If your friends keep offering you a stick of gum to buffer bad breath or you avoid flossing for fear of bloodshed in your mouth, it may be time to see the dentist: the culprit could be gum disease.
Gum disease is an inflammation of the tissues surrounding and supporting the teeth. A major factor in tooth loss in adults, it affects almost 50 percent of the US population over the age of 30 and increases with age, occurring in more than 70 per cent of people over 65 according to the American Dental Association (ADA) and Centres for Disease Control and Prevention (CDC).
Gum disease begins as gingivitis, simple inflammation marked by red, swollen gums. Bad oral hygiene – inconsistent brushing and flossing – causes plaque to build up, and over time, grow below the gum line, infecting tissue around the teeth. If left untreated, it may advance to periodontitis, a gum infection that damages the soft tissue and bone supporting the teeth.
“Gum disease covers both gingivitis (which is reversible) and periodontitis (which is not reversible but manageable),” said Dr. Sevak Abrahamian, DDS, who has practiced in Wilmington for 16 years. “The number one sign of gingivitis is bleeding gums when brushing or flossing. It is a sign of inflammation.” With good home and professional care, you shouldn’t see bleeding, he said, adding, “If untreated, periodontitis can result in the irreversible loss of bone supporting the teeth and in some individuals, this could mean the loss of all teeth and ultimately jaw deformity.”
There are numerous warning signs for gum disease: bad breath or a persistent bad taste in the mouth; red or swollen gums; tender or bleeding gums; loose, sensitive or shifting teeth; and changes in bite or in the fit of partial dentures.
Other factors contributing to gum disease, according to the Mayo Clinic, can include smoking or substance abuse; hormonal changes during puberty, pregnancy or menopause; poor nutrition; medications causing dry mouth; illnesses that affect the immune system such as cancer, and even heredity – family history of gum disease is a risk factor. “It is very important to discuss the history of gum disease with parents and grandparents,” said Dr. Abrahamian.
Neglected teeth and gums can lead to problems beyond the mouth; researchers have been studying the connection between poor oral health and health problems such as cardiovascular disease, respiratory disease or diabetes.
“Research is still ongoing,” said Dr. Abrahamian. “One of the connections we have seen is the bacteria – the germ that causes gum problems – affecting cardiovascular (heart) tissues. People with diabetes are more prone to the breakdown of gum tissue because of their compromised immune system. And in females, we have seen the connection between bad oral health and premature or low birth-weight babies.”
Fortunately, studies have shown that the consequences of gum disease improved with treatment. Harvard Health Publications and The American Journal of Preventative Medicine reported better health among people with common medical issues who were treated for gum disease “evidenced by lower health care costs and fewer hospitalisations.”
The American Academy of Periodontology recommends a comprehensive annual exam to screen for gum disease. However, if you notice any of the warning signs – bleeding gums in particular – schedule an appointment with your dentist, advises Dr. Abrahamian.
To screen for gum disease, discuss the following at your next dentist appointment:
The use of a fluoride, mouth rinse, toothpaste, floss and recommended toothbrushes to best remove plaque, based on the condition of your teeth and gums.
How often you need dental check-ups. “Family history of gum disease may require more careful monitoring by your dentist and hygienist because some people may be at higher risk,” said Dr. Abrahamian.
The proper way (and how often) to brush and floss. Dr. Abrahamian recommends patients brush twice a day and floss once, in the evening. “If it is done right, that should be adequate,” he said. “I ask patients to floss then brush. Some do it the other way around.”
Your oral habits: whether you smoke, eat poorly or grind/clench your teeth.
Review your overall health with your dentist, he or she is a valuable part of your health care team. Dr. Abrahamian adds that in addition to gum disease, regular dental visits can also screen and detect oral cancer, an aggressive but curable disease if found in time. – Sharon Adelman
(Photo of Dr. Sevak Abrahamian, DDS by Maureen Brady)