Prevalence of Periodontal Disease

Periodontal disease is the medical term for gum disease. There are several types, all of which affect the gums or jaw bone to varying degrees.
Some individuals are more susceptible to developing gum disease due to lifestyle factors. If periodontal disease is caused by lifestyle factors, the risk can be reduced and some of the damage can also be reversed by changing those factors.

Periodontal Disease

• Gingivitis is the earliest and mildest form of gum disease. It is caused by bacteria beneath the gums, which is generally caused by inadequate oral hygiene. It can be reversed by getting rid of the bacteria, which is often done simply by improving oral hygiene. The symptoms include swollen and bleeding gums. Bad breath, or halitosis, is common too. The damage is limited to the gum tissue at this stage.

  Early periodontitis is more severe than gingivitis. It includes the same symptoms, though generally more severe, and some additional symptoms. Gum tissue damage is more widespread, and can include some recession of the gums from the teeth. The damage can spread from the gum tissue to connective tissue and the jaw bone tissue at this stage.

  Moderate periodontitis is a continuation of early periodontitis, and includes the same symptoms as well as some new ones. Pockets can form in the gums, either bulging or receding. They can be filled with pus and bleed easily. In addition, more severe bone loss occurs at this stage. Due to the bone loss and the breakdown of connective tissue, the teeth can begin to shift or become loose.

  Advanced periodontitis causes the same type of damage as moderate periodontitis, though more severe. Bone loss is more pronounced and can cause severe shifting of the teeth and tooth loss. The gums may have deep spaces between them and the teeth. Bad breath is more pronounced and difficult to cure at this point.

Preventable Risk Factors

• Certain factors play a role in your chance of developing periodontitis. There are some risks that you can cut or reduce based on your lifestyle choices.

  A common habit that greatly increases your odds of developing gum disease is tobacco use. According to the American Academy of Periodontology, "...17.6 percent of current or former cigar or pipe smokers had moderate to severe periodontitis--nearly three times the percent of non-smokers. In addition, they averaged four missing teeth."

  The American Dental Association states that smokers are four times more likely to develop gum disease than non-smokers
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  Smokeless tobacco also increases the risk of gum disease. The Mayo Clinic states, "The sugar and irritants in chewing tobacco and other forms of smokeless tobacco can cause your gums to pull away from your teeth in the area of your mouth where you place the chew. Over time you can develop gum disease..."

  Smoking increases the development of calculus, a hardened plaque that has to be removed by a professional cleaning. Smoking also causes pockets between the teeth and gums, which increases bacterial growth below the gums.

  In addition to tobacco use, inadequate oral hygiene is a preventable risk of gum disease. Flossing daily is a good way to get rid of bacteria along and just beneath the gum line. A water pick, or oral irrigation system, is another good way to get rid of bacteria at the edge of the gum line. You need to brush at least twice a day, preferably more often, including after each meal. Professional cleanings twice a year are also good for reducing plaque and detecting gum disease early.

Other Risk Factors

• There are several diseases that increase the risk of periodontal disease. Often these diseases affect the immune system or other large systems of the body.
  Epstein Barr Virus (EBV), a type of herpes virus, can increase the risk of damage caused by periodontitis. According the Centers for Disease Control and Prevention, more than 90 percent of the world's population has had EBV. While this has given immunity to EBV and mononucleosis to some people, those with periodontal disease are at greater risk of suffering prolonged damage from EBV. The Mayo Clinic reported that when EBV is present in the gum tissue chronically, the risk for developing cancer or other diseases increases.

  A 2008 study called "Association Among Rheumatoid Arthritis, Oral Hygiene, and Periodontitis," published in the June issue of the Journal of Periodontology, the official publication of the American Academy of Periodontology, uncovered yet another potential side effect of RA. Researchers in Berlin, Germany discovered that patients with RA have a higher incidence of periodontal disease compared to healthy controls. Rheumatoid Arthritis is an autoimmune disease.

  According to an article by the American Academy of Periodontology, "People with diabetes are more likely to have periodontal disease than people without diabetes. A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are."

  People who are HIV positive are at an increased risk of developing a type of gum disease called necrotizing periodontitis. It causes gum tissue to die in spots and create lesions in the gums.

Misconceptions

• Just because you brush daily, floss and see your dentist twice a year doesn't mean you can't get gum disease. Even if you are free of symptoms you may still have gingivitis or early periodontitis, as they can be asymptomatic while your gum tissue is sustaining damage.

  If you have any bleeding at all when brushing or flossing, you have bacteria present beneath the gum line in those spots that bled. Brushing more thoroughly or using a water pick may be able to get rid of the bacteria and halt the damage that it is causing.

Considerations

• If you maintain good oral hygiene for a few months and continue to have symptoms of gum disease, you should consult your doctor or dentist. You may have an undiagnosed condition that is contributing to the gum problems or you may need a more intensive gum cleaning procedure.

  Scaling is a procedure that removes plaque and bacteria that is rough from around and under the gum line. It can also clean out recesses, or pockets, in the gums. Root planing removes spots of plaque or bacterial collection from the roots of the teeth and leaves the surface smooth. This helps the gums attach to the teeth as they heal.