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Gum disease can be serious

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May 27th, 2015
teeth graphic
teeth graphic

Take a close look inside your mouth—there’s a very good chance you have some form of gum disease. 

In fact, according to the Centers for Disease Control and Prevention, about 75% of Americans have some form of gum disease, and over half of adults over age 30 have the most severe form, called periodontitis. Older adults have the highest rates of periodontal (literally “around the tooth”) disease in general, which includes gum infections as well as infections of the supporting tooth structures, including the bones. Despite such a high prevalence, the American Academy of Periodontology reports only 3% of people with gum disease seek treatment.

A slow mover

Gum disease doesn’t happen overnight. The earliest stage of the disease is gingivitis. Gums appear red and swollen—but may only appear a little pinker than usual at first. Without treatment, it tends to progress slowly but can be aggravated by smoking, a poor diet (particularly high in sugar), underlying medical conditions, and poor mouth hygiene. 

“As the disease advances to periodontitis, gums begin to pull away from teeth and supporting structures break down,” says Janet Yellowitz, D.M.D., director of geriatric dentistry at the University of Maryland Dental School. “This includes bone, and teeth can loosen or fall out.” 

If you ignore gum disease

Research has shown that periodontal disease is associated with major health concerns such as heart disease, stroke, respiratory diseases, and even diabetes. A major cause of failure in joint replacements is infection. Scientists think inflammation may be the common denominator among these problems—inflammation in one part of the body can lead to the same problem elsewhere throughout bodily structures and systems.

Red, inflamed gums might make it difficult for a dentist to detect other problems such as oral cancer. “Mouth cancers are known as the great mimics because they’re not unique looking until they become fairly advanced,” Yellowitz explains. “Early detection is essential because these cancers are best treated in early stages, and surgery for advanced oral cancers can be extensive and disfiguring.”

Treatment

Treatment for periodontitis is no walk in the park. Most people will need to see a specialist (periodontist), who may perform a scaling and root planing procedure. This involves a meticulous cleaning of root surfaces in order to remove tartar and plaque, cleaning gum pockets, and smoothing tooth roots. It may also involve removing dead or infected tissue. This process is typically accompanied by the application of antibiotics.

In more severe cases of the disease, you may need surgery, including gum grafting to cover exposed roots; bone grafts to replace lost bone; or dental implants. 

Vigilance pays off

The primary cause of periodontal disease is bacteria, which typically starts on the tooth surface.  

“Your teeth need to be healthy to keep your gums healthy,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Novi, Mich. “Because seniors are at high risk for gum disease, they must do more to maintain their oral health.” 

There’s more to oral health care than simply brushing, flossing, and rinsing regularly. Seniors should schedule twice yearly visits to a dentist and take these visits as seriously as other medical appointments—especially people at a higher risk of gum disease. 

“Many older adults are taking medications, especially for chronic conditions, that cause a dry mouth,” Suneja says. Medications for allergies, pain, inflammation, urinary incontinence, and Parkinson’s disease, as well as antidepressants and heart and blood pressure medications are just a few examples. “A dry mouth makes you more susceptible to gum disease,” Yellowitz explains.

Waiting to see a dentist until you have gum irritation or pain isn’t wise. “Older adults may not feel pain as much as younger adults,” Yellowitz says. “Periodontitis could be far advanced before you feel any discomfort.”

Some people have few risks for gum disease but develop it nonetheless due to a genetic predisposition to the disease. But Yellowitz says it isn’t inevitable: “Meticulous attention to oral hygiene can counteract predisposition to the disease,” she says.

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