Gum disease—or periodontal disease, as it is called in the dental profession—is the leading cause of tooth loss in the United States, not tooth decay.
Periodontal disease in its early stages does its work very surreptitiously. Many Americans aren’t even aware of the bacterial battle raging within their mouths. To make matters worse, those who maintain good oral hygiene may still be susceptible to gum disease because of genetics. Studies show that 30 percent of people are genetically predisposed to gum disease.
Whether you are predisposed to gum disease or not, you need to know what you’re dealing with.
The Causes of Gum Disease
As with most health issues, there are several causes that can contribute to the onset of gum disease, either on their own or by teaming up with one another. Genetics has already been mentioned as an underlying factor, but there are environmental factors, as well.
Plaque - The main cause of gum disease is the buildup of plaque. If teeth are not brushed and flossed regularly, plaque can build up. When plaque is not cleaned away sufficiently through brushing and flossing, the bacteria in the plaque remain on your teeth and irritate your gums. Plaque starts off soft, but once it hardens (after 24 hours) it can only be removed by a dentist or hygienist.
Smoking – Recent studies show that smoking may be one of the most significant factors in the development and progression of periodontal disease. Many dentists will instruct their patients who smoke to quit smoking for the healing period after their surgery or procedures because the chemicals in tobacco can impede the healing process. Some dental professionals will refuse to perform extensive treatments (eg: dental implant or bone grafting) on a patient if they refuse to quit smoking because smoking may cause the treatment to fail.
Stress – Stress compromises the body’s ability to fight off infections, which is what periodontal disease is.
Medications – If you notice changes in your gums while taking medications, make sure you tell your dentist to ensure proper treatment and monitoring of your situation.
Hormones – Particularly for women, the soft tissue (gums) in the mouth may react to the hormonal changes at the onset of puberty, menopause or pregnancy. In fact, recent studies show that pregnant women with periodontal disease are seven times more likely to deliver preterm, low-weight babies!
Diabetes – Diabetics are at a higher risk of developing infections (including periodontal disease). If a diabetic’s body is busy fighting off an infection, it may impair their body’s ability to process and use insulin.
Types of Gum Disease
There are two main types of periodontal disease: gingivitis and periodontitis.
Gingivitis is a condition that affects the “gingiva” or gums, also known as soft tissue. Gingivitis is the mildest form of gum disease and is usually manifested in red, swollen, and tender tissues, and bleeding of tissues during brushing, eating, and flossing.
Periodontitis develops when gingivitis is left untreated and when plaque spreads below the gum line. When this happens and the body starts reacting to the infection, both tooth and gum tissues start to break down leading to gum recession, root canals, extractions, or tooth loss.
Symptoms of Gum Disease
If you experience any of these symptoms, either one or several, report them to your dentist immediately.
- red, swollen, tender gum tissue
- bleeding while brushing, flossing, or eating
- gum recession (where the gum pulls away from a tooth, making it appear longer than normal and maybe exposing the root)
- loose teeth
- persistent bad breath (which is caused by bacteria)
Treatment for Gum Disease
The most common treatment for periodontal disease is scaling and root planing. During this procedure a hygienist or dentist will scrape below the gum line to clean away any plaque and calculus (tartar or hardened plaque) out of the pockets that have developed as a result of the presence of bacteria. They may also follow up with anti-bacterial rinses.
For many patients this will be sufficient and aside from having to be more diligent in their brushing and flossing will likely not have another flare up.
If the condition has been left too long without treatment and the damage too extensive, surgery may be necessary. Surgery options include: pocket reduction, regeneration of hard and soft tissues (bone and gum), crown lengthening, soft tissue grafting, and implant placement (where teeth have already been lost).
As in every case, do not decide on treatment by yourself. Discuss your symptoms and all aspects of your oral and general health with your dentist. He/she will help you decide which treatment is right for you depending on your particular needs and the extent of your problems.