Gum disease: How to identify, treat, and manage it

By Rachel Reiff Ellis Reviewed By Michael Friedman, DDS Gums protect and support your pearly whites and the tissue that holds them to the bone. When your gums aren’t healthy, you risk losing those teeth — and damaging your overall health. How gum disease happens “Gum disease usually starts in areas that you’re not brushing or keeping clean,” says Mark Ryder, DMD. He’s chair of the division of periodontology at the University of California, San Francisco School of Dentistry. “Bacteria build up in a film on your teeth and you get a reaction to that bacteria — inflammation.” Inflammation, or swelling of the gums (also known as gingivitis), can be one of the first warning signs of gum disease. Other symptoms include: • gum redness • bleeding while brushing or flossing • receding gum line • loose teeth • constant bad breath • mouth sores Pain isn’t one of the first symptoms of gingivitis. “What’s unique about early gum disease is that it doesn’t cause much discomfort at all,” Ryder says. “So you really have to pay attention to these other symptoms.” If you don’t treat gingivitis, gum problems can get worse. “Infection and inflammation will spread deeper into the tissues that support the tooth,” Ryder says. “When that happens, the inflammation becomes destructive.” The gums begin to pull away from the teeth, which lets in more bacteria. At this stage, gum disease is called periodontitis. “Periodontitis causes the tissues and bone that support the teeth to break down,” Ryder says. This creates pockets where bacteria can grow. “As you lose bone, your teeth get looser and looser, and eventually, they fall out,” he says. What’s more, oral health affects your whole body’s health. Studies have shown that people with gum disease are more likely to get heart disease and less able to control their blood sugar. Who’s at risk? The CDC found that 47 percent of adults over 30 have periodontitis. After age 65, that number goes up to 70 percent. You may be more likely to get gum disease if you: • Use tobacco products • Are pregnant • Have a family history of gum disease • Have diabetes • Have high stress •Grind or clench your teeth Some birth control, antidepressants, and heart medications may raise your risk of gum disease. Tell your dentist about any medications you take regularly. For the best oral health, Ryder suggests you work to manage your risk factors. “Look at things that would make you more susceptible to gum disease,” he says. “Stop smoking, manage diabetes correctly, and if you’re pregnant, think about visiting the dentist more often during your pregnancy.” How to treat gum disease Your dentist will remove the root cause of the problem — plaque on your teeth. “The dentist would clean around all the affected areas, and really go down to the bottom of the pocket of the tooth, because that’s where the most harmful bacteria is,” Ryder says. This deepcleaning process is called scaling. The dentist will also look at other causes of plaque, like loose fillings or crowns. He may take X-rays to check for bone loss. If the disease is severe, or doesn’t get better over time, you might need surgery. You might be referred to a periodontist, a dentist who specializes in gum disease.