Gingivitis is the mildest form of periodontal (gum) disease. It is often caused by inadequate oral hygiene, which leads to plaque buildup. Other factors that may contribute to gingivitis include diabetes, smoking, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, HIV infection, and the use of certain medications.
The bacteria in dental plaque irritate the gums and cause infection. When your body launches an immune response against these invaders, the gums become inflamed. People with gingivitis usually experience little or no discomfort. Therefore, it is important to recognize the symptoms, such as gums that are red, swollen or bleed easily. Gingivitis is reversible with professional treatment and good home oral care. However, if gingivitis is left untreated, it can advance to periodontitis.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body, in essence, turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
Chronic periodontitis: results in inflammation within the supporting tissues of the teeth followed by progressive loss of periodontal attachment and bone. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva (gum). It is prevalent in adults but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
Aggressive periodontitis: occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction, and familial aggregation (seen in other family members).
Research has shown that periodontal disease is associated with several other diseases. For a long time it was thought that bacteria was the factor that linked periodontal disease to other disease in the body; however, more recent research demonstrates that inflammation may be responsible for the association. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions.
1. Gum disease and diabetes
Diabetic patients are more likely to develop periodontal disease, which in turn can increase blood sugar and diabetic complications.
People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don't have their diabetes under control are especially at risk.
Research has suggested that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.
Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications.
2. Gum disease and cardiovascular disease
Several studies have shown that periodontal disease is associated with heart disease. While a cause-and-effect relationship has not yet been proven, research has indicated that periodontal disease increases the risk of heart disease. Scientists believe that inflammation caused by periodontal disease may be responsible for the association. Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your periodontist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.
Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.
3. Gum disease and respiratory disease
Research has found that bacteria that grow in the oral cavity can be aspirated into the lungs to cause respiratory diseases such as pneumonia, especially in people with periodontal disease.
4. Gum disease and pregnancy
Your teeth and gums can be affected by pregnancy, just like other areas of your body. Most commonly, pregnant women can develop gingivitis, or pregnancy gingivitis, beginning in the second or third month and can increase in severity through pregnancy. During this time, some women notice swelling, bleeding, redness, or tenderness in the gum tissue.
If you are pregnant, or planning to become pregnant, you need to know that your periodontal health may affect the pregnancy and ultimately the health of your baby. Pregnant women who experience periodontal disease during their pregnancies may be twice as likely to develop preeclampsia. Additionally, studies have suggested that women who experience periodontal disease during pregnancy may be at risk of having a premature or low birth weight baby. The good news is that researchers are making strides to find out exactly how periodontal disease affects pregnancy outcomes. Some studies have suggested that treating periodontitis during pregnancy may reduce the risks of a preterm birth. Preventing gum problems from developing during the stresses of pregnancy also appears to be important in improving the health of mother and baby.If you are already pregnant and have been diagnosed with periodontal disease, treatment by your dental professional may reduce your chances of having a preterm, low birth weight baby. Talk to your dentist or periodontist for more information. If you're considering pregnancy, it's a good idea to include a periodontal evaluation as part of your prenatal care.
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