Gum disease (also called periodontal disease) is an infection of the tissues that support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. At each regular checkup the dentist will measure the depth of the shallow v-shaped crevice (called a sulcus) between your tooth and gums to identify whether you have gum disease.
Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.
Periodontal diseases attack just below the gumline in the sulcus, where they cause the attachment of the tooth and supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket; generally, the more severe the disease, the greater the depth of the pocket.
Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis.
In the early stage of gum disease, called gingivitis, the gums become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.
In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. Whereas healthy gums and bone anchor teeth firmly in place, infected gums can cause teeth to become loose, fall out, or have to be removed by a dentist.
Some factors increase the risk of developing periodontal disease:
- Tobacco smoking or chewing
- System-wide diseases such as diabetes
- Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives
- Bridges that no longer fit properly
- Crooked teeth
- Fillings that have become defective
If you notice any of the following signs of gum disease, see the doctor immediately:
- Gums that bleed easily
- Red, swollen, tender gums
- Gums that have pulled away from the teeth
- Persistent bad breath or bad taste
- Pus between your teeth and gums
- Permanent teeth that are loose or separating
- Any change in the way your teeth fit together when you bite
- Any change in the fit of partial dentures
It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed.
Oral health is not an entity independent from the rest of the body. In fact, your oral health plays a significant role in the overall health of your entire body. Having poor oral hygiene can lead to a higher risk of other harmful diseases outside of the mouth.
According to the National Institute of Dental and Craniofacial Research and the National Institutes of Health, evidence shows a correlation between oral disease and heart disease, stroke, pregnancy complications, and chronic degenerative conditions. It is important to maintain your body’s health by visiting your family physician, and by visiting your dentist at least once every six months.
Better health = longer life
One human mouth is home to more microorganisms than there are people on earth. Some of the bacteria found in our mouths can cause a variety of oral health problems along with gum inflammation and tooth loss. If left untreated, these problems can get worse with time and turn into periodontitis, which may ulcerate gums and destroy the soft tissue and bone that anchors your teeth to your jaw. These bacteria can also send inflammatory substances throughout the body, infecting other areas outside of the mouth.
Scientists and dental researchers are discovering that out-of-control inflammation may prove to be the force in an ever-growing list of greatly feared, chronic illnesses from clogged arteries and heart attacks to arthritis and cancer. Chronic oral infection may trigger or intensify systemic diseases.
The destructive inflammatory processes that define periodontal disease are closely intertwined with diabetes. Patients with diabetes mellitus (NIDDM) are three times more likely to develop periodontal disease than patients without diabetes. Add smoking to the mix, and the chances of developing periodontitis are 20 times higher. Chronic periodontal disease can disrupt diabetic control, suggesting that periodontal infections may have systemic repercussions. The exact nature of this complex relationship is not clear. It is likely, however, that increased genetic susceptibility to infection, impaired host response, and the excessive production of collagenase found in periodontal disease may all play important roles in NIDDM.
Acute viral and bacterial infections are known to induce insulin resistance, which disrupts blood glucose control. Factors including stress, fever, catabolism, and elevated levels of hormones antagonistic to insulin such as growth hormone, cortisol, and glucagon may play a role in the development of insulin resistance during infection. It is possible, then, that chronic gram-negative infections with persistent production of bacterial toxins, like periodontal disease, could have the same deleterious effect.
Heart Disease and Stroke
A number of studies have shown that patients with periodontitis are more likely to develop cardiovascular disease than those without periodontal infection. One such study suggests that the risk of fatal heart disease doubles for patients with severe periodontal disease. Part of the link between these two diseases may be discovered through investigations of the opportunistic, infectious bacteria that colonize the mouth. Scientists theorize that certain types of these bacteria, which form biofilms and cause periodontal disease, also activate white blood cells in the body to release pro-inflammatory mediators that may contribute to heart disease and stroke.
Preterm Low Birth Weight Babies
Emerging evidence may link severe periodontal disease in pregnant women to an increase in the risk of delivering preterm, low birth weight babies. In a recent study, mothers of preterm low-weight newborns were found to have significantly more severe periodontal disease than did mothers of full-term, normal weight babies. Scientists theorize that oral pathogens release toxins that reach the human placenta via the mother’s blood circulation and interfere with fetal growth and development. Oral infection also prompts accelerated production of inflammatory mediators PGE 2 and TNF that normally build to cue the onset of labor. Instead, the elevated levels of these inflammatory mediators trigger premature delivery.
Of all the organs in the craniofacial-oral-dental complex, it is perhaps the salivary glands and the saliva the produce that forge the strongest link between oral and systemic health. Salivary function is extremely sensitive to changes in our general well-being, ranging from subtle effects of over-the-counter cold medications to the devastation of life-threatening disease. With its vast antimicrobial arsenal, saliva represents a remarkable evolutionary selective advantage for the host against invading pathogens such as HIV, the fungus Candida Albicans , and a host of bacteria associated with oral and systemic diseases. Secretory antibodies, for example, are found in saliva. Large salivary glycoproteins called mucins appear to have antiviral properties as do cystatins, a family of proteins that are active against herpes viruses.
Saliva also contains histatins, antifungal proteins that are potent inhibitors of candida, which is normally kept in check at extremely low levels in the mouth. When the oral balance is upset, however, by HIV infection or other immunosuppressive and debilitating disorders, antifungal defenses are overwhelmed and the candida fungus flourishes uncontrolled.
Reinforcing saliva’s antiviral and antifungal activity are salivary constituents that thwart bacterial attack. These enzymes destroy the opposition by various mechanisms, including degrading bacterial membranes, inhibiting the growth and metabolism of certain bacteria, and disrupting vital bacterial enzyme systems. Functioning properly, these and other protective factors in saliva help to maintain the oral environment in optimal working order and restore it to more normal conditions when disturbed.
Xerostomia (Dry Mouth)
Another major source of dry mouth – medication – affects most of us at some time in our lives. More than 400 prescription and over- the-counter drugs are known to have xerostomic effects. Many of these medications are taken daily, particularly by older Americans, to treat chronic conditions such as hypertension and depression. Although salivary gland function does not normally decline with age, the oral dryness experienced by many older persons from certain diseases and long-term medications heightens their risk for oral and dental infections. By 2010, 40 million Americans will be 65 or older and at greater risk for these complications.
Chronic Degenerative Diseases
Infection in the periodontium (gum tissue and supporting bone), primarily by can initiate a series of inflammatory and immunologic changes leading to the destruction of connective tissue and bone. Long considered a localized infection, periodontal diseases are now linked to a variety of conditions with systemic implications.
Periodontitis, an advanced infection of these tissues, often causes tooth mobility and tooth loss, appears to share genetically determined risk factors with several other chronic degenerative diseases such as ulcerative colitis, juvenile arthritis, and systemic lupus erythematosus. Recent research points to specific genetic markers as strong indicators of susceptibility to severe periodontitis.