Everyone can benefit from following the standard guidelines for oral health: daily flossing, twice-a-day brushing, maintaining a healthy diet, avoiding tobacco use, and having regular dental checkups. Staying on top of your oral hygiene will help you avoid gum disease and keep your teeth healthy and strong for a lifetime. However, particular groups of people have unique concerns when it comes to oral health.
Age/Gender
Children and Teens
Periodontitis, the advanced stage of gum disease, is uncommon in children. But gingivitis, the first stage of the disease, is widespread. Be aware of the signs of gingivitis: swollen, red, tender or bleeding gums.
During puberty, gum sensitivity can increase with hormonal fluctuations, which leaves teens at a greater risk of gum disease. With good home care and professional cleanings, gingivitis can be prevented and treated.
Gum disease runs in families, so if one family member has experienced gum disease, everyone else should be screened. Also, bacteria can be spread through saliva, so avoid sharing forks and spoons, especially if any signs of gum disease are evident.
As with adults, children with particular systemic conditions are especially susceptible to gum disease. These conditions include diabetes, Down syndrome, Kindler syndrome, and Papillon-Lefèvre syndrome. If your child has one of these conditions, let us and your general dentist know. If your child suffers from gum disease, especially long-term, treatment-resistant gum disease, it may be an indication of a systemic condition.
The best way to prepare your child for a lifetime of good oral hygiene is to establish good habits early on, act as a consistent role model, and schedule regular checkups for professional assessment and cleaning. The stronger the habits of brushing and flossing develop in young children, the more likely they are to continue these habits through adolescence and adulthood.
Women
Because women experience stages of increased and fluctuating hormones, they are more susceptible than men to gum disease and other oral problems during certain times of life. Periodontists have even created terms to describe some of these situations: pregnancy gingivitis and menstruation gingivitis.
During both pregnancy and other phases of increased hormone levels (puberty, menstrual cycle, menopause), fluctuating hormones alter the reaction of gums to irritants such as plaque, which creates a higher likelihood of red, swollen, tender or bleeding gums.
Pregnancy carries special implications for oral health. The risk of gum disease is higher, and the potential effects of gum disease are critical. Some research has linked gum disease to low birth rate and premature labor. Be sure to let us and your general dentist know if you plan to become pregnant so we can take extra precautions against gum disease.
Age, medication, and hormonal changes combine during and after menopause to create special oral circumstances. Women may experience altered taste, increased temperature sensitivity, burning sensations, or dry mouth. These conditions can lead to gum disease, which can be exacerbated by osteoporosis. A strict regimen of brushing, flossing, and professional cleaning can help avoid trouble during this time.
Older Adults
Adults are living longer and keeping their natural teeth longer than ever before. However, the American Academy of Periodontology points out that older people have the highest rates of gum disease and need to do more to maintain good oral health and protect themselves from tooth loss.
Older adults commonly take medications that come with oral side effects such as dry mouth, altered taste, and changes in soft tissue. Arthritis and other mobility issues can make daily brushing and flossing more difficult.
Osteoporosis, most common in older adults (especially women) can increase bone loss in the jaw, and lead to tooth loss, especially in combination with gum disease. Let us or your general dentist know about any medications or mobility problems that affect your ability to take proper care of your teeth. We can recommend ways to overcome these issues.
More mature adults are opting for dental implants over dentures and bridges, because implants look and feel like natural teeth. Whether you have implants or conventional dentures and bridges, it’s vital to retain the same level of care that you would with natural teeth.
Health Conditions
Advanced, untreated gum disease degrades the tissues and bone structures that surround the teeth and very often causes tooth loss. But the effects of gum disease can be felt well beyond the mouth and jaw. Research links gum disease to a variety of systemic conditions that affect overall health, including heart disease, diabetes, and osteoporosis. We refer to this as the mouth-body connection.
In some cases, gum disease can cause problems in other parts of the body, while in other instances, conditions seemingly unrelated to the mouth can contribute to the development or advance of gum disease.
It’s important to let us and your general dentist know about any illnesses or conditions you are experiencing. An awareness of difficulties outside your mouth can help us treat certain problems related to your teeth and gums.
In turn, we may be able to identify diseases affecting other areas of your body based on the symptoms we observe inside your mouth. The following is a list of conditions known to be related to gum disease.
Diabetes
If you have diabetes, it is especially important to take good care of your teeth and gums, because gum disease and diabetes can affect each other adversely. Diabetes can disrupt the immune system’s ability to fight infection, making diabetics more susceptible to gum disease, which is essentially an infection of the tissue surrounding the teeth. Advanced gum disease can boost the level of blood sugar in the body, which further complicates diabetes.
Heart Disease, Stroke, Dementia
The American Academy of Periodontology cites research that indicates people with gum disease are nearly twice as likely to suffer from coronary artery (heart) disease as those without gum disease. Currently, the actual link between the two diseases is not entirely clear, though some scientists believe that bacteria from the mouth travel through the blood stream to affect the arteries in the heart.
Additionally, a leading cause of blood clots is C-Reactive Protein (CRP), which is released through inflammation; and gum disease is associated with significant inflammation. Other research points to a link between gum disease and stroke, and one study found higher instances of oral infection in a group of stroke survivors than in a control group.
Osteoporosis
Bone growth naturally slows over time, and bone density decreases due to age and other circumstances. Osteoporosis is a disease that weakens bones even further, making them fragile enough to fracture easily and frequently. Although we most commonly hear of hip or back fractures, all bones are affected, including the jaw.
A jaw with decreased bone density can’t support the teeth as well as a healthy jaw, which leaves those suffering from both gum disease and osteoporosis with a heightened risk of tooth loss. If you think you might be at risk for osteoporosis, talk to your doctor about having a bone density test. If this condition is identified early enough, treatment can help.
To prevent fractures, many people who have osteoporosis take medications called Bisphosphonates (such as Fosamax®, Boniva®, and Actonel®). Studies have shown that these medications can slow bone loss and increase bone density, which decreases the chance of broken bones.
However, some Bisphosphonates have also been linked to a condition called Osteonecrosis of the jaw. In these rare cases, the jaw bone does not heal following an oral surgery; in fact, the bone dies instead. Most of the time, this bone death is in connection with IV Bisphosphonates that were used in cancer treatment. This condition is difficult, if not impossible, to stop.
Your best source of information is your physician. Please make sure to discuss your options thoroughly with your physician if you have osteoporosis or are at a high risk for bone breaks.
Dr. Dalessandro does not recommend one course of action or another; the decision to take Bisphosphonates should be made by you and your physician. There is currently no known prevention for osteonecrosis of the jaw; your best prevention is good home care and regular dental visits, so brush your teeth and floss daily!
Respiratory Diseases
Research indicates that bacteria from the mouth — including those present in someone suffering from gum disease — can be inhaled into the lungs, leading to respiratory diseases such as pneumonia. Smoking is a primary cause of respiratory diseases as well as a risk factor in gum disease. Quitting smoking can improve your health in myriad ways. Please get in touch with us or your general dentist if you are looking for help with kicking the habit.
Outside Influences
Smoking
You probably have noticed that smoking can cause stained teeth, a stained tongue, and bad breath. You also know that smoking increases your risk for lung cancer, coronary heart disease, and stroke. What you may not know is that smoking and tobacco use also increases your risk of oral problems, including decay, tooth loss, bone loss, mouth sores, periodontitis, and oral cancer.
Regular smokers and tobacco users tend to experience more deep pockets between the teeth and gums, more tartar and calculus on the teeth, and more bone loss and tissue loss than non-smokers. The American Dental Association estimates that smoking may be responsible for almost 75% of gum disease among adults.
Patients who smoke find that dental and periodontal treatments are less successful than with non-smoking patients, because the chemicals in tobacco slow the healing process. It is highly recommended that you stop smoking prior to, during, and after any kind of oral surgery.
Sometimes, smoking entirely prevents any kind of healing from occurring, and the treatment will fail. Talk to your dentist or physician about your options to quit smoking and increase your health both physically and orally.
Oral Piercings
Oral piercing is a popular form of self-expression, but not only can this interfere with speaking, chewing, or swallowing, but it also may cause serious health risks. Specific to oral health, the mouth’s moist environment is home to huge amounts of bacteria that can collect around the piercing site and cause an infection.
In addition, infection can occur from touching the site with your hands, or by food particles collecting around the piercing. Some people also develop the habit of playing with the piercings in their mouth. Over time, this can injure your gums and cause sensitivity or cracks in your teeth, and result in the need for dental treatment such as crowns, fillings, or even surgery.
If you’re considering an oral piercing, please research it very carefully before making your decision. If you already have an oral piercing, keep the area clean, avoid clicking the jewelry against your teeth, and contact your dentist immediately if you notice any signs of infection. Even more important, you may want to consider removing any mouth jewelry before it causes a problem.