.

  • Use dental floss daily.

  • Periodontitis does not cause symptoms initially, so it is important to have regular dental checkups.

  • Maintain good nutrition by eating fruits, vegetables, and whole grains and making sure your diet contains plenty of calcium.

  • Do not smoke.

  • Control chronic medical problems, especially diabetes (maintaining normal blood sugar levels decreases your risk of infection).

  • In severe cases of periodontitis, advanced dental treatments may be offered, including gum surgery, bone grafts, or placement of antibiotics into the gum tissue itself.

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.

Sources: National Institute of Dental and Craniofacial Research, American Dental Association, American Heart Association

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.