Risk Factors For Gingivitis and Periodontitis
It is well established that the main cause of gingivitis, or periodontal disease, is bacterial plaque. But not everyone responds the same to the same bacterial infection. There are many factors that can contribute to making someone more or less susceptible to the progression of periodontitis. These factors are called risk factors. They can increase the risk, severity, and speed at which the disease develops. Some risk factors can be modified. If they are, gum disease and tissue destruction can be controlled and maybe even prevented with periodontal treatment.
There are several factors that can put individuals at greater risk for gingivitis or periodontal disease.
1. Poor Oral Hygiene: The bacterial plaque that continuously forms on the teeth is the main cause of periodontal infections. Without bacterial plaque there cannot be periodontitis. But as the amount of plaque increases, so does the risk for the disease. There is a shift in the bacterial population of plaque from one that is compatible with health, to one that is responsible for the disease. The best way to help control or prevent the progression of periodontal diseases is to follow a diligent plaque control program that includes daily brushing and flossing.
2. Crowded Teeth: Crowded teeth can contribute to plaque retention and interfere with oral hygiene. If this becomes a problem, it may be necessary to reshape the teeth or move them to a better position with the use of dental appliances or braces.
3. Poor Fitting Dentures, Fillings, or Crowns: These factors also may contribute to plaque retention and interfere with oral hygiene methods. If this is the case, the restorations may need to be reshaped, polished, or even replaced.
4. Occlusion (the way the teeth bite or come together): The forces created by an unbalanced bite, by clenching, or by grinding of the teeth, can accelerate the progression of bone destruction and periodontal disease. These forces can also contribute to excessive wear of the teeth, fractures, temporomandibular joint (TMJ) problems, or root canal problems. People who clench or grind their teeth may not be conscious of it, but may experience sore jaw muscles, TMJ problems, headaches, and neck or shoulder pain. Most people are more susceptible to clenching or grinding during periods of high stress. These habits can be controlled and treated with specially made dental appliances (night guards), braces, reshaping of the biting surfaces of the teeth, exercises, medications, or a combination of the above.
5. Tobacco: People who smoke or chew tobacco are more likely to have periodontitis. They also are more likely to have a poorer and slower response to periodontal treatment. The risk of acquiring periodontal disease decreases after smoking cessation and former smokers and non-smokers respond the same to treatment from a periodontist. Smoking cessation is beneficial to periodontal and overall health.
6. Poor Nutrition: Although periodontal disease is not caused by nutritional deficiency, a diet low in nutrients can diminish the effectiveness of the body's immune system. This reduces the resistance to infections such as periodontitis. To aid in the body's capacity to fight infections, maintain a well-balanced diet and avoid fad diets that exclude entire food groups and limit nutrients.
7. Stress: Stress reduces the immune response and makes it hard for the body to fight infection. A study has shown that people who are under financial stress and have poor coping ability have a two-fold increase in the incidence of periodontal disease.
8. Pregnancy and Female Hormonal Changes: The hormonal changes that occur during pregnancy, puberty, and menstruation can make the gums more sensitive to bacterial plaque and increase the risk for periodontal disease. Pre-existing periodontal problems can become more severe if plaque is not controlled. So an efficient and consistent plaque control program is essential in maintaining periodontal health through pregnancy and all stages of life.
9. Systemic Diseases: Certain systemic (general body) diseases, such as AIDS and diabetes, may decrease the body's ability to fight infection and can result in more severe periodontal disease. Always keep your dental care provider informed of changes in medical status.
10. Medication: Drugs such as birth control pills, immunosuppressants, anti-depressants, and some heart medications can also increase the risk for periodontal disease. Patients should inform their dental care provider of any changes in the medications that they may be taking.
11. Genetics: Up to 30% of the population may have a gene that is linked with an increased susceptibility to periodontal disease. Although genetics is not modifiable, knowing one's genetic profile puts individuals in a proactive position regarding dental health. Through proper home care, periodontal maintenance visits, modification of known risk factors, and early intervention, individuals have an excellent chance of keeping their teeth for a lifetime.
By Laura Minsk, DMD
Gum Disease and Early Diabetes Detection
In many cases it's the dentist - and not the physician - who has the first opportunity to detect diabetes early, because diabetics are especially prone to dental health problems.
Swollen, tender, receding and bleeding gums, loose teeth, and a sore tongue may not just be signs of poor dental hygiene. They may be danger signals for diabetes, too.
If you have any of these symptoms, you may be one of the estimated 11 million people in North America who already have diabetes, or you may be one of the 600,000 who will be diagnosed this year.
Diabetes occurs when a gland called the pancreas fails to produce sufficient amounts of the hormone, insulin, to regulate blood sugar levels. In other words: Diabetics have too little insulin and too much sugar in their blood.
When this happens, the body tissue can't convert the sugar it needs into energy. The blood stream then fills with this unused sugar and the result is diabetes - a disease medical journals often describe as the "forever" disease.
A serious illness which respects neither age, sex, race nor income level, diabetes is the leading cause of blindness in people 20 to 65 years old and can lead to kidney failure, heart attacks and even death.
But outside the dental community, few people realize that diabetics have more than their share of tooth and periodontal (gum) problems. This fact is especially true for undiagnosed diabetics or those who have failed to control their disease adequately with insulin and/or diet and exercise.
Periodontal disease among diabetics progresses rapidly, recurs frequently, and heals slowly. The resistance to treatment can lead to loosened teeth and premature tooth loss.
Your regular dental office visits provide the best chance for early detection of many health problems, including diabetes. If you have a diabetic tendency, your dentist may very well refer you to your physician - another good reason to keep your prescribed dental recall and dental cleaning appointments faithfully!
If you are diabetic, it's important that you keep your dental health history up-to-date, exercise regularly, and eat a diet that provides good nutrition:
- Have regular meals and snack times. Don't skip meals.
- Avoid sweets (cake, candy, pie, ice cream).
- Limit use of animal fats and trim fat off meats. Avoid butter, cream, egg yolks.
- Bake and broil rather than fry foods.
- Don't use alcohol, wine, or beer without your doctor's permission.
- See your dentist regularly so small dental problems can be taken care of with a local anesthetic.
Teeth don't heal themselves, so small problems turn into big ones if left untreated. Major oral surgery requires a general anesthetic which means "no food prior to surgery" - a problem for diabetics.
+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.