Like a lot of people, Susan Karcz didn’t often think about her gums. “People tend to pay more attention to teeth,” she says. “You can see them, for one thing.” Gum graft surgery changed her focus. The procedure involved removing tissue from the roof of Karcz’s mouth and grafting it onto the front of her lower jaw, an experience she does not want to repeat.
White, sparkling teeth are not the only sign of a healthy mouth. Your gums are a barrier that helps prevent inflammation that may damage your body. In fact, gum disease has been linked to health problems such as diabetes, heart disease, stroke, and premature births or low-birth weight babies.
The good news? With daily brushing and flossing, and regular check-ups, most people can prevent gum disease. Here are answers to top questions about gum disease.
What is gum disease?
Pamela Quinones, RDH, president of the American Dental Hygienists’ Association, wishes that more people paid attention to their gums. “Most people go to the dentist because they’re worried about cavities,” Quinones tells WebMD. “But once you reach a certain age, gum disease is a more important concern.”
Just as your skin protects your muscles, bones, and major organs, your gums protect your teeth and the structures that hold them in place. Gum disease, also known as periodontal disease, starts when plaque, made up of bacteria, mucus, and food particles, invades the small space between your gums and teeth. If left to fester, your gums can become infected, putting them and your teeth at risk. If gum disease progresses, it becomes increasingly difficult, painful, and expensive to treat.
What are the stages of gum disease?
Gingivitis is the earliest stage of gum disease. At this stage, gums become red and inflamed and may bleed easily. Gingivitis can usually be turned around with a regimen of daily brushing and flossing, along with regular dental check-ups and cleanings -- but it does need to be caught early. “Gingivitis is reversible. Periodontitis usually has to have some sort of intervention,” says Quinones.
- Periodontitis is a more serious stage of gum disease that can seriously damage the gums and structures that support the teeth. One of the hallmarks of periodontitis is pockets that form when gums pull away from the teeth. The bone and ligament that support the tooth start to break down and over time, the tooth becomes loose in its socket. Without treatment, the tooth could eventually have to be removed.
Besides what it does to the mouth, gum disease has been linked to conditions such as diabetes, heart disease, stroke, and premature births or low birth weight. According to Sally Cram, DDS, PC, consumer advisor for the American Dental Association, emerging research pinpoints inflammation. “They’re finding the role of inflammation in the body is very critical to a lot of these different diseases,” Cram tells WebMD. “And that’s essentially what gum disease is: infection and inflammation in the oral cavity.”
How many people have gum disease?
The U.S. Department of Health and Human Services estimates 1 in 7 adults between the ages 35 and 44 have some form of gum disease, from gingivitis to severe periodontitis. By age 65, 1 in 4 adults have gum disease. A report by the American Academy of Periodontology estimates 20% to 30% of adults have gum disease serious enough to put them at risk of losing teeth.
Gum disease more often affects men than women. One theory is that women in general take better care of their teeth. Smoking is a huge risk factor for gum disease. Up to 90% of people with severe periodontitis smoke. Further, when gum surgery becomes necessary, cigarette smoke slows down the healing process.
What are the signs and symptoms of gum disease?
“People associate disease with pain,” says Quinones, “but early gingivitis is usually not painful.” She recommends keeping an eye out for signs of a gum problem before things get serious. Here are symptoms to watch out for.
- Swollen or red gums
- Gums that are tender or bleed easily
- Chronic bad breath
- Areas of gum that appear to be pulling back from the teeth
- Pain when chewing
- Sensitive teeth
- Teeth that are loose
How do you treat gum disease?
The stage of gum disease will determine how it is treated. In all cases, however, the goal will be to bring any infection under control and prevent further damage.
- Scaling and root planning. For less severe cases of periodontitis, the dentist will remove infection-causing plaque with a method called scaling and root planing. It is essentially a deep cleaning method that removes bacteria from around the gum line and on the tooth root.
- Medications. Sometimes antibiotics or antimicrobial medications can reduce the size of gum pockets. These come in the form of mouthrinse, gel, pills, or tiny round particles that the dentist places directly in the pocket.
Surgery. If deep cleaning and medication do not return infected gums to a state of health, surgery is the next step. There are two types of surgery. Flap surgery lifts away gum tissue so the dentist can clean underneath it; then the tissue is sutured back in place. Gum or bone graft surgery grafts tissue or bone from another part of your mouth onto the damaged part of your gum or jaw.
How can you prevent gum disease?
“You can save yourself a whole lot of problems: pain, money, aggravation, by just doing simple preventive things,” says Cram. Caring for your gums involves:
- Brushing your teeth twice a day
- Flossing once a day
- Seeing your dentist for regular check-ups and cleanings
Even if you brush and floss without fail, a professional cleaning can remove tartar that your toothbrush cannot. While two cleanings a year works for some people, your dentist or hygienist may suggest a more frequent schedule if your gums and teeth show signs of damage.
In addition, behaviors that are good for your overall health also help protect your gums. These include not smoking and eating a healthy diet that’s low on sugar and high on whole grains.
When your dentist asks about your health history, she’s not being nosy. If you are pregnant or have a family history of diabetes, stroke, or heart disease, let your dentist know. Your dentist or hygienist will also want to know what medications you are taking — some of them increase your risk of gum disease. And be ready to tell your dentist or hygienist if you have noticed any signs of bleeding or swelling in your gums, or loose or painful teeth.
A little extra attention to your gums can keep your whole smile beautiful for many years to come.