Diagnosis & Risk Factors
Periodontal disease is silent, meaning it is painless and typically has very mild symptoms in its early stages. Once the disease progresses to the advanced state, patients become aware that something is wrong due to a myriad of symptoms. A thorough periodontal examination is needed when you notice any of the warning signs of periodontal disease:
- Red, swollen or tender gums
- Tender gums or pain while chewing
- Bleeding while brushing, flossing, or eating hard food
- Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
- Loose or separating (shifting) teeth
- Pus between your gums and teeth
- Sores in your mouth
- Bad breath that won’t go away
- A change in the way your teeth fit together when you bite
- A change in the fit of partial dentures
Presence of plaque and bacterial toxins are the main cause of periodontal disease. However, factors like the following also affect the health of your gums and will modify how your body’s immune system responds to periodontal bacteria and their toxins:
Smoking
Smoking is the single major preventable risk factor for periodontal disease. The habit can cause bone loss and gum recession even in the absence of periodontal disease. Research has shown that smokers are 11 times more likely than nonsmokers to harbor the bacteria and toxins that cause periodontal disease and four times more likely to have advanced periodontal disease. The risk of periodontal disease increases with the number of cigarettes smoked per day. Smoking cigars and pipes carries the same risks as smoking cigarettes. Exposure to secondhand smoke is also associated with a 50 - 60% increased risk for developing periodontal disease. Fortunately, when smokers quit, their periodontal health gradually recovers to a state comparable to that of nonsmokers.
Diabetes
Much evidence exists on the link between type 1 and 2 diabetes and periodontal disease. Diabetes causes abnormalities in blood vessels, and high levels of specific inflammatory chemicals such as interleukins, that significantly increase the chances of periodontal disease. High levels of triglycerides (which are common in type 2 diabetes) also appear to impair periodontal health. A high blood sugar level, which is the hallmark of diabetes, has even been associated with severe periodontal disease in people without diabetes, according to a 2000 study. Obesity, which is common in type 2 diabetes, may also predispose a person to gum disease. Controlling both type 1 and 2 diabetes may help reduce periodontal problems. For children with diabetes, good oral hygiene should begin at a young age. A 2006 study suggested that gum problems can start as early as 6 years of age in children with diabetes.