Got gum disease?
Want to know if you’re at risk of developing gum disease? The American Academy of Periodontology has a gum disease risk assessment survey at www.perio.org/consumer/riskassessment
Nearly half of American adults — roughly 64 million people — have some form of periodontal disease.
What’s worse: many people don’t even know they have it.
“A lot of times patients think nothing is wrong,” said Dr. Marcy Watson, a periodontist at Kaiser Permanente’s Salmon Creek dental office. “A lot of patients don’t have any idea this is going on in their mouth.”
Periodontal disease, or gum disease, is an inflammation of the gums and bone around the teeth. In the early stages, gum disease doesn’t typically cause any pain. But left untreated, periodontal disease can progress to the point it causes irreversible damage, including tooth loss. In fact, it’s the leading cause of tooth loss, Watson said.
“The key thing to remember with gum disease is it’s kind of a silent disease,” said Dr. Dave Stinchfield, a dentist at Discovery Dental in Washougal. “Many times it doesn’t rear its head until it’s quite advanced.”
Gum disease is caused by bacteria from the buildup of plaque on the gums and between the teeth. When the plaque isn’t removed through brushing and flossing, it hardens and must be removed by a dental professional, Watson said.
Gum disease comes in two different forms.
The first is a mild form called gingivitis that is typically limited to the gums. Gingivitis is reversible with thorough home care and regular professional cleanings, Watson said.
The second, more advanced form of gum disease is called periodontitis. Gum disease progresses slowly; it typically takes several years to reach the advanced stage, Watson said.
Periodontitis occurs if the plaque on teeth isn’t removed, leading the bacteria to grow underneath the gums. The inflammation that causes will spread from the gums to the bone, she said.
“Once the inflammation spreads to the bone, it results in deterioration of the bone around the teeth,” Watson said.
Know the signs
While gum disease may not be painful in its early stages, it does have symptoms.
“Some of the earliest warning signs are gums that bleed when you brush or floss,” Stinchfield said. “That means there’s inflammation present, and if inflammation is present, that means something is awry.”
In addition to bleeding, the gums may be red and a little sore. Bad breath that doesn’t go away is another sign, Stinchfield said.
Smoking, however, masks those symptoms, so smokers with early-stage gum disease may not notice any changes, he said.
As the disease progresses, people might notice more symptoms. Their teeth may feel loose or like they’re shifting. Their teeth may also appear longer since their gums are receding, Watson said.
In addition, people might notice pus in the pockets of gum tissue surrounding the teeth, Stinchfield said.
Some people are at increased risk for gum disease, such as those with poor oral hygiene, smokers and people experiencing hormonal changes, such as pregnant women and teenagers, Stinchfield said. People with a family history of gum disease, especially if they have family members who lost their teeth from gum disease, are also at a higher risk, he said.
People with other systemic medical conditions, particularly if they’re uncontrolled, may also be at higher risk, Watson said. Heart disease, respiratory disease and diabetes are all associated with periodontitis, she said.
‘Prevention is key’
Good oral hygiene and regular visits to the dentist are the best ways to prevent gum disease.
Daily flossing and brushing — and making sure the toothbrush bristles overlap the gum tissue — will reduce the plaque that can cause gum disease, Stinchfield said. Those who have larger gaps between their teeth or bridges might also benefit from water picks, which are, according to Stinchfield, “like a pressure washer for the teeth.”
People should also follow their dentist’s recommendations for cleaning and exams. Dentists can assess a person’s periodontal health, and detect gingivitis early, by measuring the pockets of gum tissue around each tooth, Stinchfield said.
“It’s so important that people have a dentist looking in there,” he said. “There’s no way to do that at home.”
Gum disease can be treated.
Gingivitis is reversible because it hasn’t reached the bone yet, Watson said. It can easily be reversed by removing the plaque on the teeth and following good oral hygiene practices at home, she said.
With the more advanced stage of gum disease, there’s no way to cure the disease, but there are ways to treat the patient back to health, Watson said. Deeper cleanings to remove tartar from the roots of the teeth can help. Some people may also need surgery or additional corrective therapy, she said.
People with periodontitis will also likely need to see their dentist more frequently, every three or four months instead of every six months, for example.
“Prevention is key because once you actually lapse into a periodontal disease status, at that point, it’s mostly just trying to slow the disease down,” Stinchfield said.
