It can often go unnoticed – until it’s too late.

While you may not think periodontal (gum) disease affects you, 75 percent of adults over the age of 35 show signs and symptoms. In fact, periodontal disease is the leading cause of tooth loss in adults. Why? Because it occurs at an age when cavities are usually a thing of the past and the initial symptoms often go unnoticed. Recent studies have also shown a possible link between periodontal disease and heart disease. One theory in support of this is that the bacteria that cause periodontal disease enter the bloodstream and promote blood clots and narrowing of the arteries that cause heart attacks. It has also been shown that if a woman develops severe periodontal disease during pregnancy, she is more likely to give birth to a low birth weight infant. Research also shows periodontal disease is linked to many other health problems, as well.

What is gum (periodontal) disease? What causes it?

Periodontal disease, or gum disease, is a bacterial infection of the gums, ligaments and bone that support the teeth and anchor them in the jaw. The bacteria, which act mainly on certain carbohydrates in our diets, are normal inhabitants of the mouth, living in a thin film called plaque. If this plaque is left undisturbed, it may eventually harden into calculus (tartar), a hard mineral shell. When plaque bacteria build up on this hard surface, it irritates and erodes healthy gum tissue. This early, reversible stage of periodontal disease is called gingivitis. If left untreated, the supporting bone becomes progressively eroded and pockets begin to form between the teeth and gum tissues, eventually resulting in tooth loss. This irreversible stage of periodontal disease is called periodontitis.

What are the symptoms of periodontal disease?

Because gum disease is painless until the final stages, it often goes unnoticed. However, there are many indications of potential periodontal disease. Here is what to watch for:

• gums that bleed when you brush your teeth

• red, swollen or tender gums

• gums that have pulled away from your teeth

• a metallic taste or persistent bad breath

• pus or discharge between your teeth and gums

• loose or separating teeth

• a change in the way your teeth fit together when you bite

• a change in the fit of partial dentures

Contact your dentist if you notice any of these symptoms.

If I have no symptoms, how do I know if I have gum disease?

Periodontal disease can be easily detected by your general dentist or a periodontist (a specialist in periodontal diseases) during regular dental examinations. Therefore, regular checkups, ideally every six months for most people, are crucial in catching periodontal disease in its early reversible stages.

During your checkup, the colour and firmness of your gums will be evaluated. Your teeth will be tested for tightness, and they way they fit together when you bite. During your periodontal examination, a small measuring instrument is inserted between the tooth and gum to measure the depth of the pockets. X-rays may be taken to evaluate the bone supporting the teeth.

What other factors can contribute to gum disease?

Smoking is a major risk factor to your oral health. Not only do the chemicals in tobacco have a harmful effect on your oral tissues, but can deplete vitamin C and other nutrients and reduce your resistance to periodontal disease.

A poor diet is also a contributing factor, especially a diet high in sugars and other sticky or gummy carbohydrates and low in the minerals and vitamins needed for healthy gums, teeth and bones.

Hormone changes during pregnancy increase the blood supply to certain tissues in the body including the gums. As a result, 30 to 60 percent of pregnant women experience red, tender or bleeding gums.

Stress can also be a contributing factor because it diminishes your body’s ability to fight infection. Diabetes, AIDS and other health conditions can lower resistance to gum disease.

How can I prevent periodontal disease?

• Brush your teeth twice a day with a soft-bristled toothbrush. Hold the brush at a 45-degree angle to the gum line and gently clean where the gums meet your teeth.

• Clean between your teeth at least once a day with dental floss (or other interdental cleaners, such as rubber tips and oral irrigators, as recommended by your dentist) to remove bacteria, plaque and food particles your tooth brush can’t reach.

• Eat a balanced diet, which includes a variety from each of the basic food groups, to maintain optimum oral health.

• Visit your dentist regularly, ideally every six months, for a preventive checkup and professional cleaning, which is essential in the prevention of gum disease, and the maintenance of good oral health.

What can I do if I already have periodontal disease?

See your dentist. In the early stages of gum disease, treatment usually involves removing the plaque and calculus in the pockets around the tooth and smoothing the root surfaces. This is called scaling and root planing. In combination with proper daily home care, this is all that is usually required to stop the development of the disease. If you wait until the symptoms are more advanced, a referral to a periodontist may be necessary, and in some cases, surgical treatment. Don’t wait until it hurts. Periodontal disease can be prevented with regular dental visits.