We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Periodontal Disease FREE

Janet M. Torpy, MD, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, Editor
JAMA. 2008;299(5):598. doi:10.1001/jama.299.5.598.
Text Size: A A A
Published online

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.


  • 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


  • 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.



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.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Spanish Patient Pages
Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles