Gum Disease Risk Factors

The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.
Adults past the age of 35 lose more teeth to gum diseases than from cavities. Three out of four adults are affected at some point in their life. The best way to prevent cavities and Periodontal Diseases is by good tooth brushing and flossing techniques, performed daily, and regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some for of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress. According to the American Academy of Periodontology, these are the other risk factors that play a role in your disease and its progression.


Studies indicate that older people have the highest rates of periodontal disease. Data from the Centers for Disease Control and Prevention indicates that over 70% of Americans 65 and older have periodontitis. This makes many people incorrectly think that you get gum disease as a normal part of the aging process. This is completely INCORRECT. The reason it is seen more as the population ages is because the longer you live, the more likely the chance that the disease can become established and progress, especially when combined with other risk factors.


Tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. There are multitudes of studies that show smoking alone can cause destruction of the periodontal attachment in otherwise healthy adults. We often get asked if smoking recreational marijuana has the same negative effects. This is yet to be known because of the difficulties to study this in the past. It is assumed it is a similar effect, but with marijuana now being legalized in multiple parts of the country, it will now be easier to study this and come up with a definitive answer.


Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early intervention treatment may help them keep their teeth for a lifetime. But don’t dismay. Just because a mother, father or grandparent lost their teeth doesn’t mean you will as well. With better access to care, better home care, diligent effort and overall better understanding of your personal healthcare, the chances of you ending up the same way is low if you will just put in the effort and time to help yourself and seek the help of a professional.


Stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. Stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases. Stress releases multiple hormones and other chemicals in the body that create inflammation and stresses the immune system making it difficult to optimally function.


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. Just as an example, we will look at the class of drugs known as bisphosphonates. Bisphosphonates (BP) are potent inhibitors of bone resorption used mainly in the treatment of metastatic bone disease and osteoporosis. By inhibiting bone resorption, they prevent complications as pathological fracture, pain, tumor-induced hypercalcemia. Even though patient’s benefit of BP therapy is huge, various side effects may develop. Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is among the most serious ones. Oncologic patients receiving high doses of BP intravenously are at high risk of BRONJ development. BPs impair bone turnover leading to compromised bone healing which may result in the exposure of necrotic bone in the oral cavity frequently following tooth extraction or trauma of the oral mucosa. Frank bone exposure may be complicated by secondary infection leading to osteomyelitis development with various symptoms and radiological findings. In the management of BRONJ, conservative therapy aiming to reduce the symptoms plays the main role. In patients with extensive bone involvement resective surgery may lead to complete recovery, provided that the procedure is correctly indicated. Since the treatment of BRONJ is difficult, prevention is the main goal. Therefore in high risk patients dental preventive measures should be taken prior to bisphosphonate administration. This requires adequate communication between the prescribing physician, the patient and the dentist.


Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed. Sometimes, these forces will actually cause the problem. When occlusion is the main issue in your bone loss, it is called, “primary occlusal trauma.” If your occlusion is just adding to worsen disease that is primarily bacteria induced, then it is diagnosed as, “secondary occlusal trauma.”


Other systemic diseases that interfere with the body’s inflammatory system may worsen the condition of the gums. These include cardiovascular disease, diabetes, and rheumatoid arthritis. In converse, the periodontal disease can effect your systemic diseases and make your overall health worse or make it more difficult for your healthcare provider to manage your disease.


A diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. Because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums. In addition, research has shown that obesity may increase the risk of periodontal disease.

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