Causes and Risk Factors of Gum Disease

The role of bacteria

Gum disease is usually caused by plaque, a sticky film of bacteria that constantly forms on teeth. If plaque is not removed with through daily brushing and cleaning between teeth, gums become irritated and inflamed. The irritated gum tissue can separate from the teeth and form spaces called pockets, where they continue to promote irritation. Left untreated, the process can continue until the bone and other tooth-supporting tissues are destroyed.

The main cause of periodontal disease is bacteria plaque, a sticky, colorless film that constantly forms on your teeth. But usually other risk factors must be present as well. In fact, 80% of people with gum disease have at least one other risk factor that makes them susceptible. Multiple factors are frequently involved. For example, stress, poor diet, smoking and viral infections all play a role in acute necrotizing gingivitis.

Aside form bacteria, age, poor dental hygiene and poor nutrition, the major risk factors are:

Genetic factors
Studies of identical twins, family histories and genetic disease all point to heredity as a risk factor in roughly 50 percent of patients with periodontal disease. The heredity factors involved are most likely minor defects in how the immune system operates. People with these abnormalities cannot fight off the bacteria responsible for causing plaque and periodontal disease even with good oral hygiene. Such heredity factors may explain why children of parents with periodontitis are 12 times more likely to harbor these harmful bacteria.

Smoking/Tobacco Uses
Smoking is the number one environmental/behavioral risk for periodontal disease. The more you smoke, the higher the risk and the more severe the disease. Smokers are much more likely than non-smokers to have tartar form on their teeth, have deeper pockets between the teeth and gums, and lose more of the bone and tissue that support the teeth. In fact, smoking can cause receding gums and bone loss even in the absence of periodontal disease. Studies on how smoking does its dirty work indicate that it has numerous bad effects on the health of gum tissue and the workings of the immune system. For example, smoking suppresses the production of antibodies directed against some of the harmful bacteria, which allows them to flourish more easily. Smoking also promotes inflammation and increases bone loss. For these reasons, quitting has become an important part of preventing and managing periodontal disease.

Pregnancy and Puberty
As a woman, you know that your health needs are unique. You know that brushing and flossing daily, a healthy diet, and regular exercise are all important to help you stay in shape. You also know that at specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, your body experiences hormonal changes. These changes can affect many of the tissues in your body, including your gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.

Stress and Grinding/Clenching teeth
Emotional stress may increase your risk for periodontal disease by depressing the immune system, making it more likely for a bacterial infection to take hold. The mechanical stress of grinding and clenching teeth exerts force on the gums and other supporting tissues and may loosen your teeth. Sometimes a mouth guard worn during sleep is necessary.

Medications
Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

Medical Conditions
Diabetes mellitus, osteoporosis, inflammatory bowel disease, Down’s syndrome and AIDS are just some of the conditions that make people more susceptible to periodontal disease. Studies show diabetes increases susceptibility and severity of gum disease by impairing the function of certain immune cells and decreasing the production of collagen and bone. Research now shows the relationship between the two diseases goes both ways. Gum disease may make it more difficult for diabetics to control their blood sugar. The loss of minerals from bones, seen in osteoporosis, is thought to make bones supporting the teeth more vulnerable to bacterial infection, increasing the risk of gum disease and tooth loss.