The more of these risk factors that you have, the more likely you are to develop gum disease
, but there is nothing to say that you actually will. If you have periodontitis then these risk factors are important in how the disease develops and how you will respond to treatment.
Factors influencing the disease can be divided into:
- Systemic factors- those related to the whole body.
- Local factors- those related to your teeth and mouth.
- How old you are. We all experience some attachment loss as we get older. When this occurs, it makes the teeth more difficult to clean and so older individuals are more prone to suffering from periodontitis.
- Your genes. I often hear patients say, “My parents lost most of their teeth due to gum disease,” or “My brother suffers from gum disease”. There is growing evidence to suggest that there maybe a genetic susceptibility to periodontitis, so if it is common in your family, you may be slightly more at risk.
- Smoking. Smoking has been identified as a major contributing factor in periodontal disease for some time. It has a role, not only in initially developing gum disease, but also in affecting the likely success of treatment and its ultimate prognosis.
Data from the Centres for Disease Control and Prevention found rather startlingly, that over 40% (20% higher than for non-smokers) of daily smokers over 65 were toothless.
It can take 11 years after a smoker has stopped smoking for their risk of gum disease to return to that of a non- smoker.
If you’re a smoker- your teeth falling out- can be added to a long line of fatal medical conditions you also find yourself at risk of, such as lung cancer and heart disease.
Inflammation is your body’s way of fighting disease by allowing more blood to get to an area and promote healing.
Smoking affects this process: the addictive ingredient in smoking- nicotine- causes your blood vessels to constrict (get smaller) and so your body isn’t able to supply your gums with the normal amount of infection fighting cells. Therefore smoking is likely to cause increased bone and attachment loss around your teeth, and will delay healing. It is this process that makes dental implants much more likely to fail and why most surgeons will often refuse to place them in smokers.
Interestingly, gums in smokers, often look healthier than they actually are, due to reduced inflammation. As such, common symptoms of gum disease such as swelling, reddening and bleeding are often absent. But don’t let this fool you, everything is going on out of sight, which makes it even more dangerous and difficult to monitor.
If you stop smoking you may experience lots of bleeding from your gums
, this can occur because all your blood vessels are allowed to open up again. It is just a temporary thing, so stick with it- you are on your way to a healthier mouth and body.
- Diabetes. If you suffer from Type 1 or Type 2 diabetes you have a poorer prognosis for both the condition and the treatment of periodontal disease. The more poorly controlled your diabetes, the more well known the complications you present with - such as problems with your kidneys and eyes. Diabetes significantly affects your body’s ability to respond to infection and increases the time required for healing.
- Other significant medication conditions. Patients taking cytotoxic/ immunosuppressant drugs for the treatment of diseases such as cancer or HIV, often show more severe and aggressive periodontitis. The prognosis for the teeth and the response to treatment are both reduced. Other conditions affecting our body’s immune response including leukemias and neutropenias have similar outcomes. Patients with Downs Syndrome may also have increased gum disease.
Local factors include:
- Immune status, stress and nutrition. Anything that affects your body’s ability to fight off disease is a risk factor, not only for periodontitis but also any medical condition. A healthy body is much better at fighting disease- so diet, exercise, a good mental and emotional state will all help.
These include anything that causes plaque to build up more easily and make it more difficult to remove. This can be existing fillings, poor margins, caries, calculus, braces and partial dentures, teeth position and the way you bite together.
See- Plaque retentive factors
in periodontal assessment for a detailed discussion of the important features we record.