causes, risks, prevention and when to consult your dentist

People say your eyes are the window to your soul, but your mouth can be the window to your health. It is estimated that up to 50% of Americans currently have mild gum disease, or gingivitis, while up to 80% have dealt with the more serious form, periodontitis, at some point. And it’s not just teeth that are at risk. According to the family dentist Kristy GretzulaDMD, gum disease has been linked to a higher risk of diabetes and heart problems such as atherosclerosis, heart attack and stroke.

To help you better understand gum disease, our team spoke with two dentists and a periodontist who gave us insight into its causes and what you can do to prevent it.

What is gum disease?

Gum disease is an infection and inflammation of the tissues that surround and support the teeth. There are two main forms: gingivitis and periodontitis.

Gingivitis is the mildest and quite common form. It causes localized irritation, swelling and redness of the gums. If gingivitis is left untreated, it can progress to periodontitis, a more serious form of gum disease.

There are different stages of periodontitis, from mild to advanced, but they all go beyond the gums, affecting the deeper tissues and bones that support the teeth.

What are the symptoms of gum disease?

The symptoms of gum disease are not always obvious. “Periodontal disease is often silent, which means that symptoms – especially pain – may not appear until an advanced stage of the disease,” he says. Y.Natalie JeongDMD, periodontist and professor and chair of the Department of Periodontics at Tufts University.

However, she recommends keeping an eye out for the following signs and symptoms:

• Red, swollen, or tender gums or other pain in your teeth or mouth

• Bleeding when brushing and flossing or eating certain foods

• Receding teeth – gums that are receding or moving away from the teeth, making the teeth appear longer than before

• Loose or separated teeth

• Pus between the gums and teeth

• Canker sores

• Persistent bad breath

• A change in the way your teeth fit together when you bite

• A Change in the Fit of Partial Dentures

The stages of gum disease

You may not have all of these symptoms, as they largely depend on the stage of gum disease. There are four, from gingivitis to advanced periodontitis.

According to the restorative dentist Naomi Levy Goldman, DMD, the lack of pockets around the teeth separates gingivitis from periodontal disease. “We use a small probe to measure the space between the tooth and the gum tissue that surrounds it. If this space is between 1 mm and 3 mm, the pouch is classified as healthy. this is the beginning of periodontal disease,” she says. When you hear your hygienists shouting numbers during cleaning, they are measuring it.

Here’s a breakdown of the four stages and their most common symptoms.

• Gingivitis: As mentioned, gingivitis is the initial stage. You may notice red, swollen gums that likely bleed easily when brushing or flossing. Bad breath and sensitive gums are also common at this stage.

• Early periodontitis: At this stage, inflammation penetrates deeper into the gum tissues, causing pockets between the gums and teeth. Gums may begin to recede, making teeth appear longer. The gums may bleed more and there may be some bone loss.

• Moderate periodontitis: As gum disease progresses, the pockets become deeper. The gums recede further and you may notice loose or displaced teeth. Bad breath, bleeding gums and moderate bone loss are also characteristics of this phase.

• Advanced periodontitis: This is the most serious stage. In advanced periodontitis, you will have deep gum pockets, significant bone loss, loose or displaced teeth, and possibly pus between your teeth and gums. Teeth are more likely to fall out at this stage, or they may need to be removed.

What are the common causes of gum disease?

Gum disease is typically caused by a buildup of plaque – a sticky, colorless film – on the teeth and gums due to poor oral hygiene. If plaque is not properly removed through regular brushing and flossing, it can harden into tartar, which can only be removed by a dentist or dental hygienist. If tartar is not cleaned regularly, it can cause gum infection and inflammation.

However, there is also a genetic component. “If a close family member has gum disease, there is a greater chance that you will develop it too, even with good oral hygiene practices,” says Gretzula.

There are also other contributing factors:

What are the risks associated with gum disease?

These can include bone and tissue deterioration, loosening of teeth, tooth infections and, eventually, tooth loss.

According to Jeong, several studies have also shown a link between periodontal disease and other health problemsIncluding:

Gum disease has also been linked to other health conditions, such as rheumatoid arthritis, Alzheimer’s disease, depression, certain types of cancer It is kidney diseasealthough more research is needed to understand how they may be connected.

Treatment of gum disease

Treatment options depend on the severity of the disease. It usually starts with professional scaling and root planing, also known as deep cleaning.

During a deep cleaning, your dentist or periodontist removes plaque and tartar from below the gum line and tooth roots. “Root planing [also] allows your periodontist to smooth the tooth root to prevent future plaque or toxins from adhering,” says Jeong. Depending on your case, antibiotics may also be prescribed to help control the bacterial infection in your gums.

Many people respond well to deep cleaning and do not require any additional treatments. However, severe cases may require surgery. There are two surgical options in these cases.

• Flap surgery/pouch reduction surgery: In advanced gum disease, flap surgery may be necessary to reduce pocket depth and make teeth and gums easier to clean. During this surgery, the gum is removed from the tooth, the roots are cleaned, and the gum is sewn back into place.

• Bone or tissue grafts: If there is significant loss of bone or tissue around teeth, grafting procedures may be necessary to regenerate lost bone or soft tissue. If your teeth are exceptionally sensitive, Jeong says you may also need a gum graft — your dentist or periodontist will take gum tissue, usually from the roof of your mouth, and place it where there is little or no gum tissue (such as over a receding gum). line).

If your dentist recommends surgery, don’t worry. “We have a lot of techniques that we use now that didn’t exist in the past, and people can be a little intimidated by the procedure, but it’s not something to be afraid of,” says Jeong.

Gum disease prevention

Still, it’s always best to prevent gum disease if possible. Fortunately, most cases can be prevented with good oral hygiene. Our experts recommend:

• Brush twice a day for at least 2 minutes

• Using an electric toothbrush if possible

• Floss once a day

• Using a water flosser once a day

• Schedule professional dental cleanings every six months or more frequently if you have gum disease

• Eat less sugar

Gretzula also says a nutrient-dense diet is crucial, with a focus on vitamin C and calcium, which can support gum health.

When to see your dentist

If you think you have gum disease, see your dentist as soon as possible to prevent further bone loss and damage to the tissues around your teeth. Even if you don’t think you have gum disease, it’s essential to keep a regular appointment with your dentist to keep your gums and teeth healthy.

For most people, a hygiene visit every six months, followed by brushing twice a day and flossing and flossing once a day is ideal, according to Goldman. “For patients who tend to develop tartar more quickly, or patients diagnosed with periodontal disease, regular maintenance for three to four months is recommended,” she says.

Common questions

Is there anything you can do to treat gum disease at home?

It depends on how advanced the gum disease is. “Daily flossing or using a Waterpik can be used to treat gingivitis at home, as long as there is no tartar buildup creating the inflammation,” says Goldman. However, if tartar is present, it needs to be removed by a professional first.

Can salt water help with gum disease?

Yes, salt water can help treat gum disease in the early stages of gingivitis, according to Gretzula. “Salt water has anti-inflammatory properties that can help reduce swelling and soothe inflamed gums. [also] promotes healing by creating a slightly hypertonic environment, which helps reduce bacterial counts and supports tissue repair,” she says. That being said, if your gum disease has progressed to one of the later stages, salt water may not be as effective.

Is it possible to reverse gum disease?

You can reverse gum disease if you catch it early, but not after it has advanced to a certain point. “In the more advanced stages of gum disease, the supporting structures of the teeth, including bone and connective tissue, have been extensively damaged or destroyed. Once bone loss occurs, it is challenging to regenerate,” says Gretzula, adding that current treatment options do not fully restore the connective tissue that anchors the teeth.

Meet our experts

• Naomi Levy GoldmanDMD, owner and cosmetic and restorative dentist, Levy Goldman Dentistry, Peabody, Mass.

• Kristy GretzulaDMD, Dentist, Hawley Lane Dental, Stratford, Connecticut.

• Y.Natalie JeongDMD, professor and chair of the Department of Periodontology, Tufts University, Boston