Gum Disease: Warning Signs and Prevention Methods

If your saliva sometimes turns pink at least a few times a week after brushing or flossing, you may have early-stage gum disease. But this troublesome condition can also have other surprising symptoms—or no symptoms at all.

“This is a very, very silent disease,” said Dr. Rodrigo Neva, chairman of periodontics at the University of Pennsylvania Center for Dental Medicine.

According to the Centers for Disease Control and Prevention, nearly half of American adults over the age of 30 have signs of gum disease, and 9% of them have severe gum disease, known as periodontal disease.

If left untreated, gum disease can become more difficult to treat. Patients may end up losing their teeth,” Dr. Neva said. Some studies link periodontal disease to other adverse health conditions, such as dementia, diabetes and heart disease.

Here's everything you need to know about gum disease, including its causes and early symptoms, as well as how to prevent it and what your dentist can do to control it.

Early stage gum disease is called gingivitis, which is characterized by inflammation of the gums (also called gums).

“It's caused by bacteria (plaque) on the teeth that release substances that irritate the gums,” said Dr. Deborah Foyle, interim chair of the Department of Periodontics at the Texas A&M University School of Dentistry.

Good oral hygiene is key to preventing gum disease because it removes plaque from your teeth before bacteria can harm your gums. Often, people suffer from gingivitis because they don't brush and floss enough. Sometimes, only part of the gums are affected, especially around the backs of the teeth, and people typically don't brush, Dr. Neva said.

Dentists can diagnose gingivitis by using a special instrument that measures the distance between the gums and teeth, said Dr. Y. Natalie Jeong, professor and chair of the Department of Periodontics at Tufts University School of Dentistry. The larger space represents the situation.

If gingivitis is not treated promptly, bacteria can invade and destroy the tissue under the gums, leading to advanced gum disease or periodontal disease. “The bone that supports the tooth begins to break down, in some cases leaving the root exposed and becoming sensitive,” says Dr. Foyle. “Gaps develop between the teeth and the teeth start to loosen.”

People who smoke, have diabetes or grind their teeth have an increased chance of developing gum disease, Dr Cheng said. Some medications, such as steroids and certain epilepsy and cancer drugs, can also increase the risk. Genetics can also make people more or less susceptible, she noted.

Dr. Neva says people who rarely get cavities may also be more susceptible to gum disease than others. This is because the bacteria that cause gum disease outcompete and suppress the bacteria that cause tooth decay.

“It's very common for patients with very, very severe periodontal disease to not have a single cavity,” he said.

Gingivitis is often overlooked because it doesn't cause pain. But Dr. Neva says people with gingivitis may notice bleeding gums when they brush or floss. The parts of the gums near the teeth may also look red instead of pink.

That said, smokers with gingivitis may not experience any bleeding gums or other symptoms, Dr. Cheng said. “People tend to think, 'Well, my gums never bleed, I should be fine,'” she says, but that's a misconception.

Regular brushing and flossing can help prevent gum disease, but once gingivitis develops, practicing good oral hygiene at home won't always solve the problem. Dr. Neva says this is because bacteria may have begun to accumulate under the gums. In these cases, professional cleaning, sometimes with antibiotics, can treat and cure gingivitis.

Once gingivitis progresses into more severe periodontal disease, people may notice their gums begin to recede, causing teeth to appear longer, Dr. Cheng says. They may also experience increased sensitivity around their gums. When they bite, their teeth may not snap together the same way because they have moved, and they may have chronic bad breath. Eventually, their teeth may begin to loosen or even fall out.

Advanced periodontal disease may not be curable. However, dentists and periodontists can recommend treatments that slow or prevent further gum and bone loss. They may also deep clean the roots of the affected teeth and recommend gum surgery.

Keeping your gums healthy is simple: Brush twice a day, floss once a day, and visit your dentist for cleanings every six months or as often as recommended, Dr. Neva says.

“The sooner we detect it,” he said, “the more we can do.”

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