1. Cosmetic Dentistry: Before and After Slideshow Pictures
2. Take the Dental Health Quiz

Author:

Terry K. Carstensen, DO

Coauthor:

William R. Fraser, DO

Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Plaque is a sticky film of bacteria that clings to the surface of teeth and gums. Brushing and flossing every day may not completely remove all the plaque, especially around the gum line. The bacteria in the plaque produce toxins that may injure the gums and supporting tissues.

Plaque that is not completely removed within 48 hours hardens into a rough deposit called tartar or calculus. Once tartar develops, the only way to remove it is by having the teeth professionally cleaned. Tartar below the gum line causes inflammation and infection. Because this process is often painless, a person may be unaware a problem exists.

Causes or factors that worsen gum disease include the following:

• Because of a dulled immune response and less oxygen in the mouth, smokers are 2 to 7 times more likely to develop periodontitis than nonsmokers.
• Diabetes worsens periodontal disease. If a person's blood sugar level is poorly controlled, a worse infection, poor healing, and a greater loss of bone and connective tissue are likely.
• Sjögren's syndrome with it's decreased saliva production can lead to periodontal disease.
• Stress increases certain hormones that make a person more susceptible to infection. Pregnancy and birth control pills can also increase hormone levels.
• Steroids, antiseizure medicines, cancer medicines, and blood pressure medicines can all affect the gums. Some drugs decrease the flow of saliva, irritating the mouth and making it prone to infection.

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See the Entire Periodontal (Gum) Disease Topic Guide »