The National Institute of Dental and Craniofacial Research (NIDCR) estimates that about 80 percent of Americans have some form of gum disease. Since we are regularly exposed to advertisements for dental products that claim to reduce the risk and incidence of gum disease, this seems like a surprisingly large number.
Yet basic prevention is still lacking for many, says Dr. Steve Dedrickson of Sevens Dental Group in Clayton. He cites poor oral hygiene and insufficient preventive care as the primary causes for gum disease, which can range from minor gum inflammation, known as gingivitis, to serious disease that affects teeth and bone.
“Other risk factors are poor nutrition, smoking, chewing tobacco, high stress levels, diabetes, Down syndrome, AIDS, and certain medications, including steroids, oral contraceptives and blood pressure medications,” he says. “Also, children of parents with gum disease are 12 times more likely to have the bacteria that can lead to periodontal disease.”
Gingivitis leads to red, swollen gums that bleed easily. Patients with this problem can manage the disease by brushing and flossing regularly and having regular dental check-ups. If gingivitis is not treated, it can lead to periodontitis, a more serious condition in which the gums recede and infection may occur.
As we’ve been told in countless toothpaste ads, the problem begins with bacteria that create a sticky substance called plaque. If not removed by brushing and flossing, plaque becomes tartar, which must be removed by a dentist or dental hygienist.
According to the NIDCR, “the body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.”
If that doesn’t alarm you enough to run for your dental floss, consider this: “Gum disease has been linked to other health problems. The incidence of heart disease is about twice as high in people with gum disease,” Dedrickson says. “The most common strain of bacteria in dental plaque may cause blood clots. When blood clots escape into the bloodstream, there is a relation to increased risk of heart attack and stroke.”
Periodontal disease also may increase the risk for diabetes, lung disease, a weakened immune system, respiratory disease, low birth-weight babies, osteoporosis and gastric ulcers.
The best approach is prevention, but catching gum disease early is the next best strategy for maintaining a healthy mouth. “Bleeding gums during brushing are not normal,” says Dr. Matthew Slaven, a periodontist with the Master’s Institute of Implants and Periodontics in St. Louis.
Slaven advises patients to brush teeth for 90 to 120 seconds, using a soft-bristle toothbrush and light pressure. “You don’t need to scrub the teeth in order to remove plaque,” he says. Electric toothbrushes may be helpful for people who have been diagnosed with gum disease. “Remember that the brush is doing the work for you,” he adds. “Just put the electric toothbrush at the gum line and gently move it across the teeth. There’s no need to make brushing motions with an electric toothbrush.”
Mouthwash is also beneficial for most people, Slaven says. He suggests a mouthwash approved by the American Dental Association. For patients who are diagnosed with gum disease, dentists also may recommend deep cleaning to remove tartar, prescription medications to treat infection, and oral surgery in the most extreme cases. Slaven recommends perio.org, the Web site of the American Academy of Periodontology, for more information about gum disease, its treatment and proper oral hygiene.