Healthy Gums, Healthy Body

Contributor
School of Dentistry

It’s likely that you evaluate the status of your teeth on a daily basis. You smile in front of the mirror to pinpoint any stains, plaque, or stubborn food particles that have found a new home between your teeth. What you should also be doing is evaluating the status of your gums.

The soft tissue that surrounds the teeth is vulnerable to inflammation and disease, and its health status is related to that of the rest of the body.

The first thing to do is assess the color and texture of the gums. Healthy gums are pink and firm. Pale, red, or swollen gums could be potential signs of illness.

One of the first stages of gum illness is gingivitis, or inflammation of the gums. Its hallmarks are irritation, redness, and swelling.

Gingivitis develops from the accumulation of plaque, the bacteria-containing biofilm coating the teeth, near the gum line.

Gingival plaque goes from being dominated by Gram-positive coccoid bacteria to being dominated by Gram-negative anaerobic cocci, filaments, and spirochetes.

Bacteria release toxins and enzymes that result in activation of the immune system. Antibodies are produced, inflammatory mediators are released, and phagocytic cells are invited.

The various components of the immune response are what give the characteristic symptoms of gingivitis.

Gum redness, for example, arises from the dilation of blood vessels. Swelling arises from the loss of fibrous connective tissue. As gingivitis progresses, bleeding can be provoked via contact with a blunt instrument.

This explains why gums may bleed during dental hygiene appointments. Healthy gums do not bleed when poked with blunt instruments.

While gingivitis is reversible, if it is not controlled, it can transform into periodontitis, which involves the separation of gum tissue from teeth and the loss of underlying bone.

Periodontitis is a chronic inflammatory disease that is more common than most people think. Findings from the Centers for Disease Control and Prevention suggest that 47.2% of American adults aged 30 and over have some stage of periodontal disease, with the prevalence increasing to 70.1% in those aged 65 and older.

Symptoms of periodontitis include receding gums and the formation of deep pockets around the teeth.

Halitosis, or bad breath, is also a warning sign, as is the presence of loose teeth.

With the progression of periodontitis, teeth lose their anchoring to the gums and bone, paving the way for potential tooth loss.

The best way to prevent gingivitis and periodontitis is to stay on top of one’s oral hygiene routine. Brushing teeth twice a day and flossing once a day go a long way in keeping gingivitis-causing plaque in check, as do biannual visits to the dentist.

A dentist may recommend changes to a patient’s oral hygiene routine if the patient is genetically or behaviorally more susceptible to gum disease.

Research suggests that power-driven toothbrushes, for example, may be more effective than manual toothbrushes in decreasing gingival bleeding and inflammation, due to their greater plaque-reducing capacity.

Thus, a patient may be recommended to switch to an electric toothbrush.

A 2006 review published in The Journal of the American Dental Association indicates that mouthrinses with 0.12% chlorhexidine may have strong anti-plaque and anti-gingivitis effects.

Another review, published in the same year in the Journal of Clinical Periodontology, suggests that stannous fluoride dentifrices may significantly reduce gingivitis as measured on a disease severity index.

Thus, chlorhexidine and stannous fluoride products may be added to a typical oral hygiene regimen as part of a gingivitis treatment plan.

Treatment for more advanced gum disease covers a spectrum of non-surgical and surgical procedures. Non-surgical methods include scaling and root planing, which involves removing plaque above and below the gum line and smoothing rough portions of teeth roots.

This is also referred to as deep cleaning.

Surgical treatment options include bone grafts, which replace lost bone, and soft tissue grafts, which fill in gaps where the gums have receded.

Any prevention or treatment plan also includes addressing smoking and unhealthy snacking habits, which contribute to poor oral health overall.

A 2007 review published in the Journal of Periodontology suggests that there is a positive relationship between stress and periodontal disease, so learning how to cope with life stressors plays a role in gum care.

It is important to keep in mind that the gums are related to the rest of the body. A 2002 article published in the Journal of the Canadian Dental Association points to associations between gum disease and systemic disorders like diabetes mellitus, pneumonia, heart disease, and preterm birth.

While causal relationships cannot necessarily be made, the relationships between gum disease and many of these disorders are bidirectional.

The next time you look in the mirror, take a few seconds to evaluate your gums, and make sure you adhere to an oral hygiene regimen that keeps them healthy.