Why you should never ignore changes to your gums
Good oral health does not stop with your teeth. Gums perform a vital task, surrounding the teeth to keep them in place and protect them from damage. However, maintaining gum health is often overlooked and, as a result, gum disease is a serious and all-too-common problem in Australia and around the world.
In Australia, almost 1 in 4 (23%) of Australians aged 15 and over have moderate or severe gum disease, which increases to more than 1 in 2 (53%) among people aged 65 and over. Globally, it is estimated that 50% of adults suffer from gum disease. The problem has reached such a point that, in 2017, the World Dental Federation made global periodontal (gum) health a priority for the next three years.
Oral health is fundamental to overall health, wellbeing and quality of life throughout a lifetime. Poor oral health, including gum disease, can impact an individual’s ability to eat, sleep, work and socialise. The prevalence of oral disease combined with the daily impact on the individual means that it really is a neglected health burden.
What is gum disease?
Periodontal disease, or gum disease is the inflammation of tissues surrounding the teeth caused by bacteria, which can result in swollen and bleeding gums. The earliest stage of periodontal disease is called gingivitis (gum bleeding), while the advanced stage of the disease is referred to as periodontitis. If nothing is done to treat early stages of gum disease, the infection can spread and begin to destroy the structures that support teeth, like ligaments fixating the teeth and the adjacent bone. As this damage progresses, teeth can become so loose that they impede eating or talking and can fall out or need to be removed.
Are you at risk of gum disease?
Although the build-up of bacteria due to improper oral hygiene is the main cause of gum disease, there are other risk factors that can increase your chance of gum disease or make it worse if you have it. These include:
- Low socioeconomic status – The majority of oral health services in Australia are provided through the private system. Unfortunately, this means the cost of accessing oral health care can be a significant barrier for lower income earners.
- Diet – Although this research is in its infancy, diets that are high in carbohydrates can increase your risk for gum disease.
- Age – conditions and medications that are related to ageing can increase the risk for gum disease.
- Diabetes – this can limit your body’s ability to fight infection due to unstable blood sugar levels. Managing diabetes is very important for good oral health. Similarly, research suggests that diabetics with good oral health are better-placed to manage their blood sugar levels than those with poor oral health.
- Illness and medications – some medications can cause dry mouth which, in turn, means you have less saliva to wash away the bacteria in your mouth. These can include antihistamines, antidepressants, as well as medications to treat vomiting and nausea, hypertension, Parkinson’s symptoms and sedatives. Also, some illnesses like HIV and cancer can impact the health of your gums.
- Hormone fluctuations and pregnancy can make gums more susceptible to bleeding. More effort in brushing and cleaning between the teeth is needed during pregnancy to keep the gums healthy.
- Smoking – this increases the risk of gum disease and, the longer you smoke, the higher the risk. Smoking can also interfere with the successful treatment of gum disease.
- Genes – even if you are genetically susceptible to gum disease (which is debated in the research community), it does not mean that gum disease is inevitable. Good oral health practices and regular visits to an oral health professional can help to prevent or manage the disease.
There is a growing body of research that shows potential connections between gum disease and other medical issues and conditions. For example, as well as diabetes, gum disease is thought to be a risk factor for atherosclerosis, heart attack and stroke and may also worsen existing heart disease. If someone has an existing lung condition, and bacteria from the mouth reaches their lungs, this can cause the condition to worsen. It is also thought that gum disease can negatively affect pregnancy and can lead to low birth weight and premature contractions of the uterus.
What are the signs of gum disease?
Gum disease can be painless, so it’s important to be vigilant about other signs. These include:
- Noticing blood in your toothpaste after brushing or after flossing
- Swollen, red or tender gums
- Receding gums
- Persistent bad breath or a bad taste in the mouth
- A change in the way your teeth come together, or a change in the fit of a partial denture
- Pus visible around the teeth or gums.
Although you may become aware of these symptoms, the inflammation might be clinically mild and therefore a regular visit to an oral health practitioner once or twice a year is the only and safest way to avoid gum disease. If you notice any of these symptoms, contact your oral health professional as soon as possible. If necessary, your dentist might refer you to a periodontist, who specialises in gum health. Your oral health professional cannot diagnose gum disease by just looking at your gums. They need to examine the space between the gums and the tooth with a blunt probe to observe if they are healthy or to diagnose gum disease.
Brushing twice a day and cleaning between your teeth with floss or an interdental brush will help prevent gum disease, and prevention is vital. Once you have gum disease, you cannot reverse or stop it alone. However, with the help of an oral health professional, gum disease can be prevented, treated, and an ongoing management plan put in place.
Professor Joerg Eberhard is a periodontist and dental-scientist conducting translational research, with a particular interest in the interactions between oral and general health through all phases of life. He joined the University of Sydney in 2016 and is currently Chair of Lifespan Oral Health in the Charles Perkins Centre and the School of Dentistry. Professor Eberhard is also a founding member of the Oral Health Advisory Panel.
 Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW.
The Oral Health Advisory Panel (OHAP), is a group of independent healthcare professionals with the aim of raising awareness of the importance of good oral health and its impact on general wellness. The Panel aims to take oral health beyond the dental clinic.
Follow the Oral Health Advisory Panel via twitter @OHAPanel to stay up to date with practical advice on good oral health habits.