How Will I Know If I Have Gum Disease?

In the vast majority of cases, periodontal disease is completely painless. Except for occasional bleeding when tooth brushing, and puffy gums, most people have no idea that they have gum disease. Gum disease only becomes painful when the teeth become loose and it hurts when biting hard foods, or the gum becomes swollen with a periodontal abscess. By this time, the bone loss around the teeth is often so severe that little can be done, and the tooth may have to be pulled. You could be on your way to losing your teeth and wearing dentures without even knowing it!

There are several factors that increase the risk and severity of gum disease. Some research has pointed to a genetic link in gum disease. If your parents, brothers or sisters, have gum disease, you may be more likely to have it as well. You may not know if people in your family have or had gum disease, but if they have worn dentures for most of their lives, their tooth loss may have been caused by gum disease.

People who have medical problems that affect the immune system are more at risk for developing gum disease. Diseases such as AIDS, leukemia, and diabetes are a few that fall into that category.

Medical conditions or treatments that reduce salivary flow can make a person more susceptible to gum disease. Diseases such a Sjogren Syndrome, dysfunction or removal of the salivary glands, those who have undergone cancer chemotherapy or radiation, or who take any of the hundreds of prescription drugs that can cause dry mouth may be more likely to develop gum disease. Saliva is important in protecting us from gum disease because it lubricates the mouth as a self-cleansing mechanism, and it contains other substances that protect the gums from disease.

Teeth that are crooked or misshaped can contribute to gum disease. Likewise, poor dental treatment, such as fillings that don't fill in the gaps between the teeth completely, or crowns (caps) that are too big, bulky, or whose edge (margin) digs too far under the gum-line can also irritate the gums, making them more susceptible to gum disease.

Habits such as smoking, poor oral hygiene (sometimes due to a lack of manual dexterity), emotional stress, and poor nutrition can also significantly contribute to the severity of gum disease. In the past, and today in many developing countries, poor nutrition can also significantly contribute to the severity of gum disease. For example, a lack of vitamin C causes the disease called scurvy, and one of the first signs of scurvy is gum disease.

Over the last few years, a number of studies have shown a high correlation between gum disease and heart disease, heart attack, stroke, respiratory problems, and low birth-weight babies. Consider the following study: Dr. Walter Loesche, a professor of dentistry from the University of Michigan, and his colleagues, studied a sample of 400 men at the Ann Arbor VA hospital in Michigan to determine if a relationship exists between gum disease and heart disease. Analysis of the plaque in men with gum disease found higher levels of gram-negative anaerobic bacteria in patients with heart disease than in patients without heart disease. This type of bacteria contains lipopolysaccharides (a fat and carbohydrate compound) that may be released into the bloodstream and cause obstructive clots in our arteries. A clogged coronary artery supplying the heart can cause a fatal heart attack.

Dr. Loesche has established that men over 60 years of age whose gums bleed around almost every tooth (a main symptom of gum disease) were four and a half times more likely to have coronary heart disease. Dr. Loesche has also established a link between more advanced gum disease and cerebral vascular accident or stroke. People who had lost more than six millimeters of bone around the tooth roots and had gum disease involving many teeth (15 to 28) were highly associated with stroke risk. People, who had had regular dental examinations, at least once a year, were four times less likely to have a history of stroke.

This study deserves serious attention, especially due to the prevalence of both periodontal and heart disease in this country.