Periodontal disease is a serious bacterial infection. It destroys the gums and supporting structures of the teeth. It is also called gum disease.

The buildup of plaque on the teeth is the main cause of periodontal disease. Plaque contains bacteria that sticks to the teeth. If plaque isn't removed, it gets hard and is then called calculus or tartar. Poor oral hygiene habits allow plaque to grow in the mouth.

Certain things may raise your child's risk for periodontal disease. These include:

• Certain genes (hereditary).
• Food stuck in the gums.
• Mouth breathing, which may lead to severe drying of the gums and teeth in the front of the mouth.
• Poor diet.
• Poor oral hygiene.
• Smoking and using smokeless tobacco.
• Autoimmune or systemic diseases.
• Diabetes.
• Hormonal changes in the body, such as during puberty.
• Repeated clenching or grinding of the teeth that your child can't control (bruxism).
• Certain medicines that can cause dry mouth.

Periodontal disease can range from mild to severe. Most children with gum disease have the mildest form, called gingivitis. It causes the gums to become red, swollen, and sore. More advanced cases of gum disease are not common in children.

Generally, gum disease isn't painful. So your child may not know if they have it. Below are the most common symptoms of gum disease:

• Red, swollen, sore gums
• Bleeding while brushing or flossing
• Gums that pull away from the teeth (receding gums)
• Loose or separating teeth that show greater than normal spacing
• Bad breath that won't go away
• Pus between the teeth and gums
• A change in bite and jaw alignment

These symptoms may seem like other health problems. Take your child to their doctor or dentist for a diagnosis.

Your child's doctor will likely refer your child to a dentist for evaluation and care. Your child's dentist can often diagnose periodontal disease with a complete history and exam of your child's teeth and gums. Your child may also need X-rays.

Your child's dentist may refer your child to a periodontist. This is a dentist with special training to treat periodontal disease.

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how bad the condition is.

Early treatment is important. It can prevent the gum disease from getting worse. If the disease is left untreated, bone under and around the teeth may dissolve. It will no longer be able to hold the teeth in place.

Treatment may include any or a combination of these:

• Good dental care. Regular cleanings by a dentist can help fight gingivitis, the mildest form of gum disease. Your child will also need to brush and floss daily.
• Deep cleaning (scaling and root planing). This treatment can help remove the plaque and tartar under the gum and infected tissue in the early stages of the disease. It can also smooth the damaged root surfaces of the teeth. The gums can then reattach to the teeth.
• Medicine. Antibiotic medicine may be put in the periodontal pockets. Or it may be given in pill form to take by mouth.
• Surgery. When gum disease is advanced, the infected areas under the gums need to be cleaned. The tissues may also be reshaped or replaced.

Good dental habits can prevent gum disease. Make sure your child:

• Brushes their teeth twice a day with fluoride toothpaste.
• Uses a toothbrush that is the right size based on your child's age and size.
• Flosses daily.
• Drinks tap water that contains fluoride.
• Sees the dentist regularly.
• Eats healthy foods, limiting those high in sugar and starch.

Until children have good brushing skills, help them brush their teeth. Talk with your children's dentist about applying a dental sealant when appropriate. Actively discourage your children from smoking both tobacco and marijuana. Smoking is a major risk factor for the development of periodontal disease.

• Periodontal disease is a serious bacterial infection that destroys the gums and supporting structures of the teeth.
• It is also called gum disease.
• The main cause is plaque buildup on the teeth.
• Children are more likely to have gingivitis, the mildest form of the disease.
• Symptoms include red, swollen, sore gums. The gums may also bleed when brushed or flossed.
• Good dental care can help prevent gum disease.

Tips to help you get the most from a visit to your child's doctor:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your doctor gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are and when they should be reported.
• Ask if your child's condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child's doctor after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.