Gum disease, also known as periodontal disease, is a bacterial tooth infection, and it's a common concern for adults. It can be caused by plaque buildup, smoking, changes in metabolism or hormone levels, or certain medical conditions like diabetes. While teenagers may develop gingivitis, a mild form of gum disease, most people don't show any signs of serious gum disease—periodontitis—until they are in their 30s or 40s. Men are more likely to develop it than women. Luckily, treatment is easy if it's identified in its early stages, so gum disease is curable.

Signs and Symptoms of Gum (Periodontal) Disease

Persistent bad breath, loose teeth, inflamed gums, sensitive gums, or gums that bleed easily are all signs that you may have gum disease. If you have gum disease, it may be painful to chew, your teeth may feel loose, and you may have receding gums (often meaning your teeth look longer!).

Stages of Periodontal Disease

When plaque is allowed to develop and remain on teeth, it hardens into tartar, which only a professional cleaning can remove. If plaque and tartar are not removed, they begin spreading below the gum line, which pulls away from the teeth. Bacteria thrive in the space that's created between the gums and teeth, causing gum disease. In general, there are two stages of gum disease:

• Gingivitis. The main symptom of gingivitis is red, swollen gums that are easily prone to bleeding. This mild form of gum disease can be reversed through daily brushing and flossing, along with regular professional dental care.
  
• Periodontitis, which is a more serious concern, because the gums actually pull away from the teeth, leaving spaces between teeth and gums where bacteria can thrive. The bacteria themselves, along with the body's immune response, begin to break down the bone and connective tissue of teeth and gums.

Some people do have a genetic tendency to be susceptible to gum disease, hormonal changes such as those during pregnancy, and diabetes and other illnesses can make the mouth more susceptible to infection. While we don't know exactly what causes periodontal disease, we do know that there are some serious risk factors, including inadequate dental hygiene and smoking tobacco products.

Smoking and Gum Disease

Smokers and smokeless tobacco users are six times more likely than non-smokers to have serious gum disease. Why? Tobacco users have more tartar on their teeth and deeper pockets between teeth and gums, decreased blood flow in the gums that affects how gums heal, and mouths that are more susceptible to infection by aggressive bacteria. Bottom line: Smoking increases your risk of gum disease, and if you have gum disease already, smoking makes it worse.

Diabetes and Gum Disease

Diabetics are more likely to have gum disease than non-diabetics, primarily because diabetics are more susceptible to infections in general. High blood sugar results in high levels of sugar in body tissue, making the tissue a natural host for bacteria that cause infection. Interestingly, research has shown that gum disease can make it harder for diabetics to control their blood sugar—severe gum disease actually may increase blood sugar—so the relationship between diabetes and periodontal disease appears to go both ways.

If you are a diabetic, dental checkups should be an essential part of your ongoing healthcare plan. Keeping your teeth and gums in their best possible health will reduce your possibility of experiencing complications from the infections that cause gum disease.

People with gum disease are nearly twice as likely to have coronary artery disease (heart disease) than those who have healthy gums.* Studies have suggested that common oral health problems like periodontal disease can be as clearly correlated with heart disease as cholesterol levels. Keep in mind that no one has proven that gum disease causes heart disease; the two conditions have simply been shown to co-exist frequently.

The "why" of the gum disease/heart disease relationship is still under intense scientific research. We do know that oral bacteria can find their way to the bloodstream through the gums. Some researchers believe that these oral bacteria cause blood cells they come in contact with to swell, narrowing an artery in the heart. Research is still ongoing about the connection between oral health and heart health, but most medical professionals believe that a patient who suffers from severe periodontal disease may also be likely to have cardiovascular problems.

If you are worried about heart disease, treating your teeth and gums well shouldn't be the only step you take toward cardiovascular health. Whether or not periodontal disease is a potential risk factor in heart disease, good oral hygiene is simply a good idea!

*American Academy of Periodontology, cited at http://www.webmd.com/heart-disease/features/periodontal-disease-heart-health

Gingivitis, gum disease, and periodontal disease are all terms used to describe forms of bacterial growth in your mouth. Typically, dentists refer to gingivitis as the first stage of bacterial infection in your gums, while gum disease—or periodontitis—is the more advanced stage of the condition. Bacteria are normally in our bodies, and most cause no harm. However, in some individuals, the bad bacteria in the plaque that forms on our teeth thrive in the warm, moist mouth environment, causing significant irritation of the gums. Gingivitis is an inflammation of the gums, while in periodontitis, the bacteria actually begin to break down the bone and connective tissues of your teeth and gums.

What are the signs and symptoms of gingivitis?

Gingivitis is inflammation of gums. The main symptoms of gingivitis are red, swollen gums, and bleeding when tooth brushing. This mild form of gum disease can be reversed through daily brushing and flossing, along with regular professional dental care.

What are the signs and symptoms of periodontal disease?

The symptoms of periodontitis/gum disease include: red, swollen gums; bleeding during and after brushing; frequent bad breath; receding gums; and loose, shifting teeth. Periodontitis is disease of the gums, a more serious concern because the gums actually pull away from the teeth, leaving spaces ("pockets") between teeth and gums where bacteria can thrive.