Gingivitis is the medical term for early gum disease, or periodontal disease. In general, gum disease can be caused by long-term exposure to plaque, the sticky but colorless film on teeth that forms after eating or sleeping.

Gum disease originates in the gums, where infections form from harmful bacteria and other materials left behind from eating. Early warning signs include chronic bad breath, tender or painful swollen gums and minor bleeding after brushing or flossing. In many cases, however, gingivitis can go unnoticed. The infections can eventually cause the gums to separate from the teeth, creating even greater opportunities for infection and decay.

Although gum disease is the major cause of tooth loss in adults, in many cases it is avoidable.

If gingivitis goes untreated, more serious problems such as abscesses, bone loss or periodontitis can occur.

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Periodontitis is treated in a number of ways. One method, called root planing, involved cleaning and scraping below the gum line to smooth the roots. If effective, this procedure helps the gums reattach themselves to the tooth structure.

Pregnancy has also been known to cause a form of gingivitis. This has been linked to hormonal changes in the woman's body that promote plaque production.

Nutrition
and Periodontal Diseases

Diet plays an important role in a person's overall wellness and oral health. Eating well and maintaining a healthy diet can help reduce your risk for developing many problems with your mouth, including periodontal diseases.

Vitamin C
According to the Institute of Medicine, the recommended dietary allowance for vitamin C is 60 mg per day - or about one orange. Consuming less than 60 mg can put you at slightly higher risk for developing certain types of periodontal diseases. The relationship between vitamin C and periodontal diseases is likely due to vitamin C's role in maintaining and repairing healthy connective tissue along with its antioxidant properties. The American Dietetic Association recognizes that fruits such as oranges, melons, and berries are excellent sources of vitamin C.

Calcium
Getting enough calcium can also reduce your risk for developing periodontal diseases. The American Dietetic Association advises that adults should try to consume at least three servings of calcium each day. Good sources of calcium include dairy foods such as milk, yogurt, cheeses, dark green vegetables, fortified orange juice, as well as rice and beans. Consuming enough calcium can help build density in the alveolar (jaw) bone that supports the teeth. This is especially important in developing years.

Periodontal diseases can eventually break down and destroy the tissues and bone that support the teeth. However, with a diet high in calcium, the rest of the jaw bone may not be at risk.

Individuals with osteoporosis, who are taking a class of drugs called bisphosphonates should pay extra attention to the bone in their jaw. Recent research has indicated that certain osteoporosis drugs may be associated with bone necrosis (loss) in the jaw. Individuals taking these drugs have an increased risk of post surgical complications. Information is still surfacing regarding this association so talk to your dental professional if you have any questions.

Vitamin D
Sometimes known as the "sunshine vitamin", vitamin D can help slow bone absorption and lessen inflammation associated with periodontal diseases. Research shows that exposure to the sun can provide your required amount of vitamin D. Ten to fifteen minutes of sun exposure at least two times per week to the face, arms, hands or back can provide adequate vitamin D. People who live in an area with limited sun exposure may want to eat foods fortified with vitamin D such as milk, eggs, sardines, and tuna fish.

Omega-3 Fatty Acids
Fish, tofu, and other forms of soybeans, canola, walnut, flaxseed, and their oils, are rich in omega-3 fatty acids. Omega-3 fatty acids have been shown to help decrease inflammation that is associated with periodontal diseases.

Dietary Supplements
Dietary supplements can be an easy way for patients to obtain their recommended dietary allowance of different nutrients. But vitamins and dietary supplements are not a replacement for good nutrition and proper oral care. Always consult with your physician before taking any kind of supplement.

Maintaining a balanced diet is an important part of achieving wellness. An unbalanced diet, often associated with obesity, may
not include fruits and vegetables, which are good sources of valuable nutrients. Be wary of sugary drinks such as soft drinks and foods high in sugars, trans-fats, and sodium. Without proper nutrients the body can have a hard time fighting off infections such as periodontal diseases.

The Relationship
Of Periodontal Diseases To Other Disease

Evidence suggests a possible link between periodontal diseases and other systemic conditions that can negatively affect a person's overall wellness, such as diabetes and heart disease.

Bacteria associated with periodontal diseases have been linked to heart disease, diabetes, stroke, and preterm or low weight births. The bacteria travel through the body's veins and arteries using them as a highway system to link to other parts of the body. Periodontal bacteria can also spread from the oral cavity to the rest of the body, including the lungs and can cause respiratory diseases associated with chronic obstructive pulmonary disease, the sixth leading cause of mortality in the United States.

No matter where bacteria travels in the body, the immune system will respond by sending white blood cells to battle the bacteria. These white blood cells release chemicals that create an inflammatory re¬sponse. Inflammation can damage tissues. Scientists now understand that inflammation causes or complicates many diseases, including pancreatic cancer and Alzheimer's disease. For example, inflammation can damage tissues in the brain which can increase a patient's risk of developing Alzheimer's. Inflammation from gum disease has also been linked to arthritis. Many scientists believe that inflammation is responsible for the development of rheumatoid arthritis in some of the estimated 2.1 million people suffering from the condition. Today, the level of inflammation in your body can be evaluated with a C-reactive protein test from a blood sample.

Autoimmune diseases can have side effects related to oral health. Conditions such as Sjogrens syndrome, Lichen planus, pemphigus, pemphigoid, HIV/AIDS, and Erythema multiforme can present many different oral complications. Advise your dental professional if you suffer from an autoimmune disease. Your dental professional can work with you and your physician to help control any periodontal infections and adverse drug interactions. Maintaining good oral health can impact your quality of life. Good oral health provides the ability to eat and speak with confidence and contributes to your overall wellness. This includes maintaining a regular oral hygiene routine, incuding daily brushing, flossing, and regular dental visits. Brushing and flossing is the best way to prevent the development and progression of periodontal diseases.

Medications
May Affect Your Periodontal Heath

Many people take an array of medications to help treat their, health problems. Sometimes these medications can have different side effects on a patient's oral health. Some of the most common oral side effects associated with medications include:

Dry Mouth (Xerostomia) - A condition that leaves the mouth without enough saliva to wash away food and neutralize plaque, leaving a patient more susceptible to tooth decay and periodontal diseases. In addition, dry mouth can cause sore throat, difficulty speaking, difficulty swallowing, and hoarseness. Medications associated with dry mouth include:

• Allergy medications such as antihistamines - Blood pressure medications or diuretics
• Painkillers
• High blood pressure medications
• Antidepressants

Talk to your dental professional if you suffer from dry mouth as there are remedies available.

Gum (Gingival) Overgrowth - A condition in which the gums become swollen and "grow over" the teeth. Overgrown gums make it easier for bacteria to accumulate and attack supporting structures of the teeth, which can lead to severe periodontal infection. Medications associated with gingival overgrowth include:

• Anticonvulsants (e.g., Phenytoin - used for treating seizures)
• Immunosuppressants (e.g., Cyclosporine - used following organ transplants)
• High blood pressure medications (e.g., Nifedipine - calcium channel blockers)

Discoloration of Gums - A condition in which gum tissues appear blackish-blue in color and at times appear to be transparent. Medications associated with discolored gums include:

• Acne medications (e.g., Minocycline)
• Arthritis medications

Osteonecrosis of the Jaw (ONJ) - ONJ is a condition in which the bone tissue in the jaw fails to heal after minor or major surgery, such as tooth extraction, causing the bone to be exposed. This exposure can eventually lead to infection and may even fracture which will require long-term antibiotic therapy or surgery to remove the dying bone tissue. Medications associated with ONJ include:

• Intravenous bisphosphonates (commonly used in patients undergoing chemotherapy)
• Oral bisphosphonates

Today's health- and beauty-conscious consumers are looking for treatments and medications to proactively protect their bodies and appearances with few or no side effects. Patients can help accomplish this goal by informing their health care provider of any changes in overall health and prescription and non-prescription medications they are taking.

Other Factors
That Have Effects On Periodontal Disease

Many patients recognize the importance of wellness, but over time different lifestyle factors can negatively impact their wellness. To help maintain wellness, keep in mind the following tips:

Strive To Be Stress Free
Minimize the stress in your life. By developing coping mechanisms to deal with stressful situations, you can minimize stress. Often, patients who are having a difficult time coping with stress can neglect their oral hygiene, start grinding their teeth, and even see changes in their production of saliva.

See The Glass Half Full
According to the National Mental Health Association clinical depres¬sion is one of the most common mental illnesses, affecting more than 19 million Americans each year. Depression can affect treatment outcomes and slow healing time after surgery. It is important for patients to comply with all pre and post treatment instructions and to inform their dental professional if they are taking any medications to treat depression. Mental health is a component of overall wellness, and as such, you should remember that even smiling and having a good attitude can contribute to your overall mental health.

Avoid Clenching Or Grinding Your Teeth
Clenching or grinding of teeth can put excess force on the supporting tissues of the mouth and can increase destruction of periodontal tissues, especially when bone loss has already occurred. Try relaxing your jaw when you feel stressed. Be sure to talk to your dental professional about wearing a night guard if clenching or grinding of teeth occurs during sleep.

Wear A Mouth Guard
Exercise is an important part of maintaining a healthy lifestyle. If you participate in any sport that carries a risk of injury, you should wear a mouth guard. These sports might include football, hockey, basketball, volleyball, and even baseball and racquet ball. Mouth guards can cushion a blow to the face, minimizing the risk of broken teeth, injuries to the soft tissues of the mouth, and reduce clenching during these activities.

Kick The Tabacco Habit
Tobacco use is one of the most significant risk factors in the develop¬ment and progression of periodontal diseases. In fact, smoking may be responsible for more than half of the cases of periodontal diseases among adults in the United States. Tobacco's negative effects on periodontal health are well documented. Smoking impairs the body's defense mechanisms, making smokers more susceptible to infections like periodontal diseases and interferes with healing, making smokers less likely to respond to treatment. Most patients that have recurrent periodontal diseases are smokers. Smoking is also associated with complications after gum surgery.

Drink Alcohol In Moderation
Drinking the occasional glass of red wine or beer has been shown to have positive effects on the body; however, heavy drinking can negatively impact the oral cavity. Alcohol can irritate the gums, tongue, and oral tissues; it can contribute to poor healing after surgery and can halt your oral hygiene routine. In addition, heavy drinkers often suffer from tooth decay as a result of the increased exposure to sugars and acids that are often found in alcoholic drinks. Heavy drinking is also associated with an increased risk of oral cancer.

Genetics
Family history may make a difference in your overall wellness. For instance, if your family member has a heart condition, they may take extra care to exercise and eat right. The same idea applies to periodontal diseases. Periodontal diseases are multifactorial, meaning that susceptibility to the disease involves genetic as well as environmental factors such as diet, smoking, and other lifestyle factors. Your genes play a major role in the onset and severity of periodontal diseases. Researchers believe there are many genes that play a role in your susceptibility to periodontal diseases, and these may differ by race and ethnic group. Currently you can determine if you are more genetically susceptible to periodontal diseases through a genetic test which can be performed using a saliva sample. This test helps dental professionals identify patients who might be at a higher risk for periodontal diseases before any symptoms arise, so that a good oral hygiene routine can be developed.