When periodontal disease first strikes, it is almost completely unnoticeable. It is caused by a buildup of plaque (a sticky substance that accumulates on your teeth) and oral bacteria. This buildup can irritate your gum tissue, leading to inflammation. Your gums become red and swollen and may bleed when you brush and floss. This early stage of periodontal disease is known as gingivitis, and if often mistaken for brushing too hard. As a result, the condition continues to progress. Your swollen gums pull away from your teeth, creating pockets. Bacteria fall into these pockets and begin to attack your periodontal ligaments and jawbone (along with your gums). Advanced stages of periodontal disease can lead to gum recession, loose teeth, and missing teeth. Your overall health may be put at risk as well, as bacteria can enter your bloodstream.