What Causes Periodontal Disease?


Periodontitis begins with plaque. This invisible, sticky film forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Although you remove plaque every time you brush your teeth, it re-forms quickly, usually within 24 hours.

Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus), a white substance that makes plaque more difficult to remove and that acts as a reservoir for bacteria. Unfortunately, brushing and flossing can’t eliminate tartar — only a professional cleaning can remove it.

The longer plaque and tartar remain on your teeth, the more damage they can do. Initially, they may simply irritate and inflame the gingiva, the part of your gum around the base of your teeth. This is gingivitis, the mildest form of periodontal disease. But ongoing inflammation eventually causes pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. In time, the pockets become deeper and more bacteria accumulate, eventually advancing under your gum tissue. These deep infections cause a loss of tissue and bone. If too much bone is destroyed, you may lose one or more teeth.

Although the destructive cycle that starts with the accumulation of plaque is the most common cause of periodontal disease, a number of other factors can contribute to or aggravate the condition. These include:

  • Tobacco use. Smoking is the most significant risk factor for periodontal disease. Chewing tobacco also contributes to periodontal disease. Tobacco use in any form damages your immune system, putting you at greater risk of periodontal infection. It also creates a favorable environment for harmful bacteria and interferes with the normal mechanisms for limiting bacterial growth in your mouth. Even exposure to secondhand smoke appears to contribute to periodontal disease. And because smoking impairs healing, smokers are less likely to respond to treatment than nonsmokers are.
  • Heredity. Sometimes you may do everything right and still develop periodontal disease. In that case, you — along with close to one-third of the population — may have inherited a predisposition to gum problems.
  • Drugs. Hundreds of prescription and over-the-counter antidepressants, cold remedies and antihistamines contain ingredients that decrease your body’s production of saliva. Because saliva has a cleansing effect on your teeth and helps inhibit bacterial growth, this means that plaque and tartar can build up more easily. Other drugs, especially anti-seizure medications, calcium channel blockers and drugs that suppress your immune system, sometimes cause an overgrowth of gum tissue (gingival hyperplasia), making plaque much tougher to remove.
  • Diabetes. A number of health problems can take a toll on your gums. One of the most significant of these is diabetes, which makes you more prone to many infections, including gum infections. But the relationship between diabetes and periodontal disease doesn’t end there. Gingivitis and periodontitis impair your body’s ability to utilize insulin, making diabetes harder to control. And because diabetes and periodontal disease may make you more susceptible to heart attack and stroke, having both conditions increases your risk of cardiovascular disease.
  • Hormonal changes. Changes in hormone levels that occur during pregnancy, menopause or even menstruation can make your gums more susceptible to periodontal disease.
  • Nutritional deficiencies. A poor diet, especially one deficient in calcium, vitamin C and B vitamins, can contribute to periodontal disease. Calcium is important because it helps maintain the strength of your bones, including the bones that support your teeth. Vitamin C helps maintain the integrity of connective tissue. It’s also a powerful antioxidant that counters the tissue-destroying effects of free radicals — substances produced when oxygen is metabolized by your body.

When to seek medical advice

Healthy gums are firm and pale pink. If your gums are puffy, dusky red and bleed easily, see your dentist. The sooner you seek care, the better your chances of reversing damage and preventing more serious problems.

For more advice, why not seek a consultation – you can contact me here: https://periodontal.co.uk/new-contact/

What Age Do Most Adults Start Losing Their Teeth?

What age are most adults when they start losing their teeth? Well, it may surprise you to learn, adult teeth don’t ‘die’, which means they don’t fall out from natural causes (unless you call falling head-first off your bike or being punched in the face a natural cause!)  Disease or trauma are the main culprits for adult teeth dying.
Most people assume losing teeth is a natural consequence of the aging process. Not so. All too often, just like most things in life, if you lose your teeth and end up with false teeth, you’re probably the cause.
Baby teeth fall out on their own to be replaced with adult permanent teeth. However, adult teeth don’t fall out from natural causes.

So that’s the good (and the bad) news. You don’t have to lose your teeth, but if you do, don’t blame nature, in most cases the cause can be found a little closer to home.

What Are The 3 Causes of Adults Starting to Lose Their Teeth?

1) Trauma –
Obviously, a severe blow or knock to the head can cause your teeth to be instantly knocked out. Even if this doesn’t instantly knock them out, it may cause them to be damaged beyond repair and eventually you lose them.
Other less obvious forms of trauma include using your teeth to open bottles, tear open bags or hold things. Your teeth weren’t designed to be used as a Swiss army knife!
Finally, is you are a chronic jaw clencher or tooth grinder, beware. Did you know clenching and grinding the teeth can put more than 800 pounds of pressure on your teeth? …Clearly, this can lead to fractures and tooth loss.

2) Serious Illness –
Besides gum disease, chronic illness such as diabetes, cancer, osteomyelitis, and autoimmune diseases, can result in adults losing their teeth at an early age.

3) Periodontitis (Gum Disease)
Periodontal or gum disease is known as the ‘Silent Disease’ because it doesn’t start as a full-blown disease causing serious damage to your mouth. It can sneak up on you. Before you know it, the signs you ignored destroy bone resulting in tooth loss.

Now we know that, what can we do to stop our teeth from falling out?

As you can see, in all the reasons for adults losing their teeth mentioned above, not once have we mentioned old age. No matter your age, your teeth can be healthy. The flip side of that is, if you don’t look after them,  you could lose your teeth at any age.
So age is really does not a determining factor as to when we start to lose our teeth. Like so many things, lifestyle, diet and good health practices, in this case good oral health practices, are far more important in keeping teeth healthy and determining what age our teeth will start to fall out.
Of all the causes mentioned above, studies reveal gum disease is far and away the main cause of adults starting to lose their teeth. And in most instances, gum disease is the result of not taking good care of your mouth with regular, daily brushing and flossing.
So the best answer to keep teeth healthy and stop them from falling out is to give them a good ‘workout’ everyday combined with  regular check ups and proper home oral hygiene. Remember the “Two by Two Rule” Just two minutes, twice a day, especially at bedtime.

So, in a nutshell, the best way to stop your teeth from falling out is to make sure you give your teeth a good ‘workout’ everyday. Unlike going to the gym though, keeping your teeth healthy and in tip-top condition is a far less arduous task than keeping your body in shape. Just two minutes of cleaning, flossing and mouth-washing everyday, backed up with regular trips to the dentist and hygienist  will have your teeth fit for a lifetime!

In fact, this quote sums it up perfectly:“You don’t have to clean all your teeth every day – just the ones you want to keep.”

If you are worried about bleeding gums, bad breath or worried you may have gum disease, why not contact me for some advice?
You can reach me here: https://periodontal.co.uk/ask-a-periodontist/

The Mouth Is The Mirror Of The Body

Most of us do not pay much attention to our mouths, we clean our teeth in the morning and evening, and some of us use dental floss or interdental brushes to make sure that our teeth are clean and then rinse out and that’s it!

However, a recent UK Adult Dental Health Survey (*1) showed that most of us have gum disease so there is obviously more we should be doing.   Gum disease is an infection caused by dental plaque bacteria which creep in underneath the gums. This infection slowly erodes away the foundations of the teeth. Then the gums start shrinking, the teeth get loose and wobbly, and if left untreated, finally we end up with abscesses and tooth loss.  But that is not all!

Published research has shown that gum infections have very harmful effects throughout  our bodies. Did you know that there is a major connection between gum disease and heart disease?  It has been shown that the bacteria from gum disease can settle on the heart valves and damage them permanently. Once this happens the heart is unable to work efficiently and the heart becomes more susceptible to other infections.

Also, that women who have active gum disease during their pregnancy are more likely to have preterm and low birth weight babies!  The body cannot concentrate all its resources on the baby while it has to continuously fight off an-ongoing infection in the mouth.

It is well known that people with uncontrolled diabetes are more susceptible to infections. If these people also have gum disease, either it gets worse, or the diabetes becomes more difficult to control, or both.  So if the immune system has to struggle to control two problems at the same time to try and maintain health, it often fails to manage either.

New findings:  Links between gum disease and bowel cancer, asthma and even erectile dysfunction

The list of how a compromised immune system due to gum disease is associated with other serious diseases is growing daily. Rheumatoid arthritis has been linked with gum disease, and more recently bowel cancer, asthma, and even erectile dysfunction.  As more and more medical conditions are associated with this ongoing silent infection that most of us have in our mouths, it is clear that although gum disease does not cause pain or swellings or any other alarming symptoms in its early stages, the effects of the infection from the highly toxic bacteria lodged underneath the gums echo throughout our bodies and can cause or contribute significantly to other illnesses in other parts of the body.

However, gum disease may not be causing any of these diseases; it may be the other way around!  If you have a medical condition which is compromising the immune system the body becomes increasingly unable to control the dozens of species of bacteria that normally inhabit the mouth.  So, if you suddenly develop the signs of gum disease, is that because there is something going on somewhere else in your body which has weakened the immune system’s ability to keep your mouth healthy ?

If this is so, then the mouth is the mirror of the body.  A healthy mouth may well be a reflection of a healthy immune system and a mouth with swollen, red, or bleeding gums may well be telling us that all is not well somewhere else.  So if you have the signs of gum disease, or you suddenly develop them for no apparent reason, you should take this very seriously and get it dealt with by a dentist, hygienist, or periodontist (a dental specialist in managing gum conditions), but more importantly you may need to ask yourself when you last had a check-up at the doctor!  When did you last have a blood test to check your sugar levels or have your blood pressure taken? Is there something else going on that the symptoms in your mouth are telling you?

Making sure that your immune system is in tiptop condition gives your body the best chance of maintaining wellness and successfully dealing with other conditions and diseases if and when they occur.

So, when you look in the mirror, look in your mouth too, and if you see the signs of gum disease, think about your general health and how this may be affecting you, because it might just be reflecting some nasty little surprises that you can get under control before they become major problems.

Tips For Recognising Gum Disease:-

1.  Do your gums bleed for no apparent reason?
2.  When you brush your teeth is there some pink staining of your toothpaste, when you spit
out in the basin?
3.  Are your gums sore and swollen?
4.  Do your teeth feel loose?
5.  Are your teeth moving out of alignment?
6.  Do you suffer from bouts of bad breath or bad tastes in your mouth?
7.  Are your gums shrinking (receding)?

If you have any of these symptoms or if you think you may have periodontal (gum) disease, see your dental professional and ask specifically for a periodontal (gum) examination.

Be aware that early periodontal disease is symptomless so you should have this checked out even if your mouth seems healthy.

This advice is provided by a well known periodontist, Dr Peter Galgut Ph.D., M.Phil., M.Sc., BDS, MRD.RCS, LDS RCS, MFGDP (UK), MF Hom. (Dent) FHEA CUEW

Peter Galgut is a well-established clinical periodontist with a specialist practice in Golders Green, North-West London. He is a world-renowned lecturer and research scientist in periodontology and twice winner of UK Dentist of the Year.  If you would like more specialist advice from Dr Galgut please click here to contact me

1 Adult oral health survey 2009

Eight Secrets on How to Look After Your Gums

Gum disease can be a scary thought, and as with most things, prevention is most definitely better than cure!

Here are eight secrets on how to look after your gums and prevent gum disease.

1) Brush your teeth and gums regularly and efficiently.

2) Remember to clean in between your teeth using dental floss or interdental brushes.

3) Any spots of bleeding must be brushed extra well to remove the bacteria in dental plaque that are trying to infect them.

4) Use an antiseptic mouthwash, swishing it vigorously through the spaces between your  teeth particularly where you have bleeding, soreness, or swelling of your gums.

5) If the bleeding does not stop within 4 days of extra vigorous care, you must see a dental professional (Periodontist, Dentist or Hygienist) for advice and treatment before the infection starts damaging your gums.

6) If the Dentist and Hygienist can’t solve the problem, you need to see a Periodontist.

7) Do not ignore bleeding or red gums even if there is no pain, because the sooner the infection is removed, the less damage will have occurred.

8) Beware: Other symptoms such as bad breath, soreness or burning sensations in your mouth, gum swellings and moving or loosening teeth need to be treated as soon as possible to prevent you losing them

If you’re worried about gum disease or would like some more specialist advice,  you can click here to contact me. 

Don’t forget to leave your favourite tip or secret way of keeping your  mouth fresh, clean and healthy. Leave your comment below and I’ll post  the 10 best one’s on my facebook page.

More tips coming up soon,


Peter Galgut
Leading UK Periodontist
Dentist of the Year 2010 & 2013


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