Gum disease, also known as periodontal disease, is an infection that occurs in the gums, deep tissues and bones that support your teeth. (The word “periodontal” means “around the tooth.”) Unless the disease is treated, it can ultimately lead to tooth loss. In fact, the American Academy of Periodontology lists gum disease as the primary cause of tooth loss in adults age 35 and over.
How Gum Disease Starts
Your mouth naturally produces a sticky substance called plaque. Without adequate brushing and flossing, this plaque builds up on your teeth. The bacteria in plaque produce poisons, or toxins, which irritate the gums, causing infection. As the infection increases in severity, it breaks down the bones and tissues that hold your teeth in place.
The Two Primary Stages of Gum Disease
Gingivitis: The initial stage of gum disease, known as gingivitis, is the mildest form of the disease. During this stage, the gums become swollen and red, and may bleed with brushing or flossing. Gingivitis is frequently painless, and as a result, many people suffering from it don’t seek advice or treatment. But with professional treatment and daily attention to oral hygiene, gingivitis can be reversed before it progresses.
Periodontitis: Untreated gingivitis may develop into periodontitis, the more extreme form of the disease. In this stage, the infected gums begin to separate from the teeth. The newly created spaces between the gums and the teeth are called pockets. As the disease progresses, these pockets grow larger, allowing for greater damage to deep tissues as well as bone. When enough tissue and bone are affected, the teeth loosen and may fall out or need to be removed.
Signs To Watch For
Because gum disease can exist without pain or discomfort, it’s important to be aware of the possible warning signs that may indicate a problem:
- Gums that appear red or swollen
- Gums that feel tender
- Gums that bleed easily (during brushing or flossing)
- Gums that recede or pull away from the teeth
- Persistent bad breath
- Loose teeth
- Any change in the way teeth come together in the biting position
- Any change in the way partial dentures fit
If you suspect that you may be suffering from gingivitis or periodontitis, make an appointment with our office or your dentist immediately. We can diagnose the problem, determine how far the disease has progressed, and recommend an appropriate treatment.
The good news about gum disease is the simplicity of preventive care for most people. The best way to avoid gum disease is to follow the same measures you take to avoid cavities: brush your teeth with fluoride toothpaste twice daily, floss every day, maintain a healthy diet, avoid tobacco use, and have your teeth professionally cleaned on a regular schedule.
Your dentist may recommend twice-yearly or more frequent checkups depending on the state of your oral health. Even with daily home care, plaque can build up and harden into a tough substance called tartar. In this state, only a dental professional can remove it.
In the early stage of gingivitis, it’s possible to reverse or even eliminate the disease by increasing the level of oral care. But it’s important to catch the disease as early as possible. Regular dental checkups are vital, as is an awareness of the warning signs of gum disease. If gingivitis progresses to periodontitis, serious problems including tooth loss can occur.
Risk Factors for Gum Disease
A lack of good oral hygiene is a primary cause of gum disease. However, other circumstances can increase your chances of experiencing gum disease. Following are additional risk factors that you may be able to control to reduce your chance of developing gingivitis or progressing to periodontitis.
Smoking and Tobacco Use
It’s long been established that smoking and tobacco use (cigarettes, cigars, pipes, chewing tobacco) increases the risk of cancer, lung disease, heart disease, and other serious health problems. It is also a recognized risk factor for gum disease. Not only does tobacco use increase the occurrence of gum disease, it can also hinder the healing process by decreasing your ability to fight infection in your gums.
A diet lacking in vitamins and minerals makes it more difficult for your immune system to fight infection. Too many sugary foods and carbohydrates increase the production of plaque, which is the underlying cause of gum disease.
You have a higher likelihood of developing gum disease if it runs in your family. According to the American Academy of Periodontology, up to 30% of the population may be genetically predisposed to gum disease. If your close family members have gum disease, be extremely diligent in your home care and your dental visits.
Women experience hormonal fluctuations during puberty, pregnancy and menopause, which can affect tissues in the body, including gums. Increased sensitivity in the gums can create a higher susceptibility to gum disease. Pay special attention to daily oral care and make regular visits to the dentist.
No matter what the cause (work, finances, depression, etc.), living in a state of stress can make it difficult for the body to fight off infection, including gingivitis and periodontitis. Stress is also a contributing factor to teeth grinding and clenching, which can accelerate the rate of tissue damage with gum disease.
Some drugs – including certain types of antidepressants, heart medications, anticonvulsants, steroids, chemotherapy, oral contraceptives and other medications – can affect your oral health. Drugs that lessen the flow of saliva can leave your teeth less protected than normal, and drugs that cause abnormal tissue growth can have an adverse effect on your gums. Be sure your dentist is aware of any medications you are taking.
Any illness that interferes with the immune system’s ability to fight infection – such as diabetes, leukemia or AIDS – can leave you more susceptible to gum disease. Additionally, uncontrolled diabetes can increase your risk for gum disease; and gum disease may decrease your ability to control your diabetes. Take special care to brush and floss daily and make regular visits to the dentist.
Advanced, untreated gum disease degrades the tissues and bone structures surrounding the teeth and eventually causes tooth loss. But the effects of gum disease can be felt well beyond the mouth and jaw. Research links gum disease to a variety of systemic conditions that affect overall health, including heart disease, diabetes and osteoporosis. We refer to this as the mouth-body connection.
In some cases gum disease can cause problems in other parts of the body, while in other instances conditions seemingly unrelated to the mouth can contribute to the development or advancement of gum disease.
It’s important to let us and your general dentist know about any illnesses or conditions you are experiencing. An awareness of difficulties outside your mouth can help us treat certain problems related to your teeth and gums. In turn, we may be able to identify diseases affecting other areas of your body based on the symptoms we observe inside your mouth. Following is list of conditions known to be related to gum disease.
If you have diabetes, it is especially important to take good care of your teeth and gums, as gum disease and diabetes can affect each other adversely. Diabetes can disrupt the immune system’s ability to fight infection, making diabetics more susceptible to gum disease, which is essentially an infection of the tissue surrounding the teeth. And advanced gum disease can boost the level of blood sugar in the body, further complicating diabetes.
Heart Disease and Stroke
The American Academy of Periodontology cites research indicating that people with gum disease are nearly twice as likely to suffer from coronary artery (heart) disease as those without gum disease. Currently the actual link between the two diseases is not entirely clear, though some scientists believe that bacteria from the mouth travels through the blood stream to affect the arteries in the heart. Other research points to a link between gum disease and stroke, with one study finding higher instances of oral infection in a group of stroke survivors than in a control group.
In a normal body, bone growth slows over time, and due to age and other circumstances, bone density decreases. But in people with osteoporosis, bones are weakened to the point that they are fragile enough to fracture easily and frequently. Although we most commonly hear of hip or back fractures, all bones are affected, including the jaw. A jaw with decreased bone density can’t support the teeth as well as a healthy jaw, which leaves those suffering from both gum disease and osteoporosis with a heightened risk of tooth loss. If you think you might be at risk for osteoporosis, talk to your doctor about having a bone density test. If this condition is identified early enough, treatment can help.
Research indicates that bacteria from the mouth – including those present in someone suffering from gum disease – can be inhaled down into the lungs, leading to respiratory diseases such as pneumonia. Smoking is a primary cause of respiratory diseases, and it is also a risk factor in gum disease. Quitting smoking can improve your health in myriad ways. Please get in touch with us or your general dentist if you are looking for help with kicking the habit.
During pregnancy and other phases of increased hormone levels (puberty, menstrual cycle, menopause) the risk of oral health problems is higher than normal, due to increased gum sensitivity. And some studies have linked gum disease to low birth weight and premature labor. If you are planning to become pregnant, be sure to assess your oral health first and begin treatment if you have gingivitis or periodontitis.