The processes of inflammation and infection in the mouth begin with bacteria.
Bacteria lurk in the tongue, nasal cavities, tonsil areas, gingival pockets, and can also be found floating in saliva. The body is constantly fighting these bacteria, and healthy bodies are able to keep them at bay. When our immune systems stop responding, bacteria take hold. Diseases and weakened immune systems--such as from diabetes--can decrease the ability of the immune system to respond effectively to bacteria, and this triggers the beginnings of oral disease.
Bacteria find the mouth to be an ideal location to take root and foster. They can easily attach to the teeth and gums. Also, the mouth and gums offer a nutrient rich, oxygen-poor environment--ideal conditions to grow for bacteria.
Once in place, oral bacteria are tough to get rid of because they form multi-layered biofilms-- which can become lodged in the gingival crevices around the tooth.
When the body's immune system senses the presence of these biofilms, it launches neutrophils in a defensive strike against the bacteria. At this point, the gums will show redness and swelling as the first signs of inflammation.
If managed properly, the body's immune system and proper treatment can get rid of the plaque, and the redness and swelling will disappear. However, if left to foster, the continued presence of bacteria and the continued fight by the body's immune system may gradually weakened the immune system. Specialized white blood cells (macrophages) will be sent to fight the bacteria, and they secrete inflammatory substances that--while battling the bacteria--also cause intense inflammation which can break down gum tissue and create a periodontal pocket.
Once the bacteria form a periodontal pocket, full blown periodontal disease begins. At this stage, gums begin to recede from the teeth, and surrounding bone structure begins to erode. Additionally, the inflamed area can release inflammatory substances throughout the body. Research has shown that bacteria from dental plaque can enter the bloodstream through small ulcers in the gum and can then travel throughout the body.
Keeping bacteria in check is an ongoing process that is managed by two approaches--sweeping away bacteria so they cannot take root in the mouth, and through chemical means. The goal is to break up bacteria on a daily basis before it adheres.
The first step is determining the amount of pathogenic bacteria that populate the mouth and how much damage might be done. Based on the findings, the appropriate approach--from brushing and flossing to more aggressive approaches--can be determined.
The next level of treatment--as appropriate--involves chemical treatments, such as antibacterial mouthwashes and toothpastes. Also, Scaling, root planing, and antimicrobial inserts into gum pockets can be deployed as needed.