DEAR DOCTOR K: My dentist is always going on about gum disease. Is it really a big deal? If so, what should I do to prevent it?
DEAR READER: I understand your skepticism. It seems hard to believe that your gums could cause serious problems. The kidneys, the liver, the heart, the brain – of course. But the gums?
Yes, the gums: Your dentist is right. Periodontal disease is the leading cause of tooth loss in adults.
Our mouths house complex networks of bacteria. When all of the species are in balance, our gums are protected from disease-causing bacteria. Disturbing this balance provides an opening for disease-causing bacteria to cause inflammation of the gums, and that destroys gum tissue.
The effects of gum disease vary from person to person. In some people, it causes mild redness and swelling of the gums (gingivitis). In others, it can destroy the tooth’s bony support structure, leading to tooth loss.
However, the reason your dentist may be urging you to protect your gums is not just because of the dental problems gum disease causes. People with gum disease are also at higher risk for cardiovascular disease, diabetes, chronic respiratory disease, pregnancy complications and dementia.
We don’t yet know if gum disease actually causes these health problems. There is considerable evidence that inflammation in the gums causes harmful molecules to leave the gums and spread in the bloodstream throughout the body.
On the other hand, it might be that the link between gum disease and diseases of other organs is explained in a different way. For example, people with chronic health issues have more difficulty taking care of their teeth and gums.
The good news is that the association probably works both ways. That is, successfully treating gum disease probably reduces the severity of the other diseases with which gum disease is linked, and vice versa.
Here are some of the best ways to reduce your risk of gum disease:
Brush and floss. Brush your teeth at least twice a day. Floss before bedtime.
Don’t smoke. People who smoke up to a half a pack of cigarettes per day are almost three times as likely as nonsmokers to have periodontitis.
Eat a healthy diet. A diet rich in vegetables, vegetable oils, fruits, legumes, nuts and fatty fish helps suppress inflammation in the gums and throughout the body.
Get regular dental checkups and cleanings. Your dentist or dental hygienist can remove bacteria-harboring plaque and spot the first signs of periodontal disease.
Get treatment at the first signs of gum disease. Swollen, bleeding gums, pockets of pus, or gums that have pulled away from your teeth are the most dramatic signs of gum disease. Subtler changes include widening spaces between your teeth, and bridges or partial dentures that don’t fit as well as they once did.
So your dentist is not exaggerating the importance of gum disease. It’s something you can do a great deal to prevent.
(Dr. Komaroff is a physician and professor at Harvard Medical School.)
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