Are You at Risk for Gum Disease and Its Many Health Threats? Most patients are unaware of both the consequences and the treatment options

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(MS) -- By Robert H. Gregg II, DDS
Eighty percent of U.S. adults suffer from some degree of gum disease, yet only 60 percent are aware of it1. And only 3 percent choose to treat it2. That's alarming, because gum disease, or periodontitis, threatens much more than oral health; studies have linked gum disease to heart disease, strokes and even stillbirths.
With such broad health consequences, how do you know you are at risk?

A Mouthful of Risk
Not surprising, risk factors begin in the mouth--with poor oral hygiene and diet. Bacteria and plaque build up without proper brushing and flossing. Teeth with cracks and crevices or improperly sealed fillings and crowns can trap food and encourage plaque and bacteria growth.
Patients with impacted wisdom teeth are also at risk and often experience no symptoms. For this reason, dental professionals recommend that preteens, teens and young adults have their dentists examine them for signs of gum disease.

Risks Increase With Age
The older people get, the greater their risk for gum disease. More than half of American adults 35-69 show signs of gingivitis surrounding three or four teeth; about 30 percent show significant levels of gum disease3. Eighty-six percent of people older than 70 show moderate gum disease and more than 25 percent lose their teeth4.

Factors That Run in the Family
Genetics may be responsible for about half of periodontal disease cases. Those whose parents suffered gum disease are 12 times more likely to harbor the bacteria that cause plaque and gum disease5.
Even spouses and partners may be at risk, say researchers who've found that a particular oral bacteria may be contagious over long periods of exposure.

The Smoking Gun
Of all the risks for periodontal disease, smoking is the most preventable. Smokers are four times more likely to develop advanced periodontal disease and exhibit bone loss and gum recession even without gum disease. More than 40 percent of smokers lose their teeth during their lifetimes6.
Even secondhand smoke carries risks, with a 50 percent to 60 percent higher incidence of gum disease7. When people quit smoking, however, risks return to normal over time.

Women and Gum Disease
Despite their better dental hygiene, women account for about 75 percent of periodontal office visits8. Studies point to the effects of female hormones on oral health -- effects that are also triggered by prescription birth control and menopause. Some women see gingivitis flare-ups a few days before their periods and during ovulation as the hormone progesterone dilates blood vessels, causing inflammation and slowing down the repair of collagen -- the protein that supports gums.
These same hormonal fluctuations are in force throughout pregnancy, typically worsening at two months and peaking around the eighth month of pregnancy. These hormonal changes don't actually cause gum disease; they simply make women more vulnerable to it. Stepping up oral hygiene can make a big difference -- especially important given the recent research that links gum disease with low birth weight and other complications including stillbirth9. These risks make dental visits a vital part of prenatal health care.

Socioeconomic Status and Ethnicity
As with many diseases, gum disease appears in greater numbers among the poor, particularly poor children and elderly people as well as racial minorities. Those with fewer financial resources for dental visits show the greatest amounts of oral bacteria. Approximately 44 million Americans live without medical insurance; 110 million have no dental insurance10.

Diseases Associated with Periodontal Disease
Many diseases also contribute to the development of periodontal disease, whether as a direct result of the disease or as a side effect of medication. Some of the most common are diabetes, osteoporosis, cancer, herpes, HIV and autoimmune disorders.

Additional Causes of Gum Inflammation
A variety of additional conditions also cause gum inflammation and are associated with higher rates of gum disease, including:
* Mouth breathing
* Stress. Its effects on the immune system are well documented. Some studies show that those effects include development of periodontal disease.
* Alcohol abuse
* Canker sores
* Allergies
* Side effects of prescription medications

Successful Treatment is Key
Ninety-two percent of pregnant women who were successfully treated for gum disease delivered full-term babies; whereas 62 percent with unsuccessful treatment delivered pre-term and 52 percent of women who were not given any treatment delivered pre-term. These findings were published in the British Journal of Obstetrics and Gynecology by Marjorie Jeffcoat, Professor of Periodontics at the University of Pennsylvania11.
Prevention of systemic diseases might be achieved with the successful treatment of gum disease.
Success is determined by the treatments' ability to reduce or eliminate gum inflammation, slow or stop attachment loss and decrease pocket depth - and that can vary depending on the type of treatment. The LANAP(R) treatment is one of the most successful protocols in treating gum disease because it can target the source of the inflammation without hurting or removing any healthy gums, allowing the body to recover from the chronic infection.

A Treatment Alternative
Regardless of its causes, moderate to severe periodontal disease is treatable. Traditional surgery has long been the only option - a painful process where gums are cut open, biofilm on teeth is scraped away, then the gums are sewn together and recovery begins.
An FDA-cleared laser treatment called the LANAP(R) protocol offers a less painful, more successful treatment. The doctor does not cut open the gums -- leading to less pain and a shorter recovery. The PerioLase(R) MVP-7(TM) is the only laser approved for this treatment. The PerioLase MVP-7 uses a specific wavelength to target and destroy dark colored p. gingivalis bacteria - a main contributor to gum disease.
Ask your dentist if you are at risk for gum disease and what treatment is right for you.
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About the Author: Robert H. Gregg II, DDS; President and Chairman of the Board, Millennium Dental Technologies, Inc.; President, The Institute for Advanced Laser Dentistry
Dr. Robert Gregg is a former faculty member at the UCLA School of Dentistry. He has been using lasers clinically since August 1990, including CO2, free-running pulsed (FRP) Nd:YAG, both single and variable pulsed; FRP Ho: YAG, surgical Argon, CW diodes and Er: YAG. He has given lectures both nationally and internationally on the subject of clinical laser applications, and has conducted seminars for the UCLA Department of Continuing Education. In addition to authoring several peer-reviewed articles on the clinical applications of FRP Nd:YAG for endodontic and periodontal uses, he is an author of the Curriculum Guidelines and Standards for Dental Laser Education, versions 1992 and 1998. Dr. Gregg has obtained his Mastership and Educator's Certification in the Academy of Laser Dentistry as provided for in the Laser Curriculum Guidelines. He has been appointed as a peer-review member of the Dentistry Today CE Editorial Board to review all CE articles related to the topic of lasers. He is a co-developer of the FDA-cleared PerioLase(R) MVP-7(TM) pulsed Nd:YAG laser and is a founder of Millennium Dental Technologies, Inc. Dr. Gregg is also a co-developer and patent holder of the LANAP(R) laser periodontitis treatment. He maintains a group private practice where he sees patients.
1, 5, 8. A.D.A.M. and Simon, Harvey (2009). Gum Disease In-Depth Report. The New York Times. Retrieved from
2. Mackarey, Paul J. (February 7 2011). Laser Treatment Offers Help for the Gums. The Scranton Times Tribune. Online Edition. Retrieved from
3. Genco, Robert, Offenbacher, Steven & Beck, James (2002). Periodontal Disease and Cardiovascular Disease. Journal of the American Dental Association, Vol. 133. American Dental Association.
4,7. Fehrenbach, Margaret J. Risk Factors for Periodontal Disease. The Preventive Angle Vol. 6, Issue 2. The Richmond Institute for Continuing Dental Education and Young Dental.
6. Angelos, William. (July 18, 2005). Smokers More Likely to Lose Teeth. Daily News Central: Health News. Retrived from
9. Dang, Titi (2010). Understanding and Preventing Periodontis (Gum Disease). Pearly White Dental. Retrieved from
10. Cohen, Robin A. (2009). Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, 2009. Center for Disease Control and Prevention and National Center for Health Statistics. Retrieved from
11. Jeffcoat, M., Parry, S., Sammel, M., Clothier, B., Catlin, A., Macones, G. Periodontal Infection and Preterm Birth: Successful Periodontal Therapy Reduces the Risk of Preterm Birth. British Journal of Obstetrics and Gynecology. Published September 15, 2010. TF117094

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