Veteran dentist Dr P S Egan, says, ``Periodontal disease affects the gums and other supporting structures of the teeth. Gingivitis, the early stage of gum-disease, starts with plaque, which is a soft, sticky and colourless film of bacteria that forms on the teeth. If not removed from time to time, bacterial plaque can release toxins and enzymes that irritate and inflame gum tissues. Gums then become red, swollen, sensitive and can bleed painfully.''

``In its more advanced stage, this disease affects the bone and other supporting structures and is known as periodontitis,'' he says. ``This happens when the plaque responsible for gingivitis is not removed and hardens around the gum line and forms tartar.'' The tartar causes an inflammation which creates space between the teeth and gums. It then starts eating out the underlying bone. ``With more bone getting destroyed, the tooth loosens its hold and may fall out itself.''

He lists the symptoms of periodontitis as gaps or pus between gums and teeth, loose teeth and bad breath. For gingivitis, one must watch out for red, swollen and tender gums which bleed while brushing.

Gingivitis is completely curable as the dentist will clean and scale the For periodontitis, one may require surgery. But even that may not help if the disease is extreme. Smoking is another problem, says Egan. A recent Swedish study found that ``smoking impaired the healing process following periodontal surgery, and smokers are 3.3 times more likely to suffer advanced periodontitis than non-smokers.'' But plaque formation can be prevented by ``brushing and flossing after meals or at least twice a day,'' says Egan. ``Mouthwashes containing chlorhexidine, an effective anti-microbial, should be used to gargle for plaque-free oral hygiene. Eating a blanched diet rich in dietary fibre, fresh fruits and vegetables, eggs, fish, meat and carrots also helps clean the teeth.'' Lastly, one must visit a dentist twice a year because he or she can help detect minor problems and plaque formation in the budding stage before they can develop into serious gum-disease.

``Gum disease is serious because of its connections with other deadly diseases,'' says Dr Prerna. ``Take people with diabetes. Case studies have shown that diabetic individuals are three times more likely to deveop destructive periodontal disease; and a history of periodontal disease can, in turn, adversely affect diabetes treatment and control.''

She cites another study on pregnant women, which found that mothers with periodontal disease are almost eight times more likely to deliver premature low birth weight infants than mothers without periodontal disease.

``Besides, several recent studies continue to suggest a connection between periodontal disease and cardiovascular disease as the former tends to hamper treatment of the latter,'' says Dr Prerna.