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Gum Disease: Gingivitis and Periodontitis | Hawaii Family Dental

According to the Center for Disease Control, up to 50% of Americans suffer from gum disease. And, new evidence has found that people who have gum disease are twice as likely to have heart disease and gum disease has been linked to Alzheimer's and dementia.

When not treated, gum disease (also known as periodontal disease) can damage the bones, gums, and tissues, eventually leading to tooth loss. Bad breath, red or swollen gums, tenderness, and bleeding of the gums are symptoms of gum disease. 

Additionally, pain when chewing, loose and sensitive teeth, receding gums, and pus coming from the gums are other indications. Chronic conditions and systemic diseases like rheumatoid arthritis, heart disease, and low birth weight have also been linked with gum disease.

The association between gum disease and rheumatoid arthritis (RA) is well established in a number of studies. Likewise, it can speed up the progress of its symptoms.

A study conducted in 2014 also discovered a similar connection between heart disease & periodontal diseases. People with periodontal diseases have almost twice the risk of having cardiovascular disease. According to scientists, the inflammation of the gums can cause hardened arteries or atherosclerosis. It is already well established that atherosclerosis makes blood flow to the heart difficult. Also, streptococcus sanguis, a bacteria found in periodontal disease, can spread to the heart and plays a role in strokes.

Pregnant women with gum disease are also putting themselves and their soon-to-be-born babies at risk. Studies show that chronic inflammatory disease can prevent a fetus from growing to its full potential. Thus, this can lead to a low birth weight among infants and/or pre-term birth. When the baby is born with low birth weight or earlier than expected, chances of deformities and physical issues can arise.

However, gingivitis is reversible. Its progression can be halted with proper oral care, which includes regular brushing, flossing, rinsing using an anti-bacterial mouthwash, and visiting the dentist twice a year for professional teeth cleaning, and healthy food intake through a well-balanced diet. Additionally, lifestyle changes like quitting smoking or vaping will also be helpful to prevent the development of gum disease.

What Is Gum Disease?

Gum disease has several stages. In its earliest form, it's called gingivitis. Gums are red, sensitive, and maybe swollen. Gingivitis can be cared for during cleanings every 6 months. It can also be prevented through brushing and flossing daily. 

When gingivitis is not immediately treated, it can advance to a more serious stage of gum disease, called periodontitis. At its moderate stages, periodontitis will result in bleeding and pain around the teeth. Gums will continue to recede, and the teeth will begin to loosen as bone support is lost. When it progresses to more advanced stages, the tissue connecting and holding the teeth in place suffers, while the gums, bones, and other related issues which serve as support for the teeth are now damaged.

 

What Causes Gingivitis And Periodontitis?

Plaque and tartar buildup are the primary causes of periodontal diseases. Poor oral hygiene encourages the formation of plaque or the invisible, sticky film made up of chiefly bacteria. Plaque forms when starches and sugars in food interact with the oral bacteria. The longer plaque and tartar dwell on your teeth, the more dangerous they become to your oral health.

The film of bacteria requires daily removal, that when not done, hardens under your gum line. This can turn into tartar. Tartar creates a protective shield for bacteria and causes irritation along the gum line. It is also difficult to remove and requires cleaning with a hygienist or dentist. The result of not removing plaques and tartars from the surface of your teeth could lead to more serious dental health problems that could lead to enamel erosion and eventually tooth decay or tooth loss.

Other factors that can increase the risk of an individual developing gum disease include:

  • Hormonal changes make the development of gingivitis easy as gums become sensitive. Typically, these affect women during puberty, monthly menstruation, pregnancy, and menopause. Still, men can experience hormonal changes as well in adolescence and during later years due to menopause.
  • Diabetes and other illnesses including their treatments also affect the condition of the gums as they can interfere with the immune system. Moreover, diseases like diabetes provide a higher risk of developing infections. Medications can also reduce saliva production which is essential in protecting the mouth against harmful bacteria.
  • Habits such as smoking and too much alcohol consumption can also trigger periodontal disease as they weaken the gum tissues’ natural tendency to repair themselves. In a study conducted by the National Institute of Dental and Craniofacial Research, smoking is one of the most significant risk factors that contribute to the development of gum disease.
  • Stress is also a risk factor for periodontitis as it gives the body a more difficult time to combat infection.
  • Clenching teeth, also known as bruxism causes excess pressure being exerted on the supporting tissues of the teeth. This can speed up the damage periodontitis do to the teeth and gums.
  • Malocclusion. When your teeth are out of alignment, this can put a strain on your gums. Because parts of your teeth are out of alignment, some of the underlying bone might not be able to provide the support your gums need, causing them to recede. In this case, fixing up your teeth might be able to do the trick.

Gum Disease And Alzheimer's

A new study in the Science Advances journal suggests a link between Alzheimer's and gum disease. It points at Porphyromonas gingivalis, a bacterium in the mouth to be responsible for gum disease.

According to Stephen Dominy, the co-author of the study and co-founder of the pharmaceutical company Cortyexyme, although previous research suggests a link between mouth bacteria and Alzheimer's, the evidence of causation is not convincing enough.

This time, Dominy, together with Casey Lynch, also the co-founder of Cortexyme, discovered that P. gingivalis can migrate from the mouth to the brain. The team looked at mice infected with the mouth bacteria and found that the infectious agent eventually goes into the brain.

The Bacteria Also Secrete A Toxic Protein Called Gingipain. This Can Destroy The Brain's Neurons. P. gingivalis Can Also Boost The Production Of Amyloid Beta. Amyloid-Beta Is A Component Of Brain Plaque Which Has Associations With The Neurodegenerative Disease.

Aside from strengthening the link between Alzheimer's and gum disease, the study also kindles hope for treatments against neurodegenerative disease through COR388. In fact, some believe that this compound is the most effective inhibitor of gingipain.

COR388 was found to lower the presence of P. gingivalis by disrupting gingipains. With the reduction of gingipains, inflammation also reduces in response. Thus, amyloid-beta in the brain additionally reduces or is eliminated completely. It also helps preserve the neurons of the hippocampus which is responsible for memory. It is also the part of the brain which deteriorates over time as the neurodegenerative disease progresses.

Gum Disease And Cancer

Numerous studies have found a link between gum disease and esophageal cancer.

Studies have found links between periodontal diseases to systemic diseases including heart diseases, rheumatoid arthritis, and cancer.

Researchers at According to the findings, the likelihood of esophageal cancer can increase by 21 percent due to gum disease bacteria, Prophyromanco gingivalis and oral bacteria, and Tannerella forsythia.

Additionally, in research published in The Lancet Oncology, it was found that men’s susceptibility to various cancers increases. Respondents with gum disease recorded higher risks at 49 percent for kidney cancer, 30 percent for white blood cell cancer, 54 percent for pancreatic cancer, and 36 percent for lung cancer.

Moreover, according to the Spectrum Health Medical Group Cardiovascular Services, the gum layer's inflammation can trigger inflammation throughout the body due to the funneling of bacteria into the bloodstream. The swelling can then harden arteries, leading to a condition called atherosclerosis and a harder time for blood to flow.

 

Gum Disease And Systemic Diseases

Studies suggest that periodontal disease can lead to some systemic diseases. These include cancer, rheumatoid arthritis, stroke, heart disease, respiratory infection, preeclampsia, and diabetes. After all, the infection and inflammation due to gum disease can travel down to other parts of the body.

Arthritis | In a study in the PLoS Pathogens journal, it was found that the gum disease-causing bacterium, Porphyromonas gingivalis, can intensify the severity of rheumatoid arthritis. It also leads to an earlier onset of the disease and a faster progression of its symptoms.

Cancer | In a study in The Lancet Oncology, it was found that periodontal diseases increase the risk of cancer by 14 percent. Heighten risks are observed for lung cancer at 36 percent, kidney cancer at 49 percent, pancreatic cancer at 54 percent, and white blood cell cancers at 30 percent.

Diabetes | Gum disease can be affected blood sugar, which can contribute to the advancement of diabetes.

Heart Disease | According to studies, gum disease doubles the risk of developing heart disease. This rate may be even higher in comparison to individuals with high cholesterol. Scientists have also found a link between hardened arteries or atherosclerosis and gum disease. The bacteria found in gum disease, Streptococcus sanguis, can spread to the heart and make it hard for the blood to flow to the heart properly.

Preeclampsia | Preeclampsia, often known as a pregnancy complication that causes high blood pressure, swelling of hands and feet, and excess protein, increases risks of gum disease as well. Pregnant women are at risk for the development of gum disease due to the change in hormones. Expecting mothers with gum disease have a higher chance of birthing a premature and low birth weight baby.

Respiratory Infections | Respiratory infections like Chronic Obstructive Pulmonary Disease and pneumonia become riskier for people with gum disease. In a study, it was found that participants with the respiratory disease had severe gum health due to the oral pathogens associated with gum disease which increase the likelihood of respiratory diseases.

Stroke | Gum disease, particularly its advanced type, periodontitis, is linked with a higher risk of stroke. This is due to its heightened systematic inflammatory response.

How can children get gum disease?

Can Children Get Gum Disease?

Anybody can develop gum disease regardless of their age. Without proper care, your little ones can contract this painful ailment. While they may stay relatively safe the first few months out of the womb, once they contract decay-causing bacteria, they become susceptible to gum disease as well. Can children get gum disease, then? Yes, they can.

But just because they can don’t mean they have to. Of course, certain factors make children and adolescents more susceptible to gum disease than others. In teenagers, hormonal changes may disrupt the blood flow in their gums and make them more likely to swell. And in children, the thin enamel of their teeth makes them more vulnerable to bacterial attacks. 

Handled well, however, this risk can lower significantly. And it can prevent any full-on flare-ups that can be damaging to their young bone structures.

That said, how can children get gum disease? And what can you do to avert it?

Gum disease in children begins with contamination

Previously, we talked about how parents can pass on bacteria to their children through shared saliva. This sharing isn’t limited to kissing your kids on the mouth. It also occurs when you share eating implements or when you blow on their food. And if the parents are prone to tooth decay and dental diseases, the more likely will the bacteria increase in their children. 

The bacterial transmission doesn’t necessarily mean your child will get periodontal disease on the fly, however. Gum disease occurs when plaque build-up on the teeth grows to the point that it goes below the gumline. When this infiltration happens, it triggers your body’s immune response and causes your gums to swell. 

One could then say that gum disease only occurs if there is a build-up of plaque to begin with. Babies who have yet to teethe, then, aren’t eligible for this type of ailment. But if their mouths have a high concentration of decay-causing bacteria, the faster they’ll manifest the disease once their teeth erupt. 

In teens, hormones also play a role in this manifestation—particularly in women. During puberty, heightened hormone levels add more blood flow to the gums. This increased flow causes them to swell and become more sensitive to brushing and flossing. At this stage, a woman is more vulnerable to gum disease than men are and thus will need to keep to a solid oral health routine to prevent the condition from worsening.  

Prevent Gum Disease With These 7 Tips

Some methods to help reduce the risk of gum disease include:

#1 Reduce Stress

Stress can trigger a plethora of health problems. Besides higher blood pressure, the risk of mental health problems such as anxiety, and changes in our weight, stress can also increase our bacteria count in our body and lower our immune system. The latter two alone can increase our risks of various oral health problems such as gum disease.

It is wise that we take time out of our days to wind down and relax, especially if our lifestyle is particularly stressful.

#2 Avoid Dangerous Medications

Certain medications such as oral contraceptives and antidepressants can risk oral health problems such as gum disease if taken long term.

Please speak to your healthcare provider regarding the risks of taking a specific medication. This is especially important if you already have a genetic predisposition to gum disease.

#3 Eat Healthy

A diet consisting of restricted calories and unhealthy foods is not a diet one wants to have if trying to prevent various oral health problems.

Gum disease, primarily due to bacteria overgrowth, thrives off a sugary diet. In protecting your teeth and gums, it is wise to stick to a healthy diet. Such a diet should consist of a wide array of fruits and vegetables, protein, grains, and dairy. However, one should restrict alcohol and sugary, processed foods.

If you have a particular diet (e.g., veganism) or cannot consume grain or dairy products, speak with a nutritionist or doctor for advice.

#4 Reduce or quit the use of tobacco products.

Tobacco is another factor that may lead to the development of gum disease in the future. Kicking tobacco products to the curb, including cigarettes and cigars, is essential in maintaining good oral health. Apart from reducing the risks of gum disease, eliminating tobacco use can also lower the chance of oral cancer development.

#5 Visiting the dentist biannually

Because gum disease occurs in stages, it’s vital to continue biannual dental visits to ensure gum disease is not currently present. After all, some may not notice signs of gum disease early on.

Fortunately, gum problems can be caught and treated early. If your dentist advises that your gums are weak, it merely suggests that you should better tend to the hygiene of your gums. In doing so, you can prevent gingivitis (early stage of gum disease) from happening, thus permanent gum disease.

#6 Getting treated for current bruxism (teeth grinding)

Teeth grinding places force on teeth and gums, causing gum disease to set in quicker. For this reason, it’s vital that those who grind their teeth receive treatment (e.g., a mouth guard). Additionally, it would be helpful to tackle the underlying cause of their tooth grinding, such as high stress, to reduce gum problems.

#7 Upkeeping your oral hygiene routine

Of course, keeping your gums and teeth clean means better oral health and a lower chance of gum problems, including gum disease.

Twice-a-day brushing, rinsing with fluoride-based mouthwash, and flossing are all essential to decrease the bacteria present in your mouth. In turn, good hygiene can keep your oral standing where it needs to be.

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