Gum Disease Causes, Symptoms, Treatment & Prevention

About Gum Disease

Gum Disease CausesIf you have gum (periodontal) disease, you're not alone. Many U.S. adults currently have some form of the disease. It ranges from simple gum inflammation, called gingivitis, to serious damage to the tissue and bone supporting the teeth. In the worst cases, you lose teeth.

Whether your gum disease is stopped, slowed, or gets worse depends on how well you take care of your teeth and gums every day, from now on.

Generally, people don't show signs of gum disease until their 30s or 40s. Men are more likely to develop it than women. Although teenagers rarely develop the severe disease, periodontitis, they can have the milder gingivitis.

Gum Disease Causes

Most commonly, gum disease develops when poor brushing and flossing habits allow plaque to build up along and under the gum line.

Plaque that is not removed can harden and form "tartar" that can only be removed by thorough cleaning by a dentist or dental hygienist.

Additional factors that may contribute to gum disease include:

  1. Smoking

    Smoking is one of the most significant risk factors associated with gum disease. It also can lower the chances for successful treatment.

  2. Hormonal changes in girls/women

    These changes can make gums more sensitive and make it easier for gingivitis to develop.

  3. Diabetes

    People with diabetes are at higher risk of infection, including gum disease.

  4. Illnesses

    Treatments for cancer, HIV/AIDS, and other diseases can negatively affect the health of gums.

  5. Medications

    Hundreds of prescription and over-the-counter medicines can reduce the flow of saliva, which protects the mouth. Without enough saliva, the mouth is vulnerable to gum disease and other infections. Some medications also can cause abnormal overgrowth of gum tissue, making it difficult to keep gums clean.

Stages of Gum Disease

  1. Gingivitis

    The longer plaque and tartar remain, the more harmful they become. The bacteria inflame the gums, which become red, swollen and can bleed easily. This is called gingivitis, a mild form of gum disease.

    Gingivitis can usually be reversed with daily brushing and flossing and regular cleaning by a dentist or dental hygienist. Typically, there is no loss of bone or tissue that hold teeth in place.

  2. Periodontitis

    Left untreated, gingivitis can advance to "periodontitis" (which means "inflammation around the tooth"). Here, gums pull away from the teeth, forming pockets that become infected.

    The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. The infection starts to break down the bone and connective tissue holding the teeth.

    If not treated, the bones, gums, and tissue are destroyed. Eventually the teeth loosen and may have to be removed.

Gum Disease Symptoms

Common symptoms of gum disease include:

  • Bad breath that won't go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Receding gums or longer-appearing teeth

Gum Disease Diagnosis

Any symptom may signal a serious problem and should be checked by a dental professional. A dentist or dental hygienist may:

  • Ask you about your medical history to identify underlying conditions or risk factors (such as smoking).
  • Examine your gums and note any signs of inflammation.
  • Use a tiny ruler ('probe') to check for and measure any pockets between the gums and teeth.
  • Take an x-ray to see if there is any bone loss.
  • Refer you to a periodontist – an expert at diagnosing and treating gum disease, who may recommend treatment options not offered by your dentist.

Gum Disease Treatment

All gum disease treatment requires the patient to maintain good daily care. Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with post-operative care, and risk factors, like smoking, which may lower chances of success.

The main goal of treatment is to control the infection. Depending on the extent of the gum disease, treatment may include:

  1. Deep Cleaning (Scaling and Root Planing)

    With a deep cleaning, a dentist, periodontist, or dental hygienist scrapes off the tartar from above and below your gum line, and gets rid of rough spots on your tooth root, where the germs gather. This helps remove disease-causing bacteria.

    In some cases, lasers are used to remove plaque and tartar. This can result in less bleeding, swelling, and discomfort than traditional deep cleaning methods.

  2. Medications

    Medications may be used with scaling and root planing, but they cannot always take the place of surgery. Long-term studies are needed to determine whether medication reduces the need for surgery and is effective over a long period.

  3. Surgical Treatments
    • Flap Surgery

      This common technique involves lifting back the gums, removing the tartar, and suturing the gums back in place so that the tissue will shrink to fit more tightly around the tooth. This sometimes makes the teeth appear longer.

    • Bone and Tissue Grafts

      Grafting replaces or encourages new growth of bone or gum tissue destroyed by periodontitis. In "guided tissue regeneration" a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow.

Gum Disease Prevention

  • Brush your teeth twice a day (with a fluoride toothpaste).
  • Floss daily.
  • Visit a dentist regularly for check-ups and professional cleanings.
  • Eat a balanced diet.
  • Don't smoke.

Find a Periodontist

When considering any extensive dental or medical treatment options, consider getting a second opinion.

Contact your local dental society for a list of dentists or periodontists in your area or find a periodontist online. Dental schools may also offer a second opinion.

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