DEAR DOCTOR K:
Why is it important to keep my gums healthy? What are the consequences of gum disease?
Gum disease can harm more than just your mouth; it can affect your overall health. Before describing why, I need to explain what gum disease is.
Gum disease, or periodontal disease, is the primary culprit in adult tooth loss. It occurs when plaque — the sticky, bacteria-laden film that collects on your teeth — grows out of control. Gum disease begins when plaque forms in a shallow trough where the gum meets the tooth. Without proper cleaning, successive layers of plaque build up, preventing oxygen from reaching the deepest part of this trough.
The bacteria that cause gum disease thrive in this oxygen-free environment. They release toxins that injure the surrounding tissue. Your immune system responds to the injury and tries to heal it — a process called inflammation. White blood cells travel to the injured area to fight the infection. In waging their fight, the white blood cells make certain chemicals of inflammation.
We need the immune system to protect us against the invasion of germs and to help us heal. But the immune system doesn’t work perfectly — it’s kind of a blunt instrument. In fighting the injury, the white blood cells and these chemicals can actually add to the damage.
The immune system begins attacking the gum tissue itself. The tissue that attaches the tooth to the gum is destroyed, and the detached gum pulls back from the root of the tooth.
Next, the disease attacks the ligament that holds the tooth to the jawbone. As the ligament continues to break down, the tooth loosens in its socket. Eventually, it may fall out. I’ve put an illustration showing the progression of gum disease at the end of this post.
Gum disease can cause discomfort and a host of other unpleasant symptoms, including:
- swollen, red or tender gums
- gums that bleed easily
- pus between the teeth and gums
- bad breath
- buildup of hard brown deposits along the gum line
- loose teeth, or teeth that are moving apart
- changes in the way dental appliances fit
But what many people don’t realize is that gum disease has also been linked to a number of conditions beyond the mouth. These include premature birth, heart disease and diabetes. The common thread between these conditions is inflammation.
The immune system’s effort to heal the gum injury causes the chemicals of inflammation to enter the blood and travel throughout the body. These chemicals can injure not only the gums, but also other parts of the body.
When it’s caught early, gum disease is almost always correctable. The first step is a thorough professional cleaning to remove plaque and tartar. This treatment, along with better brushing and flossing habits, usually does the trick.
For more advanced cases, surgery may be needed to remove damaged gum tissue, or antibiotics to reduce bacteria and inflammation.
The progression of gum disease
Gum disease develops when inflammation spreads to the tissues that support the teeth. Healthy gums
(A) are firm and tightly hug the teeth. Without proper cleaning, plaque can build up where the gum tissue meets the tooth. As plaque accumulates, the gum tissue pulls away from the tooth, creating a tiny pocket. The gums become inflamed, a condition called gingivitis
(B). Gingivitis can get worse, causing a more severe gum disease known as periodontitis
(C). Here, the pocket widens as the gum pulls back from the root of the tooth. The disease also destroys the periodontal ligament and bone, reaching the tooth socket. Depending on the level of severity, the ligament and bone damage can cause the tooth to become loose, and it may fall out.