The ‘quiet disease’ lingering in our mouths

When gingivitis is left untreated, the bacteria can invade and destroy the tissues under the gums, causing advanced gum disease. “The bone supporting the teeth starts to break down, leaving the roots of the teeth exposed and sensitive in some cases,” Foyle says. “Spaces develop between the teeth, and the teeth start to get loose.”

People who smoke, have diabetes or grind their teeth have an increased chance of developing gum disease, Jeong says. Some medications, such as steroids, and certain epilepsy and cancer drugs, can also increase the risk. Genetics can also make people more or less susceptible, she notes.

People who rarely get cavities may be more likely than other people to get gum disease, too, Neiva says. That’s because the bacteria that cause gum disease outcompete and suppress the bacteria that cause tooth decay.

“It’s very common to see patients with very, very advanced periodontal disease not having a single cavity,” he says.

Gingivitis often goes unnoticed because it doesn’t cause pain. But people with gingivitis may notice that their gums bleed when they brush or floss, Neiva says. The part of the gums adjacent to their teeth may also look red rather than pink.

Smokers with gingivitis may not experience any bleeding or other symptoms, Jeong says. “People tend to think, ‘OK, my gums never bleed, I should be just fine,’” she says – but that’s a misconception.

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Regular brushing and flossing can help prevent gum disease, but once gingivitis has set in, good oral hygiene at home may not be enough. That’s because the bacteria may have started to accumulate below the gum level, Neiva says. In these cases, a professional cleaning and, sometimes, antibiotics, can treat – and cure – gingivitis.

Once gingivitis has progressed into more advanced periodontal disease, people’s gums may start to recede, causing their teeth to look longer, Jeong says. They may also experience increased sensitivity around the gums. Their teeth may not fit together the same way when they bite because they have shifted, and they might have chronic bad breath. Eventually, their teeth may start to loosen and even fall out.

Advanced periodontal disease can be incurable. Dentists and periodontists can, however, recommend treatments that slow down or prevent further gum and bone loss. They may also deep-clean the roots of affected teeth and recommend gum surgery.

Keeping your gums healthy is ultimately simple: brush twice a day, floss once a day and see your dentist for cleanings at least every six months, Neiva says.

“The sooner we detect it,” he says, “the more we can do.”

The New York Times

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