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Numerous risk factors have been identified for gum disease. Because some of them are within your control, it is important to be aware of them.

Did you know that the number one cause of tooth loss among adults begins with the common condition of gingivitis? In these early stages, the only symptoms may be red, swollen, tender or bleeding gums or discomfort or pain when chewing; but in its advanced form the disease threatens the integrity of the tooth structures and can cause teeth to fall out or need extraction. The disease can affect both soft and hard tissues that hold the teeth in place so gums, ligaments and bone are all under threat.

Gum disease is a condition that doesn't usually make itself apparent until people are in their thirties or forties and periodontitis is rare before that time, although teens can experience milder forms such as gingivitis. Typically, gum disease develops when plaque builds up around and under the gum line but there are certain factors (such as being male) which can also increase the risk. In this article, we are going to look at the most common risk factors that impact upon the development of periodontitis.

Main causes of gum disease: Bacteria, plaque and tartar  

Our bodies are full of bacteria (good and bad) and our mouths are no exception. If harmful bacteria is not cleaned from the teeth through flossing or brushing, plaque forms which, over time, can harden and become calculus or tartar. Calculus or tartar cannot be cleaned by brushing alone and requires the intervention of a dentist or dental hygienist.

What other factors affect the health of your gums?


This the key risk factor for periodontitis. Studies indicate that over 70 percent of Americans aged 65 and over have periodontal disease.

Smoking and chewing tobacco

Smoking in general impairs immunity, so apart from other health problems that it may be linked with, oral health generally is also at stake. Compared with non-smokers, smokers have twice the risk for gum disease. The more you smoke, and the longer you do it, the bigger your risk of developing the disease becomes. It is also important to note that treatment for gum disease is more likely to fail in smokers.


Despite good oral hygiene and dental habits, some people may be genetically more susceptible to gum disease. Early identification is key so that affected individuals can get appropriate preventative treatment to enable them to save their teeth.

Hormonal changes in girls and women

Hormonal changes, especially during pregnancy or even during menstrual bleeding, can make gums more sensitive, swollen or inclined to bleed. “Pregnancy gingivitis”, the early stage of the disease, is common and is thought to occur in as many as half of all pregnant women.


Stress is detrimental to maintaining a strong immune system, hence its strong association with many health disorders. As it impacts upon immunity, so therefore does it increase the risk of periodontitis as the body is less able to fight infection and repair damaged tissue/structures.


Along with the myriad other side effects that may be present, medications can compromise your oral health. This may result from reduced saliva (a common side effect of many medications) damaging the natural balance of the mouth, or abnormal gum growth/recession which impair good dental hygiene. There are a number of widely used medications which can impact upon dental health; it is therefore important to inform your dentist of any medications you are taking, along with any overall health changes, to ensure early intervention as necessary.

Clenching or grinding your teeth

Gum disease affects not just the gums but also the supporting structures that surround the teeth. Where people clench or grind their teeth (known as bruxism) these supporting structures become subjected to excessive pressure over time, leading to teeth loosening and periodontal pockets enlarging. This allows bacteria to collect and irritate gums and the underlying bone and kick-start the gum disease process.

Other systemic diseases

There are a number of serious health conditions that compromise immunity and have at their root increased inflammatory response; many also have a strong interrelationship or association with periodontitis. Heart disease is a good example of a condition in which gum disease seems to be more prevalent but conversely its presence can also worsen the existing condition. Those with diabetes have impaired immunity generally, and a related increased risk of infection (including periodontal disease). Rheumatoid arthritis is another inflammatory condition where severe gum disease is seen in increased incidence: you may be up to twice as likely to develop it, according to some research. Lastly seriously life-threatening conditions such as AIDS and cancer are both strongly associated with poor periodontal health, both due to the condition itself and the treatments prescribed.

Poor nutrition and obesity

A diet that is rich in whole, natural foods and low in starchy, processed and sugary elements is key for good oral hygiene, as sugar (even from natural sources) increases the risk of gum disease and tooth decay. A nutritious, healthy diet also benefits overall health and well-being by strengthening the immune system, enabling it to fight infection and repair damaged tissue — the starting point of periodontal disease.  

Focusing on a number of key nutrients can also be beneficial to supporting bone and gum regeneration:

  • Co-enzyme Q10 - found in meat, organ and muscle meats, oily fish, legumes and some fruits and vegetables
  • Collagen - from gelatin and bone broth, egg whites, sulphur and citrus foods
  • Catechins - found in green tea, cacao and berries
  • Vitamin C - high in foods such as crucifers and leafy greens, thyme and parsley, citrus fruits
  • Beta Carotene – found in orange-colored fruits and vegetables
  • Omega-3 oils from nuts and seeds, plant oils and oily fish

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