Guidance on caring for your gums Published March 28, 2011 By Maj. Jody Harrison 99th Dental Squadron NELLIS AIR FORCE BASE, Nev. -- Periodontal disease, or gum disease, primarily develops as a result of gum infections and may lead to loss of teeth if left untreated. There are two main types of periodontal disease: gingivitis and periodontitis. According to the latest National Health and Nutrition Examination Survey, 50 percent of the adult population has gingivitis and 35 percent has periodontitis. Gingivitis occurs when bacterial plaque, a sticky white substance that develops on the surface of the teeth, infects gum tissue. This plaque, which is largely composed of bacteria, produces toxins that can irritate and inflame the gums and cause bleeding, swelling and pain. If untreated, this inflammation may spread beyond the gums and lead to bone loss. This is called periodontitis. While bacterial plaque is primarily responsible for the development of periodontal disease, smoking, diabetes, genetics and other risk factors may contribute to the extent and severity of periodontal disease. Smoking is considered one of the most modifiable risk factors for periodontal disease. On average, smokers are four times more likely to develop periodontal disease compared to non-smokers and the severity of periodontal disease directly relates to both the duration and amount an individual has smoked. Smoking also impacts an individual's response to periodontal treatment. In most cases, smokers respond less favorably to non-surgical and surgical management of periodontal disease. People who desire to help manage their periodontal disease through smoking cessation should speak to their dentists for more information or contact the Health and Wellness Center at 653-3375. Diabetes is a disease that affects the body's ability to produce or properly utilize insulin. People with diabetes are more likely to develop gum disease than those without it and people with it tend to have extra symptoms such as fungal infections, dry or cracked lips, dry mouth, dry or burning tongue and an increase in dental decay due to decreased salivary flow. By properly controlling daily blood sugar levels, either with diet, medicines, exercise or a combination of these, people with diabetes will reduce their risk of developing periodontal disease. In addition, controlling daily blood sugar levels will help those who already have periodontal disease by decreasing the severity of the disease. Evidence indicates that diabetic patients who improve their periodontal health may also improve their diabetes by reducing their insulin requirements and long term blood sugar levels. Genetics is also a risk factor for developing periodontal disease. Studies examining the periodontal health of identical and fraternal twins suggest that periodontal disease may be attributed to genetics up to 50 percent of the time. In addition, the presence of certain genes, polymorphisms, may increase the risk of developing periodontal disease depending on one's heritage. Additional risk factors that may contribute to the formation and progression of periodontal disease include, but are not limited to, stress; certain hypertensive, seizure, and immuno-suppressive medicines; pregnancy and hormone changes. To determine if you have periodontal disease, check to see if these signs and symptoms apply: bleeding and swollen gums, loose teeth, longer appearing teeth as a result of bone loss and recession, and teeth that have moved or shifted. Since these changes often go unnoticed by most patients and occur over a long period of time, it is important to visit your dentist every six months. If your dentist determines that you have periodontal disease, depending on the severity of your disease, you may be referred to a specialist for treatment. If you've been diagnosed with periodontal disease, it is important to maintain good oral hygiene with proper brushing and flossing. Your dentist or hygienist can review these oral hygiene techniques with you and tailor home hygiene instructions based on your needs and capabilities. Additionally, it's important to follow-up with your dentist for scheduled maintenance visits. Evidence suggests that well-maintained patients with periodontal disease lose fewer teeth than those who have the disease but either neglect treatment or are not compliant with scheduled maintenance visits. If you think you may have periodontal disease or have been told you have periodontal disease and have not been treated, contact your dentist for an examination.
