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
Periodontal Disease: Leading Cause of Adult Tooth Loss
Periodontal disease is a bacterial infection. Without proper dental care the bacteria that are present in plaque can infect the gums (gingivitis) and destroy the bone and tissues that support the teeth in what is called periodontitis-- the leading cause of tooth loss and bad breath (halitosis) in adults. In addition, gum disease has been linked to more serious health threats such as diabetes, cardiovascular disease, respiratory disease, and pre-term, low-birth weight babies.
Is periodontal disease contagious? Can it be passed from one person to another like tuberculosis or meningitis? Can you get periodontal disease by kissing someone who has it? The answer to all these questions is YES.
In a dental care article published in the Journal of the American Dental Association, it was revealed that periodontitis might be passed from parents to children and between intimate partners.
The bacteria that inhabit the periodontal pockets are also present on the oral soft tissues, teeth, tongue and saliva. They can be transferred from one person to another through saliva, intimate kissing, sharing of food, utensils, or toothbrushes, and can result in exposure to saliva that contain the bacteria that cause periodontal disease.
Based on these findings and the fact that periodontal disease has a genetic component, it is recommended that if one family member has periodontitis, all family members see a dental care professional or periodontist for a periodontal screening. Parents need to know that gum disease and halitosis are not just adult health problems and that children can also be affected.
To prevent transmission of periodontitis between family members or intimate partners, it is important to follow proper dental care and oral hygiene techniques that include daily brushing and flossing and to see a dental care provider routinely for professional cleanings and examinations.
By Laura Minsk, DMD
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