What Are the Stages of Gum Disease & Can You Reverse It?

October is Dental Hygiene Month. In honor of this important occasion, we want to talk about one of the most important oral health topics: gum disease. What are the stages of gum disease, and can you reverse it?

According to the ADA, up to half of all Americans over age 30 have an official diagnosis of some form of gum disease. By age 65, nearly 70 percent of all people are affected, making gum disease one of the most common seniorhood illnesses.

These numbers make it clear that periodontitis and other forms of gum disease are at epidemic levels in the United States. But why exactly is this the case? What drives gum disease, and can you reverse it or heal once you have an official diagnosis?

We have the answers.

What is Gum Disease?

The term “gum disease” tends to be a bit vague. Officially, it includes both periodontitis and gingivitis, but these are, in fact, two totally separate conditions.

Gingivitis is caused by bacterial invasion (infection) and inflammation around the base of the teeth along the gumline. It is usually mild, manifesting as tenderness, redness, and swelling without loss of tissue.

Periodontitis, on the other hand, is a severe infection that attacks, and often destroys, tissues surrounding the base of the teeth. Left untreated, it eventually begins to erode the gumline and tooth itself, leading to cavities, problems with the root of the tooth, and erosion of the underlying bone structure.

Gingivitis almost always precedes periodontal disease. In fact, most dentists consider it the “first sign” of impending problems – which is exactly why it’s so important to treat gingivitis or prevent it from occurring in the first place.

Why Does Gum Disease Occur?

Your mouth is filled with millions of tiny bacteria at any given time. Some, including Streptococcus salivarius K12, are beneficial as they:

• Aid digestion
• Eliminate bad breath
• Even fight off other bad germs

Bad Bacteria:

Others, such as Streptococcus mutans, don’t provide any benefit at all. Instead, they directly infect tissue and interfere with oral health. These are the same bacteria that directly lead to:

• Gingivitis
• Tooth decay
• Cavities
• Gum loss
• Eventually, full-scale periodontitis or tooth loss

Research shows that maintaining a thorough oral health regimine is the best way to prevent and treat most gum diseases. That means brushing two to three times a day for around three minutes, flossing, and seeing your dentist every six months!

Who Is At Risk?

So we know that an extensive oral health regime helps. That said, science also proves that some people may be more prone to developing gum disease than others – including seniors,  Mexican Americans, non-Hispanic blacks, and smokers.

Sometimes, it’s clear why a certain group of people have an increased risk for gum disease. For example, smoking suppresses the immune system, making people more susceptible to infection. It makes sense that smokers would thus be more prone to gum disease.

In other cases, it’s harder for scientists to define why certain groups seem to be more affected than others (e.g., Mexican Americans). It’s likely that genetics, diet, or even water quality (depending on location) play a role.

Some studies also show that hormone fluctuations might make someone more prone to developing gum disease. For example, gingivitis is common in pregnancy because calcium levels often become depleted. Calcium plays a key role in tooth strength.

Why is Gum Disease Dangerous?

We mentioned that gum disease can lead to inflammation, infection, tissue loss, tooth loss, and loss of the underlying bone structures under the teeth. This alone is enough to make gum disease a very big problem! Unfortunately, it’s really only the beginning.

Studies show that gum disease can lead to a constellation of other health problems, especially if it is left unaddressed:

• Diabetes
• Heart disease
• Kidney disease
• Alzheimer’s Disease
• Asthma
• Osteoporosis

Some of these diseases can, in the right circumstances, lead to chronic or even fatal health conditions. And while we know that there’s a link, science doesn’t yet fully understand why the link exists for every connected disease.

Evidence is currently strongest for a link between Diabetes and gum disease out of all the associated systemic conditions. Patients are significantly more likely to develop gum disease if they suffer from Diabetes. This is probably a result of the fact that most diabetics have lowered immune function.

One study even revealed that patients who were diagnosed with periodontal disease were more likely to have heightened levels of HbA1C. This might mean that periodontitis is an early warning sign for full-blown Type 2 Diabetes.

Can You Reverse Gum Disease?

Now, for some good news: gum disease is treatable, no matter how advanced it is or how much damage you’ve already accumulated.

If you think you’re suffering from gingivitis or periodontitis, your first step should be to schedule an appointment with your dentist. He or she can help you assess where you are and create a plan to help you restore as much of your oral health as possible.

If you suffer from dental anxiety, there are also ways to complete treatment.

After your initial appointment, your dentist will probably suggest one or more of the following treatment options:

1. Dental cleaning:

Your dentist’s hygienist will use a variety of tools to strip plaque, tartar, and other “bad germs” from your teeth and gum line.

Afterwards, he or she will place two mouth trays loaded with a special fluoride solution into your mouth and over your teeth for around 10 to 15 minutes. This process is usually painless and completed while you are awake.

2. Dental scaling:

If you have particularly sticky and stubborn plaque or tartar, or if your plaque has developed into calculus under the gum line, your dentist may suggest scaling and root planing.

He or she will use a special tool to scrape it away, smoothing down any rough spots on your teeth at the same time. Because this process can be a little uncomfortable, it is generally completed under a local anaesthetic.

3. Flap surgery:

If scaling isn’t enough to restore your oral health, or if bacteria and infection becomes trapped underneath the gum line, you may need flap surgery (sometimes called pocket reduction surgery) instead.

This procedure, which is usually completed under a local or general anaesthetic, involves lifting up the gums and more thoroughly stripping and smoothing the surface of the tooth underneath. Afterward, your dentist will re-fit your gums to the surface of your tooth snugly, making it harder for bacteria to get in.

4. Advanced surgeries:

Patients with periodontitis often need surgery in order to restore their oral health. This may include bone grafts, which use fragments of bone sources from other areas of your body to re-stabilize your teeth and regenerate tissue. Soft tissue grafts sourced from the roof of your mouth may be used to add volume to lost gum tissue.

Implanting medical mesh may help to stimulate bone or tissue growth while also adding stability. Lastly, maxillofacial surgeons can reshape the bone underneath your gums to eliminate pockets or “holes” where bacteria can accumulate.

Common Questions About Gum Infections: