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Gum Disease: Gingivitis and Periodontitis | Hawaii Family Dental

The Centers for Disease Control states 50% of Americans over 30 years old suffer from gum disease, ranging from mild irritation (gingivitis) to severe infection (periodontitis). And it gets worse as we get older, increasing to 70% by the time we reach ages 65 and older. 

When not treated, 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.

In a study by the University of Louisville, gum disease-causing bacterium was found to amplify the severity of rheumatoid arthritis. Likewise, it can speed up the progress of its symptoms.

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. 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 a 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 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 may be swollen. Gingivitis is usually cared for during routine cleanings every 6 months, 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 tissues 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 mainly of 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 a cleaning with a hygienist or dentist.

Other factors can increase the risk of an individual in developing gum disease including:

  • 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 itself. 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.

Gum Disease and Cancer

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

Researchers at the New York University Langone Health has found a link between gum disease and esophageal cancer. According to the findings, the likelihood of esophageal cancer can increase by 21 percent due to gum disease-causing 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 Treatment and Prevention

Practicing good oral habits like brushing, flossing, rinsing with mouthwash, and visiting the dentist twice a year can prevent the occurrence of gingivitis. Limit your sugar intake and include in your diet food that can help you fight gum disease. Also, if you smoke, it is best to quit as it is bad for your gums and overall health.

There are various treatments available for periodontal diseases which depend on the stage, response to treatment, and overall health condition. Treatments include:

Non-surgical treatments for gum disease such as:

  • Professional dental cleaning is done to remove plaque and tartar buildup. Although this procedure is not a treatment for active gum disease, it serves as an essential preventive measure to prevent its development.
  • Deep cleaning including scaling and root planing also rid the teeth of plaque and tartar by scrapping them away and smoothing the rough spots.

Surgical treatments for gum disease such as:

  • Flap surgery or a pocket reduction surgery reduces the space between the gum and tooth caused by pocket to decrease the areas where disease-causing bacteria can hide. Through this method, the gums are lifted back, and the tartar is removed.
  • Bone graft is done to replace the bone damaged by the periodontal disease through the regrowth of the bone using your bone, a synthetic bone, or a donated bone. This procedure aims to restore the stability of the teeth.
  • Soft tissue grafts fill in the areas where gums have receded through the stitching of grafted tissue taken from the mouth's roof and stitched in place as an addition to the affected area.
  • Guided tissue regeneration stimulates the growth of the bone and gum tissue done in combination with flap surgery. Through this procedure, the bone and connective tissue can regrow.
  • Bone surgery reshapes the bone around the tooth to decrease the shallow craters in the bone because of moderate to advanced bone loss, making the collection and growth of bacteria difficult.

Periodontal 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 affect the blood sugar, which can in turn, 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, 200 participants between 20 to 60 were observed. It was found that participants with 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.

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