Gingivitis: gum disease can be asymptomatic – 07/10/2023 – Equilibrium

If your saliva sometimes turns pink at least a few times a week after brushing or flossing your teeth, it’s possible that you have early-stage gum disease. This condition can also have other surprising symptoms — or none at all.

“It’s a very, very silent disease,” says Rodrigo Neiva, professor of periodontics at Penn Dental Medicine.

According to the US Centers for Disease Control and Prevention, nearly half of older American adults show signs of gum disease, and 9% have severe gum disease known as periodontal disease.

When left untreated, the condition can be more difficult to cure. “Patients can end up losing their teeth,” says Neiva. And some research has linked periodontal disease with other health conditions, such as dementia, diabetes, and heart disease.

Early gum disease, called gingivitis, is characterized by inflammation of the gums.

“It’s caused by bacteria on the teeth — plaque — releasing products that irritate the gums,” says Deborah Foyle, acting chair of the department of periodontics at the Texas A&M University School of Dentistry.

Good oral hygiene is key to preventing gum disease because it removes plaque from your teeth before bacteria can damage your gums. People often develop gingivitis because they are not brushing and flossing properly. Sometimes only parts of the gums are affected — especially the gums at the back of the teeth, where people often don’t brush well, Neiva points out.

Dentists can diagnose gingivitis using a special instrument that measures the distance between the gums and the teeth, said Y. Natalie Jeong, professor and chair in the department of periodontology at Tufts University. Larger spaces are indications of this condition.

When gingivitis is left untreated, bacteria can invade and destroy the tissues under the gums, causing advanced gum disease. “The bone that supports the teeth begins to break down, leaving the roots of the teeth exposed and sensitive in some cases,” says Foyle. “Spaces develop between the teeth, and the teeth start to come loose.”

People who smoke, have diabetes or grind their teeth are more likely to develop gum disease, says Jeong. Some medications, such as steroids and certain epilepsy and cancer medications, can also increase your risk. Genetics can also make people more or less susceptible, she notes.

People who rarely get cavities may also be more likely than others to get gingivitis, says Neiva. This is because the bacteria that cause gum disease overpower and suppress the bacteria that cause cavities.

“It’s very common to see patients with very advanced periodontal disease, without any caries,” he says.

Gingivitis often goes unnoticed because it doesn’t cause pain. But people with gingivitis may notice that their gums bleed when they brush or floss, Neiva points out. The part of the gums adjacent to the teeth may also appear red instead of pink.

Smokers with the condition may not experience any bleeding or other symptoms, Jeong points out. “People tend to think, ‘Okay, my gums never bleed, I must be fine,'” she says — but that’s a misconception.

Regular brushing and flossing can help prevent gum disease, but once gingivitis sets in, good oral hygiene at home may not be enough. Bacteria may have started to build up below the gum level, says Neiva. In these cases, professional cleaning and sometimes antibiotics can treat — and cure — gingivitis.

Once gingivitis has progressed to more advanced periodontal disease, the gums can start to recede, making the teeth appear longer, says Jeong. People may also have heightened sensitivity. Their teeth may not fit together in the same way when they bite because they have shifted, and they may have chronic bad breath. Eventually, teeth can start to loosen and even fall out.

Advanced periodontal disease is not always curable. Dentists and periodontists can, however, recommend treatments that slow or prevent further gum and bone loss. They can also deep clean the roots of affected teeth and recommend gum surgery.

Keeping gums healthy is basically simple: Brush your teeth twice a day, floss once a day, and see your dentist for cleanings at least every six months, says Neiva.

“The sooner we detect the problem, the more we can do”, he concludes.

Translated by Luiz Roberto M. Gonçalves