When Good Gums Go Bad

Want to keep your natural teeth as long as possible? Take care of your gums.

Some 50 percent of adult Americans, and 70 percent of seniors, will get gum disease, or periodontal disease, in their lifetimes. And gum disease, left untreated, leads to tooth loss.

The first stage in gum disease is the formation of plaque, a sticky film, on teeth. Plaque is caused by the wide variety of bacteria that live in the mouth when they interact with the different sugars in our food.

Daily brushing and flossing go a long way toward removing that plaque buildup. It’s pretty common, though, for even dedicated brushers and flossers to miss a spot or two, which can lead to plaque buildup. When that leftover plaque reaches between the gum and the tooth, it hardens into tartar. And that sets the stage for gum disease.

That hardened tartar below the gumline irritates and inflames the gums and can cause them to pull away from the teeth. In the first stages of this progression, gum disease is known as gingivitis.

Normal gums are firm and pink. Inflamed gums usually appear darkish red or purple, and may be puffy. Those inflamed tissues are fragile, which is why it’s pretty common for people with gum disease to see blood on their toothbrushes, or even outlining the affected teeth at the gumline. Any break in the mouth tissues can open them to infection, and infection is when things really begin to get serious.

Infection below the gumline can cause tooth decay and a host of other problems, including a foul taste or odor in the mouth, bad breath, and trouble eating due to pain. Even worse, that infection and the decay it causes can cost you teeth and even bone.

That’s periodontal disease, and it may have effects on your overall health as well. The research isn’t settled, but there are strong indications that periodontal disease can be associated with conditions like heart attack, stroke, problems during pregnancy, and lung disease.

Your first line of defense against periodontal disease is to brush at least twice a day and floss at least once. Regular, consistent oral care is needed because plaque usually forms again within 24 hours after it’s removed. And plaque is invisible, so you can’t go by your teeth’s appearance to know whether it’s building up.

Your second line of defense is regular dental checkups and cleaning. Your dental hygienist and dentist will be able to pinpoint trouble spots with your gums that you won’t notice until things get worse.

If tartar is detected, it’s removed through a process known as scaling. If tartar has accumulated on the roots of the teeth, it’s removed through planing. Both of these procedures can be uncomfortable, which is another reason to brush and floss.

More recently, laser root planing has been proven effective. Laser treatment sterilizes the area, causes relatively little tissue damage and swelling, and results in less bleeding and discomfort.

If the disease has advanced, various forms of antibiotic and antimicrobial medication may be prescribed. Those can include oral antibiotics, topical gels, and antimicrobial mouth rinses, among other options.

In severe cases, surgery is required. If the underlying bone has been compromised, one grating may be required to restore it.

Some people are genetically vulnerable to gum disease, while others can be made more likely to develop gingivitis by medications, immune disorders, smoking, diabetes, poor nutrition, poorly-fitting dental work, hormonal changes in women, and simply getting older, among other things.

Some of those risk factors are beyond your control, but you can quit smoking, eat well, and manage your diabetes. If you have a history of gingivitis or periodontal disease, be sure to mention it to your medical doctor. If your dental bridge or dentures don’t fit properly, see your dentist.

No one can guarantee that you won’t develop gum disease, but you can definitely tilt the odds in your favor.

1. Brush twice daily and floss at least once.
2. Rinse your mouth thoroughly after meals to help remove food particles.
3. Inspect your gums periodically for any changes.
4. Have regular dental checkups and cleanings.
5. If you use tobacco in any form, quit.
6. If you’re diabetic, manage your blood sugars carefully.
7. Keep to a balanced, healthy diet.
8. If your dental work irritates your gums, see your dentist as soon as possible.

Nearly half of all adult Americans will develop some form of gum disease. Take control of your oral hygiene, manage any risk factors that you can, and work with your dental provider. You’ll have the best chance of remaining in the 50 percent or so of adults who won’t develop gum disease.