Hello my lovely teeth & gum lovers!! This evening I thought we would talk a little bit more about Gum Disease. Now I know I already talk to you guys about this A LOT already, I go on and on about brushing your teeth, and cleaning in between your teeth and how important it is to do this as part of your daily routine, this is because the biggest risk factor for Gum Disease is plaque control, you’ve got me, cats outta the bag! But for some people, despite their best efforts, Gum Disease can creep up on them anyway. So yes cleaning and removing plaque is really important but its equally as important to know the facts look at the whole picture.

There are lots and lots of factors that will contribute to Gum Disease, if feels like we find out new things about this every day but I’ve tried to keep it simple with the top five most common risk factors to be aware of.

Diabetes

Diabetes type 1 and type 2 will both increase your risk of developing Gum Disease. This will escalate if your Diabetes is poorly controlled, but what does that mean exactly? Poor glycaemic control means you have too much glucose/sugar in your blood stream and this increases your risk of developing Gum Disease. We can measure your glycaemic control by looking at levels of something called Hba1c in your blood. Hba1c will fluctuate from person to person depending on when they have eaten, what they have eaten, what medication they have taken etc. In patients with diabetes we are looking for this level to ideally be less than 7%, in patients who do not have Diabetes this should be even lower, between about 4.5% and 6%. Controlling your blood sugar levels is not just vitally important for your general health but also for your gums and to reduce your risk of loosing teeth in the future. Most of my diabetic patients will see me every 3 months so we can keep at really close eye on their gum health because having Gum Disease that has not been treated makes it harder to control blood sugars. Its a vicious cycle. Also if you have Gum Disease and don’t treat it, the level of Hba1c in your blood increases in you blood and as this creeps up you are more and more likely to develop Diabetes. You can read more about Diabetes and Gum Health in my blog post here.

Smoking

Smoking is the worst. Smoking will increase your risk of gum problems because it reduces the amount of bone that you have holding your teeth in place, increasing the chance of you losing teeth in the future. Smoking will also reduce blood supply to your gums making you more prone to infections like Gum Disease AND even when you have treatment for Gum Disease smoking means it might not be successful. It can also will effect your general health, increase levels of plaque in your mouth which increases gum inflammation, discolours your teeth and increases your risk of developing oral cancer so its really best to quit if you can. If you need any help with this you can speak to your GP, local stop smoking service or you can get some great info on the NHS website which I’ll link here.

Stress

Stress, but not just stress, also anxiety and depression increases your risk of developing Gum Disease. This isn’t just because you are more likely to neglect the old tooth brushing routine when you’re stressed, although this is a factor, its also because when you’re stressed it raises levels of a hormone called cortisol in your body. Cortisol increases inflammation in your body and Gum Disease is caused by inflammation caused by plaque so if you’re stressed and your oral hygiene isn’t great to being with or neglect it due to stress, Gum Disease could be spreading through your gums like wild fire. This Gum Disease will destroy bone and increase your risk of losing teeth in the process. If you’re feeling stressed trying to control it in any way you can, I’m no expert, but my suggestions would be:

speak to your boss
speak to your partner
speak to your mates
get some exercise
get outdoors
try some yoga
try a great mindfulness app like Calm or Headspace
speak to your GP

Your body will show you you’re stressed even if you don’t think you are, and one of the first places this crops up is your gums.

Family History

I got it from my momma (or papa) is usually a great thing, its not however when it comes to Gum Disease. Sadly I see this happen all the time, I ask all my patients if they have a family history of Gum Disease, some people don’t know or they’re not sure I mean, its not exactly a dinner table conversation, but some people do know and usually their mum, dad, sister or brother have encouraged them to get their gums checked out. Of course this isn’t always the case but if your parents, grandparents or siblings have had Gum Disease its probably a good idea to have this conversation with your Dentist or Dental Hygienist and to have your gums checked regularly.

Diet

What you put in your body has a big effect on your general health, but also your gum health. If you’ve already read my blog on Vitamin C, if not I’ll leave a link to it here, you’ll know how important it is to get 40mg of Vitamin C into you every day either through fresh fruit and vegetables or through some form of dietary supplement. Its not just about vitamin C though, having a wide and balanced diet that includes omega 3, magnesium and vitamin D to name just a few is really important for gum health. Its also really important not to eat too much sugar and to reduce your consumption of alcohol to reduce inflammation in your body which related to Gum Disease and gum problems.

Some people, unfortunately, are more likely to get Gum Disease than others. All of these risk factors will mean that you are more likely to be suffering from Gum Disease now, or to develop Gum Disease in the future. Some people are facing a cocktail of different risk factors all together at once.

This isn’t fair, but its kind of the hand we’ve been dealt, so we have to do just that deal with it, keep our teeth and gums clean and control these risks wherever we can. Ok, we can’t do too much about family members having Gum Disease and passing this susceptibility onto us through the gene pool BUT you can:

stop smoking, it will be hard but you can
you can control your glycaemic level if you are diabetic or pre diabetic
you can think about what you are eating and drinking to protect your gums
you can try to control your stress levels

Over lockdown I’ve been listening to loads of really inspiring webinars, one of my fav’s was by a super periodontist called Ian Dunn. He describes Gum Disease as a loaded gun and its so good that I’m going to steal it (thanks Ian) with just the minor tweak of calling them loaded gums because I think its hilarious.

All of these risk factors that we have just talked about are like bullets in the chamber of a loaded gun. You might have one bullet, you might have two, three, four five bullets. You might have even more than this. Now on the most part this will be ok, yes loaded guns/gums (I’m laughing again) are more dangerous and require expert care but, a gun will cause the most damage when the trigger is pulled.

That trigger my friends is plaque, more specifically plaque that hangs around at the gum line because of poor oral hygiene which in is a massive risk factor for Gum Disease on its own let alone when you mix it in with the risk factors we’ve talked about above. This is why I go on and on about it all the time and I cannot stress it enough a gold standard oral hygiene routine which you can do every day at home is key. This means:

Using something to clean in between your teeth every single day without fail like interdental brushes, floss, a water flosser or if you’re like me a combination of all three. You can read more about interdental cleaning on my blog post here.
Brushing twice a day with either an electric or soft manual toothbrush, my favs are the Oral B Genius 9000 * or the Curaprox 5460 Ultra Soft *, timed with a timer for 2 minutes, angling 45 degrees to the areas where your gum meets your tooth. You can read more about toothbrushing on my blog post here.
Using a toothpaste that meets your dental needs that includes fluoride, for my patients who have Gum Disease I like Oral B Gumline Purify * Corsodyl * and Sensodyne Sensitivity & Gum *. You can read more about my favourite toothpaste on my blog post here or on my YouTube channel.

If you feel you are suffering from any of these risk factors you should be making an appointment to see a Dental Hygienist as soon as you can do so and try to see them regularly, every 3 months or so, being higher risk isn’t the end of the world, it just means we can’t stick out heads in the sand, we need to be aware of the risks and try to modify these risk factors where ever we can. If you have any questions please message me through the contact us section or comment below.

Remember those gums may be loaded, but its down to you if the trigger is pulled or not.