Gum Disease

Gum Disease

Gum disease, or Periodontal disease, also known as periodontitis, is an infection and inflammation of the tissues that support the teeth.   Gum disease (or periodontal disease) is one the most prevalent diseases in the world, with an estimated 70% of the world’s population affected by some form of the disease. According to the Centers for Disease Control and Prevention (CDC), almost half of American adults have gum disease. Poor dental hygiene habits, stress, hereditary issues, some medications, a compromised immune system, and hormonal fluctuations can all work against you, increasing your odds of developing periodontal disease.

At its core, periodontal (gum) disease is an infection caused by bacterial plaque, a thin, sticky layer of microorganisms (called a biofilm) that collects at the gum line in the absence of effective daily oral hygiene. Left untreated for long periods of time, plaque build up will lead to inflammation that can gradually separate the gums from the teeth and result in eventual bone loss around the teeth.  As the bone loss manifests, little spaces develop between the teeth that are referred to as “periodontal pockets.” The pockets function as deep craters that offer a sheltered environment for the disease-causing pathogenic bacteria to reproduce. If the infection remains untreated, the inflammation continues and further bone loss occurs around the bone that support the teeth. Should this infectious process continue unabated, your teeth will eventually loosen and eventually be lost.


Stages of Gum Disease


Gingivitis is the first and most common form of gum disease we see in patients. Gingivitis causes the gums to become red, swollen, inflamed and tender because of bacteria accumulation from plaque or tartar buildup. Gingivitis can also cause the gums to bleed easily when consuming certain foods, or when brushing and flossing. At this stage, bone loss has not yet occurred and tissue damage is still reversible.

Periodontitis (periodontal disease) is the next stage of gum disease that develops if gingivitis is left untreated. During this stage of the disease, irreversible damage occurs to the teeth’s surrounding bone structure and tissue. Eventually, this may lead to teeth becoming loose and may even result in teeth requiring extraction. Teeth affected by advanced periodontitis will need to be removed and teeth replacement options such as dental implants or a fixed bridge may be required to prevent other dental concerns from arising and to restore proper bite function.

Risk Factors for Gum Disease


  • Poor oral hygiene:  Plaque buildup is the primary cause of gum disease. When we become less diligent about our oral hygiene, the bacteria in the mouth are allowed to proliferate and form a biofilm (plaque), which causes inflammation of the gums.
  • Genetics: Some people are genetically more predisposed to gum disease. It’s important to look at your family history and determine if any of your relatives had gum disease or lost their teeth as you may be at risk.
  • Pregnancy: Gums are sensitive to hormone fluctuations, and it is not uncommon for pregnant women to experience an inflammation of the gums known as “pregnancy gingivitis.” Luckily this type of hormonally driven gingivitis — characterized by red, swollen gums that bleed easily — is reversible.
  • Age: The chance of developing gum disease increases with age. Over 70% of Americans 65 and older have periodontal disease according to the U.S. Centers for Disease Control and Prevention. This may be influenced by other diseases, medications that cause dry mouth, or other causes of plaque buildup.
  • Smoking: Smoking is a significant risk factor for the development and progression of gum disease. Since nicotine constricts blood vessels, smokers may not see the typical symptoms such as red, puffy, bleeding gums, so the disease may cause damage before smokers realize there is a problem with their gums.
  • Diabetes: Uncontrolled diabetes puts you at higher risk of periodontal disease. Not only can diabetes make gum disease worse, gum disease can make diabetes symptoms worse.

Symptoms of Gum Disease


Although it is important to know the risks of gum disease, it is also important to recognize the symptoms so you can get immediate treatment. Some of the most common symptoms include:

  • Bleeding, inflamed and tender gums
  • Hardened yellow or white substances between your gums and teeth
  • Sensitive teeth
  • Dark spots or gaps at the base of your teeth, along the gum line
  • Persistent bad breath or bad taste in your mouth
  • Permanent teeth that are loose or drifting away from one another
  • Gums that have pulled away or down from the teeth

In many cases, the early signs of gum disease go unnoticed, and patients do not realize that they have developed gum disease until it is damaging their gums. To help catch gum disease early on, it is essential that you visit your dentist regularly for checkups.

Treatment of Gum Disease at Gold Coast Smiles


How we address your gum disease depends a great deal on how advanced it is and how much damage it has caused. At Gold Coast Smiles, we emphasize the importance of an optimal oral health regimen and routine maintenance visits at a minimum of 6 month intervals. Our goal is to ensure your smile is healthy year-round, without the need for extensive treatment. However, if gum disease is present, or has progressed, we offer a variety of treatment methods that combat each stage of the disease, including:

Root Scaling and Planing
Also known as deep cleaning, this gum disease treatment helps remove the accumulation of debris and bacteria below the gum line and around the roots of the teeth and is often the first treatment of gum disease. This conservative procedure prepares the surface of the tooth and the soft tissues to heal and reattach. Anesthetic can make this cleaning more comfortable, and it is usually spread out over two or more appointments. Medication and antimicrobial irrigation under the gums may also be part of this initial therapy.Without this treatment, soft tissue continues to become inflamed and irritated, resulting in progression of periodontitis.

Periodontal disease treatment also calls for more frequent maintenance cleanings, at intervals of three to four months, depending on the severity of the disease. Our goal is to minimize or halt the progression of gum disease so that your gums remain healthy and do not relapse into further possible infection.

Advanced Periodontal Therapy

When periodontal disease progresses to the point where conservative measures are no longer adequate in managing the disease, more advanced therapeutics can be provided. We work closely with gum specialists, or periodontists, who have advanced clinical training and expertise in the treatment of all forms of periodontal disease. In these instances, we closely coordinate your care with a periodontist and employ a comprehensive approach to your regimen that combines several treatment modalities that eliminate disease and restore proper health and function.  More advanced periodontal procedures such as pocket reduction surgery and various type of grafting procedures may be combined with dental implants and other restorative treatments to replace severely diseased teeth, restore proper chewing function, and reinforce other teeth that may have been less affected by gum disease.

As with all other forms of periodontal disease, following active treatment, we will customize a more frequent maintenance schedule to ensure your oral and overall health are well maintained.

Healthy Teeth & Gums are Crucial to Your Overall Health


A growing body of evidence suggests inflammation could be the connection between systemic disease and gum disease, and, as a result, treating the inflammation could help manage both the conditions.  Systemic conditions with connections to oral health include diabetes, heart disease, Rheumatoid Arthritis, and Alzheimer’s, among others.

Gum Disease & Heart Disease


Gum disease has been linked to a myriad of chronic systemic conditions including heart disease.  Coronary artery disease occurs when fatty deposits, called plaques, build up on the walls of your arteries.  The gradual build up of plaque over time causes the arteries to narrow, constricting blood flow.  Nutrient rich oxygenated blood is then restricted from traveling to the heart which leads to shortness of breath, chest pains and eventually heart attack.

Periodontal disease (gum disease) has been identified as a risk factor for several medical conditions one of which is heart disease.  Although research is ongoing, studies have continued to show a link between periodontitis and heart disease through a pathway of increased systemic inflammation that results from inflammatory proteins produced by bacteria in inflamed gums.  These inflammatory toxins are suspected to enter the bloodstream from their original source of infection in the mouth and contribute to swelling and the disease process in coronary blood vessels.

The Diabetes & Gum Disease Connection


It is well documented that people who suffer from diabetes are more susceptible to developing infections than non-diabetics.  What is not widely known is how periodontal disease is often considered the sixth complication of diabetes, particularly when the diabetes is not under proper control. Diabetes causes glucose levels in the blood to elevate. This is due to the body being unable to produce enough or any insulin. When blood sugar is improperly controlled, our bodies can become more susceptible to further complications. One of these complications is now gum disease. When someone has diabetes the immune system is weakened and resistance to infection lowers. When the body’s resistance to infection is low, it is harder to fight off the bacteria invading our gums. This then creates further susceptibility to gum disease. Experts suggest the relationship between diabetes and periodontal disease can worsen both conditions if either condition is not properly controlled.  Diabetics have about twice the risk for periodontal disease as healthy patients, and almost one-third of people with diabetes have severe periodontal disease.

Diabetes and periodontal disease are linked through the following:


  • Increased blood sugar – Moderate and severe periodontal disease elevates glucose levels in the body, increasing the amount of time the body has to function with high blood sugar.  This is why diabetics with periodontal disease have difficulty keeping control of their blood sugar.  In addition, the higher sugar levels found in the mouth of diabetics provide food for the very bacteria that worsen periodontal infections.
  • Blood vessel thickening – The thickening of the blood vessels is one of the other major concerns for diabetes sufferers.  The blood vessels normally serve a vital function for tissues by delivering nutrients and removing waste products.  With diabetes, the blood vessels become too thick for these exchanges to occur.  This means that harmful waste is left in the mouth and can weaken the resistance of gum tissue, which can lead to infection and gum disease.
  • Smoking – Smoking and tobacco use is detrimental to anyone’s oral and overall health, but it is particularly harmful to diabetics.  Not only does tobacco impede the healing process, it also vastly increases the chances of an individual developing periodontal disease.  For diabetics who smoke, the risk is exponentially greater.  In fact, diabetic smokers aged 45 and over are twenty times more likely to develop periodontal disease.
  • Poor oral hygiene – It is essential for diabetics to maintain excellent levels of oral health.  In the absence of routine brushing and flossing, harmful oral bacteria can ingest the excess sugar attached to the teeth and proliferate more freely below the gum line.  This exacerbates the metabolic complications that diabetics experience.

    Regular dental visits are important. Research suggests that treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease. Practicing good oral hygiene and having professional deep cleanings done by your dentist can also help to lower your HbA1c.

    Periodontal Disease & Rheumatoid Arthritis 


    Studies show a strong connection between Rheumatoid Arthritis and gum disease. Both diseases have inflammation in common, which explains the connection. Inflammation is a protective immune system response to viruses and bacteria. RA is an autoimmune disease which causes it to mistakenly trigger inflammation even if there are no viruses or bacteria present. Since RA often affects the small joints of the hands and wrists, many patients have difficulty maintaining proper brushing and flossing habits. With less effective dental hygiene, patients with RA are at increased risk of developing, or worsening, periodontal disease.

    Moreover, in a recent study, scientists looked at the effects of the bacterium porphyromonas gingivalis, which causes periodontal (gum) disease. They found that this bacterium that causes gum disease can also lead to earlier onset, more rapid progression of symptoms, and increased severity of RA. Fortunately, Research has shown that RA patients with periodontal disease receiving non-surgical periodontal treatment experienced “noteworthy improvement” in their RA outcomes.  Regular dental visits and conservative periodontal maintenance cleanings can significantly help and neutralize the impact of RA on the overall health of patients.

    The Possible Link Between Gum Disease & Alzheimer’s


    Alzheimer’s is a devastating disease that currently affects an estimated 5.7 million Americans.  It’s considered a form of dementia, a degenerative brain condition which leads to increasing difficulty with memory and behavior.

    A recent study showed evidence of a link between a common oral bacteria and Alzheimer’s.  It found a connection between Porphyromonas gingivalis, the same bacteria linked to Rheumatoid Arthritis and that damages gum tissues and causes periodontal disease, and dementia.  Proof for this link was found in studies involving laboratory mice. Tests showed that the P. gingivalis bacteria infects and causes inflammation in the areas of the brain affected by Alzheimer’s. Additionally, the presence of gum disease made symptoms more severe for mice that are predisposed to dementia. Further surprising was the fact that introducing periodontal disease inducing bacteria to healthy mice triggered brain inflammation and neurological damage.

    Scientists are continuing to study the possible cause and effect relationship between periodontal disease and Alzheimer’s in humans. One hypothesis is that when bacteria enter the brain, it produces an immune response which destroys brain cells. As brain damage progresses, the patient would show signs of memory loss and confusion which are trademarks of Alzheimer’s disease.  The bacteria alone do not cause Alzheimer’s, but the presence of these bacteria raises the risk substantially for developing the disease and is also implicated in a more rapid progression of the disease.

    Alzheimer’s disease is a terrible way to spend one’s final years, and just as bad when we watch (or care for) loved ones as they endure this sad disease. To lower your risk, keep your mouth as bacteria free as possible and be committed to regular dental check-ups.

    What We Can Do


    Since chronic inflammation is a systemic problem, the best way to begin controlling it is via a whole-body approach. Maintaining a healthy weight, getting moderate exercise (and, if you use tobacco, quitting the habit) will help with this. So will bringing untreated inflammatory diseases, such as gum disease, under control.

    Gold Coast Smiles has a number of effective treatments for periodontal disease, including nonsurgical procedures such as deep cleanings and the local application of antimicrobials. For more serious conditions, we employ a comprehensive approach alongside periodontal specialists to address those more advanced cases. Finally, to keep your gums healthy between regular maintenance visits, we can help you develop an effective and custom tailored oral hygiene routine you can practice at home.

    Although it’s too early to conclude that periodontal disease causes heart disease or other systemic conditions, there appears to be a strong connection. And although certain genetic factors may be fixed, it is possible to control external factors like excess weight, tobacco use and gum disease. Maintaining good oral hygiene is the best and easiest way to avoid periodontal problems. But if problems occur, don’t wait; The sooner we begin treatment, the better your chances for controlling gum disease, and perhaps systemic diseases too. 


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