Gum disease is one of those conditions that we often don’t think of, but it’s becoming an increasingly prevalent issue.
Figures from the UK government reveal around one-fifth of adults have been diagnosed with gum disease to some degree, with women more commonly affected than men. Plus, it becomes more of an issue as we get older – with those aged 55-64 twice more likely to have gum disease than those aged 25-34.
But gum disease has far greater impacts than just dampening photo-friendly smiles. Research suggests it can contribute to a host of significant health conditions, from heart disease to cancer. So what can we do?
What are the main causes of gum disease?
While various factors can contribute to gum disease, one culprit looms particularly large: plaque.
“Plaque is a sticky film of bacteria that forms on the teeth,” explains Dr Sepideh Jalali, clinical director at Tooth Club. If plaque is allowed to build up, it can harden into tartar, irritating the gums and causing inflammation – which leads to gum disease.
As we get older, it becomes easier for plaque to (literally) stick around. This is because, over time, our teeth face increasing wear and tear from years of use.
“You’re providing more areas for bacteria to settle and it can then collect and prove difficult to clean away,” reveals Dr Safa al Naher, founder and principal dentist at Serene in Knightsbridge.
Sepideh adds that the ageing process also negatively impacts our immune system, so it’s less able to fight infection and gum disease can more easily take hold.
Other factors that can contribute to gum disease include:
- Not brushing our teeth properly or often enough
- Smoking
- Poor diet
- Taking certain medications
- Health conditions (such as diabetes)
How menopause impacts oral health
Studies show that up to 60% of women experience changes to their gum health during midlife.
“During the perimenopause and menopause, the decrease in oestrogen and progesterone can make gums more sensitive and reduce the production of saliva from the salivary glands, triggering symptoms such as dry mouth,” reveals Miranda Pascucci, dental therapist and head of clinical education for oral health brand TePe.
Saliva plays a vital role in keeping plaque at bay by cleaning away bacteria. If we have a dry mouth, our teeth become more vulnerable.
Declining oestrogen can have other impacts on gums, too.
“Oestrogen plays a role in maintaining bone density,” shares Dr Tanya Patel, founder and principal dentist at the a.b.c. smile clinic.
“As levels decline, the jawbone, which anchors the teeth, can start to lose strength. This weakened support structure can make it easier for gum disease to progress.”
We can think of this process like a building’s foundation weakening over time and putting extra strain on everything above.
Hormonal changes can also cause gum tissues to become thinner – making them more likely to look redder or paler in colour and more prone to bleeding. “Many women notice their gums become more sensitive or start to recede during this time, which can be an early sign that gum health is under threat,” Sepideh says.
What are the main signs to look out for?
There are a number of early signs of gum disease to look out for, before even heading to the dentist.
“Red, swollen gums and bleeding when brushing or flossing are often the first indicators,” says Tanya. “Healthy gums shouldn’t bleed.
“Ongoing bad breath – despite brushing – can also be a sign of bacteria build-up and infection.”
If untreated, concerns can progress from gingivitis (early-stage gum disease) into periodontitis (later-stage gum disease) – with symptoms becoming even more pronounced. At this point, we may experience:
- Receding gums
- Pus between teeth and gums
- Changes to the way we bite
- Difficulty eating
- Loose teeth and tooth loss
Why we need to take gum disease seriously
Treating gum disease is essential to prevent oral concerns such as bleeding, bad breath, and tooth loss, says Safa. But the effects of this condition extend well beyond our mouths. “Gum disease is also linked to a lot of other health problems, such as heart disease and dementia,” she says.
A large study following older adults over 26 years found those who had signs of gum disease and mouth infection at the start of the research were more likely to have developed Alzheimer’s. Another analysis of six studies discovered similar findings – that patients with periodontal disease are at much higher risk of experiencing Alzheimer’s.
The relationship between gum disease and Alzheimer’s may be based around inflammation, says Tanya.
“Bacteria and inflammation in the mouth don’t stay local; they can enter the bloodstream and impact other organs,” she explains. “We’re only just beginning to fully appreciate the role oral inflammation plays in broader health conditions like arthritis, Alzheimer’s, and other chronic illnesses.”
A hearty issue
Research has also revealed links between gum disease and cardiovascular disease (CVD). One study found that periodontitis patients faced a 34% higher risk of CVD compared to those with healthy gums, while another found that those with periodontitis were around twice as likely to experience stroke.
Severe gum disease has also been associated with an increased risk of lung, colorectal, breast, skin, oesophageal, and gallbladder cancers. However, experts are still unsure as to how gum disease and cancer are linked.
“Treating gum disease isn’t just about saving your teeth, it’s about looking after your whole body,” says Sepideh.
How to treat – and prevent – gum disease
While it sounds bleak, there is good news.
“Gingivitis can be prevented and reversed with effective oral hygiene measures,” says Miranda. “However, the sooner the disease is diagnosed and treated, the better.”
If we notice symptoms, booking a dental appointment is our first port of call. Here, dentists can provide treatment to deeply clean teeth and remove plaque and tartar.
“Routine dental visits can also help to identify potential issues before they become serious problems,” says Miranda. “Early detection of cavities, gum disease, and other oral health conditions can prevent the need for more extensive and costly treatments later on, as well as reducing the risk of general health conditions, including heart disease.”
There are also steps we can take outside of the dentist chair to help maintain happy and healthy gums – and a combination approach of professional and at-home care is key.
Safa and Melissa recommend the following approaches:
- Brush first thing in the morning and last thing at night
- Use an electric toothbrush, if possible
- Floss between teeth using floss or interdental brushes
- Change your toothbrush at least every three months
- Use a tongue cleaner to help remove bacteria from the surface of your tongue
