Gum disease is a common type of dental disease that affects the supporting structures of the teeth such as the gum tissue and the bones surrounding the teeth. Gum disease is different than tooth decay in that it causes holes in the bones that support the roots of the teeth. Tooth decay causes holes in tooth resulting in cavities. Gum disease is so common that 90% of the population has a form of the disease. It's primarily caused by neglect of not brushing and flossing on a daily basis, and not regularly going to the dentist.
Gingivitis is the beginning phase of the gum disease process. It is caused by plaque build-up on the teeth, which can lead to a bacterial infection. Gingivitis causes red, bleeding gums and is noticed when a person brushes their teeth. "Bleeding is not caused by brushing the gums too hard but is related to the bacteria building at the gum line," says David Okano, DDS, MS, section head of Periodontics at the University of Utah School of Dentistry. Gingivitis can be reversible if the individual regularly flosses, brushes their teeth, and sees their dentist every six months.
If gum disease continues, an individual may notice swollen gum tissue, receding gums, and pockets around the teeth. These pockets are spaces that deepen between the gum of the tooth due to the bone being resorbed. Individuals may notice food get caught between their teeth or underneath the gum tissue. In more severe late stages of gum disease, teeth can shift and loosen.
Gum disease can eventually lead to bone loss. In this stage, an individual can lose bone support causing the tooth to loosen. If an individual gets to this phase of gum disease, it's much harder to treat and sometimes untreatable in the most advanced cases of bone loss. Okano points to a recent study that found nearly 50% of adults (age 65 and older) experience the bone loss phase of gum disease. The percentage of those with severe bone loss is around 8% and are at the greatest risk for tooth loss. According to Okano, a person after the age of 35 is far more likely to lose a tooth due to bone loss from gum disease compared to tooth decay.
There is a growing body of scientific evidence that supports gum disease may be associated with other health complications. Years of research has found diabetic patients are more susceptible to gum disease. "We know patients who are diabetic and not well controlled can be more prone to infection," Okano says. The effect of gum disease and diabetes is referred to as "bi-directional" which means there's influence both ways. Gum disease is not only more likely to occur in a patient that has uncontrolled diabetes, but inflammation in gum disease makes it harder to control diabetes. Diabetes has also been listed as an underlying health condition that might increase risk of severe illness from COVID-19.
Other evolving research has associated gum disease to other systemic diseases including:
- Cardiovascular disease (heart attacks and stoke)
- Pulmonary disease
- Pregnancy with pre-term delivery of babies with low birth weight babies
- Certain cancers (kidney and pancreatic)
- Alzheimer's disease
Everyone is susceptible to gum disease, but some may be a greater risk. According to several NHANES studies, individuals over the age of 65 have a greater severity of gum disease. Hispanic populations and African Americans may also have higher incidences of periodontitis.
Prevention is the key to gum disease, stresses Okano. It's important to brush and floss your teeth daily. An individual should also see their dentist regularly, at least every six months. Those with more severe forms of gum disease should see a periodontist.