Exploring Gum Disease Causes, Signs and Symptoms in 2024

Gum disease is a prevalent but largely preventable condition that impacts the tissues around the teeth. In fact, a study from 2019 revealed that 90% of adults in Singapore experience some form of gum disease, ranging from mild to severe!

Gum disease is a progressive condition that doesn't develop overnight. Early detection and treatment are essential to prevent it from worsening. Understanding the risk factors for gum disease can help you take proactive steps to protect your oral health. 

What is Gum Disease? An Overview

Gum disease refers to the infection and inflammation of the tissues surrounding the teeth. It is primarily caused by plaque buildup on the teeth and gums. Gum disease can be categorised as-

• Gingivitis: This is the milder and reversible form of gum disease. It is characterised by inflammation and redness of the gums, often accompanied by bleeding during brushing or flossing. At this stage, the infection affects only the gums and has not yet reached the bone that support the teeth.
  
  
• Periodontitis: If gingivitis is not addressed, it can advance to periodontitis. This more severe form of gum disease involves the progressive destruction of the bone that support the teeth. As the disease progresses, pockets may form between the teeth and gums, trapping plaque and bacteria. This can lead to further infection, bone loss and ultimately, loss of tooth. For severe cases that involve significant bone loss, a bone graft may be necessary.
  

What causes gum disease?

We know that gum disease occurs due to the accumulation of plaque on the teeth and gums. But what exactly is plaque?

Plaque is a sticky, colourless film composed of bacteria, food remnants and saliva. It begins forming just minutes after brushing. In its early stages, there are relatively few bacteria, posing no immediate threat to dental health. However, within 24-48 hours, plaque matures and bacterial colonies multiply rapidly, potentially damaging tooth enamel and leading to decay.

Within 48-72 hours, plaque can mineralise and harden into tartar, a rough and porous substance that provides a surface for further plaque accumulation and bacterial growth. Unlike plaque, tartar cannot be removed through regular brushing and flossing alone and requires professional cleaning by a dentist or dental hygienist.

Tartar buildup significantly contributes to the development of gum disease. Scaling and root planing is a common treatment for gum disease. Regular brushing and flossing are essential to remove plaque and prevent gum disease. By practicing daily oral hygiene, including brushing your teeth twice a day and flossing, you can significantly reduce plaque formation and maintain optimal dental health.

Related Articles

• Effective gum disease treatment guide: Kiss Gingivitis Goodbye
• How To Cure Gum Disease Without A Dentist

Below are some factors that contribute to an increased risk of developing gum disease (gum disease causes).

Poor Oral Hygiene

Inadequate brushing and flossing allow plaque to build up on teeth and gums, leading to gum inflammation and disease.

Crooked Teeth

Misaligned or crowded teeth can make it more difficult to clean effectively, increasing the risk of gum disease.

Poorly Fitted Dental Restorations

Dental appliances that do not fit properly can trap plaque and bacteria, contributing to gum irritation and disease.

Smoking and Tobacco Use

Tobacco use weakens the immune system and makes it harder for gum tissue to heal.

Genetics

Some individuals may be more genetically predisposed to gum disease, making regular dental care especially important.

Medications

Certain medications can affect oral health by reducing saliva flow or causing gum tissue overgrowth.

Systemic Diseases

Conditions such as diabetes and autoimmune diseases can increase the risk of gum disease due to impaired immune function and inflammation.

Hormonal Changes

Such as during puberty, pregnancy, and menopause can make the gums more susceptible to irritation from plaque.

What key signs and symptoms of gum disease should I look out for?

• When gums bleed, especially during brushing or flossing

• Swollen or tender gums

• Receding gums or gums that appear to be pulling away from the teeth, making the teeth look longer

• Persistent bad breath which is not easily eliminated with brushing or mouthwash

• Pus between teeth and gums, indicating the presence of an infection

• Shifting or loose teeth or a change in the way teeth fit together when you bite.

• Visible tartar buildup that appears as a yellowish or brownish buildup along the gum line.

By maintaining good oral hygiene and promptly seeking dental care, you can prevent gum disease from advancing and causing more severe issues. If you have severe gum disease and are experiencing significant bone loss, your dentist may recommend guided tissue regeneration. Identifying the early stages of gum disease is important for timely treatment and prevention of complications.

The link between periodontal disease and general health

Periodontal disease, if left untreated, can have serious consequences that extend beyond oral health. Numerous studies have linked it to systemic health problems. Early detection and treatment of the various stages of gum disease are essential to prevent severe complications.

Periodontitis and diabetes¹: It's a two-way relationship. This means that diabetes not only impacts the development and severity of periodontitis, but periodontitis also affects how diabetes progresses and is managed. Studies have found that people with periodontitis are twice as likely to have diabetes compared to those without periodontitis.

Periodontitis and heart disease²: It is thought that bacteria or toxins from infected gums can travel through the bloodstream, potentially leading to the development of blockages in arteries. Studies have shown that individuals with periodontitis are 0.5 to 2.8 times more likely to experience heart disease.

Periodontitis and pregnant women³: Research findings suggest that periodontitis is associated with a significant six-fold increase in the risk of premature birth. This means that pregnant women with periodontitis are at a much higher likelihood of delivering their babies prematurely compared to those without this dental condition.

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References

1. Soskolne, W. & Klinger, Avigdor. (2002). The Relationship Between Periodontal Diseases and Diabetes: An Overview. Annals of periodontology / the American Academy of Periodontology. 6. 91-8. 10.1902/annals.2001.6.1.91. 
2. Shetty B, Fazal I, Khan SF, Nambiar M, D KI, Prasad R, Raj A. Association between cardiovascular diseases and periodontal disease: more than what meets the eye. Drug Target Insights. 2023 Feb 2;17:31-38. doi: 10.33393/dti.2023.2510. PMID: 36761891; PMCID: PMC9906023.
3. Uwambaye P, Munyanshongore C, Rulisa S, Shiau H, Nuhu A, Kerr MS. Assessing the association between periodontitis and premature birth: a case-control study. BMC Pregnancy Childbirth. 2021 Mar 12;21(1):204. doi: 10.1186/s12884-021-03700-0. PMID: 33711951; PMCID: PMC7953642.