Great Gums! by Deborah Southard These days keeping your mouth healthy involves more than just brushing and flossing print article      send to a friend

His trip to the dentist gave him the answer.  John had been undergoing radiation therapy for skin cancer on his face.  His doctors had failed to tell him that the radiation would cause a significant drop in saliva production.  And when his saliva level dropped, bacterial plaque had a field day.  Since John hadn't changed his oral hygiene habits, dental decay began to set in and he was set along the road to periodontal disease.

Perio what? Periodontal disease is something most of us could live without.  Put simply, it's an infection of the gums that can lead to tooth and bone loss.  "Perio" means "around" and "dontal" is "tooth," the whole phrase meaning "around the tooth." 

The infection starts with bacterial plaque that moves below the gum line.  "Bacteria is the primary component of plaque and is the sole cause of periodontal disease," says Craig Wilson, DDS, a Santa Rosa, California periodontist.   

The beginning stage of gum disease is called gingivitis, a swelling and reddening of the gums that results in increased sensitivity and bleeding.  "The most prevalent type of periodontal disease is gingivitis," notes periodontist James Simonds, DDS, also of Santa Rosa.  "When it begins to involve detachment of the gums and bone loss, it becomes periodontitis," he adds.  If gingivitis isn't nipped in the bud, the disease will advance, the gums will begin to detach from the teeth, the bone that holds your teeth in your mouth will slowly be destroyed, and you could begin losing teeth.

Don't take risks

There are a number of factors that will put you at greater risk for periodontal disease.  "They are secondary factors -- by themselves will not cause periodontal disease," Dr. Wilson comments. 

Listed below are just a few examples:

Poor oral hygiene - This includes poor brushing skills and a lack of flossing. 

The recommended brushing time is three minutes, moving the brush in small circles at an angle against the gum line.  Flossing helps remove plaque from in between the teeth, where your brush won't reach.

You're probably sick of hearing it, but it's true.  In a recent study, the Centers for Disease Control found that more than half the cases of gum disease in adults may be linked to smoking.  Smokers were four times as likely as non-smokers to have periodontal disease, but smokers who had quit for over 11 years were at no increased risk.  So it's never too late to quit!

Diet - While an unhealthy diet won't cause periodontal disease, it can contribute to the poor condition of the gums.  A diet high in sugar will only add to the risk of tooth decay and gum disease, whereas eating a diet complete with fruits and vegetables will not only be healthier for your body, but also for your teeth.

Radiation - Radiation therapy for head and neck cancers causes a drop in saliva production.  Patients will experience dry mouth and, unless they change their oral hygiene habits, they could develop periodontal disease.  Saliva helps to prevent the proliferation of the bacterial plaque that causes gum disease and, when the saliva is gone, the plaque flourishes.

Calcium and Vitamin C - Recent studies have shown that low intake of calcium and Vitamin C can increase the risk of periodontal disease.  Calcium is essential for healthy bones and teeth, so if you're getting the recommended daily allowances, your mouth will be better equipped to fight infection. (And you thought milk was just for cereal.)  Vitamin C is necessary for maintaining healthy connective tissue and will keep your gums snug against your teeth.  An orange a day might very well keep the periodontist away.

Stress - Research has shown that stress can make it more difficult for the body to fight off infection.  This includes periodontal disease.  It's just one more reason to try to eliminate stress in your life.

Diabetes - If you are diabetic, you are at a higher risk for developing gum disease.  What's worse, the subsequent infections will interfere with your body's ability to process insulin and your diabetes may become more difficult to control.

Genetics - Scientists identify genetic markers for diseases every day.  Believe it or not, due to a genetic variation, there is a section of the population (about 30%) that is more susceptible to periodontal disease; their immune systems overreact to bacterial plaque.  A company called Interleukin Genetics Inc., has developed a test to detect this genetic variation.  "You can have individuals that work really hard at their oral hygiene but still lose ground with their fight against periodontal disease," says Cathy Draper, a registered dental hygienist (RDH) and president of the California Dental Hygienists' Association (CDHA).  Identifying people who are more prone to gum disease will mean early treatment and, quite possibly, a healthy set of teeth for a lifetime.

Launch an Attack

The first step in preventing periodontal disease is to make sure that you are brushing and flossing daily.  "There are two phases of preventive work.  One is home care.  If you have poor plaque control, that creates opportunity for the bacteria to come in contact with the tissue," says Dr. Simonds. 

If you're not sure your technique is correct, your dental hygienist can demonstrate the proper method at your next visit for a cleaning.  "It's important to demonstrate where the plaque is located in the mouth," notes Draper.  The hygienist can identify the first signs of gingivitis and will advise you if you need to make any changes to your dental routine.  "Depending on whether if it feels like you're losing ground, you can introduce some new techniques," Draper concludes. 

In essence, the hygienist is the first line of defense against periodontal disease; they might very well become your best friend.  "Oral hygiene is one of the most difficult things to master, and one of the least enjoyable," says Dr. Wilson.  "Unfortunately there's no magic pill to take the plaque away."

The second step is to identify any additional risk factors.  Do you smoke?  Are you under a lot of stress?  Do you have diabetes?  Do you get adequate amounts of calcium and Vitamin C?  Eliminating stress and taking vitamins will help you with two of the factors, but the others might be harder to control.  Kicking the smoking habit is no easy task; your dentist, hygienist, or your doctor will have a number of suggestions and will be able to help you plan your attack.

Remember, regular cleanings are essential for keeping your teeth healthy; you should be getting your choppers cleaned every six months.  And if you're especially prone to gum disease due to a genetic predisposition or diabetes, you may want to see the dentist more frequently to check on your progress.  John Parker eventually lost a bridge because of his gum disease, but now, regular checkups keep his mouth healthy, and he makes sure to ask about adverse side effects to any treatment he undergoes.

Lucky for you, gum disease can be prevented and controlled; with good information and the right tools you can be on the road to better oral hygiene.  By understanding the risk factors and learning how to keep your mouth healthy, you can keep your pearly whites.