1. Bacterial plaque
Bacterial plaque (biofilm) is the main cause of gum inflammation (gingivitis). Some types of bacteria can further promote the development of periodontitis.
Gingivitis and periodontitis are caused by bacteria that build up on the surfaces of teeth. This plaque is also called biofilm. If oral hygiene is inadequate, bacteria can multiply quickly. While most types of bacteria are harmless to healthy people, some types of bacteria - even in small numbers - can cause serious infections.
If bacterial plaque on tooth surfaces is not removed regularly, the gums will react with inflammation after just a few days. The gums will turn red, swell and bleed even with the slightest mechanical contact, such as when using dental floss. However, if the teeth are cleaned regularly as part of oral hygiene at home, these signs of inflammation will also disappear within a few days.
2. Tartar
Tartar is calcified bacterial plaque that can form both above and below the gum line. Tartar must be professionally removed regularly.
The bacterial plaque can calcify (mineralize) into tartar. All tooth surfaces can be affected by tartar. The root surfaces in areas with gum pockets are particularly often affected.
The surface of tartar is rough and is therefore constantly being repopulated by bacteria. For this reason, the formation of tartar should be prevented as much as possible through regular, good oral hygiene at home. However, tartar that has already formed cannot be removed through oral hygiene at home. For this reason, regular check-ups at the dentist's office with professional teeth cleaning are essential.
3. Smoking
Smoking reduces the gums' resistance to harmful bacteria. Smokers have more gum problems and lose more teeth than former smokers or non-smokers.
Smoking is not only harmful to general health. In addition to the lungs and cardiovascular system, the gums are also severely affected.
Even with good oral hygiene at home, smokers suffer from a greater loss of jawbone. As a result, smokers have more gum pockets and a greater number of pathogenic bacteria there. Smokers also respond less well to gum treatment than non-smokers. This means that smokers have a significantly higher risk of losing their teeth earlier than non-smokers.
In former smokers, the condition of their gums can improve after a few years and with good professional care. Former smokers respond better to treatment just one year after quitting smoking than patients who continue to smoke.
4. General diseases (e.g. diabetes mellitus type II)
Diabetics without blood sugar control have an increased risk of developing periodontitis. People suffering from periodontitis also have an increased risk of diabetes. It is advisable to be tested for both diseases.
Periodontitis and diabetes influence each other. Diabetics without blood sugar control have an increased risk of developing periodontitis and, conversely, people with periodontitis have an increased risk of diabetes. On the other hand, diabetics with well-controlled blood sugar levels do not have an increased risk of periodontitis. Interestingly, the treatment of one disease also has a positive effect on the treatment of the other. For this reason, it is essential that diabetics are examined by dentists and that people with periodontitis are examined for diabetes by their GPs.
There needs to be more awareness of the information about periodontitis and diabetes, and especially the importance of early detection. Unfortunately, only a few people know that these connections exist, and only about half of those suffering from diabetes know that they actually suffer from this disease.
5. Nutrition
The impact of an unhealthy diet on the gums is often underestimated. The consequences are an increased risk of both diabetes and periodontitis itself.
An unhealthy diet increases the tendency of the gums to become inflamed. In both gingivitis and periodontitis, this leads to greater swelling at the gum line and an increased breakdown of the tooth anchorage, even leading to earlier tooth loss. An unhealthy diet also increases the risk of developing diabetes, which can further affect the general situation. People with diabetes have an increased risk of developing periodontitis on the one hand and of responding less well to the necessary gum treatment on the other.
6. Stress
Stress reduces the gums' resistance to harmful bacteria. People suffering from psychological stress therefore have an increased risk of developing periodontitis.
The impact of psychological stress on the gums is often underestimated. The consequences are an increased risk of periodontitis.
Psychological stress reduces the gums' resistance to harmful bacteria. On the one hand, this means that those affected have a weaker immune system and suffer from more severe gum disease. On the other hand, those affected also take less time for daily oral hygiene at home. The resulting increased bacterial load has an additional negative effect on the already weakened immune system.
7. Genetics
Due to genetic differences, the immune system's defense against pathogenic bacteria can vary in periodontitis. Consequently, the clinical picture can vary from person to person.
Gingivitis and periodontitis are caused by bacteria that settle on the tooth surface. When the immune system defends itself against these bacteria, the body's own proteins are released in the inflamed gingiva, which can damage the tooth anchorage itself and lead to its degradation. How the immune system reacts to the pathogenic bacteria can vary from person to person due to genetic differences. For this reason, not all people develop the same symptoms of periodontitis, even if their oral hygiene at home is inadequate over a long period of time.
8. Age
Due to the duration of the chronic disease, the consequences of periodontitis usually only become more noticeable in old age – and in old age.
In rare cases, periodontitis can begin as early as the age of 18 or, in very rare cases, as early as adolescence. However, most sufferers become ill at the age of 35. Since the disease usually progresses slowly, those affected do not notice the first symptoms until much later - or even too late.
Periodontitis that is left untreated or not treated professionally enough continues to progress. In old age – and in old age – the consequences are even more noticeable due to the duration of the disease: more bone loss, more tooth loss, diabetes that is more difficult to control and even more cardiovascular diseases.
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