If you often experience bleeding gums, that may be a sign that you have inflammation somewhere. Don’t ignore this red flag, because it could have serious consequences. Often, you won’t feel direct pain and might not notice what’s happening. This is dangerous, because you run the risk that your inflamed gums could lead to bone degradation in your jawbone. Through this, teeth and implants can come loose and even fall out. Our dental hygienist is here to share her knowledge and provide insight into the various bacteria and causes of bone loss. She also has some tips to offer.
Which bacteria cause bone loss?
Where gingivitis (gum disease) is mainly caused by the amount of plaque (so by all bacteria), periodontitis (advanced gum disease) is often due to the activity of specific bacteria. There’s been a lot of research into the role that bacteria play in periodontitis. Bacteria secrete waste products that are harmful to the supporting tissues that surround the teeth and molars. Some bacteria also try to invade the body through the pocket (the space between the tooth and gums).
Over one hundred billion bacteria in your saliva
If your mouth were free from bacteria, no bone loss could occur around your teeth and molars. Unfortunately, this isn’t the reality: your saliva alone has more than 600 different bacterial species, and just one millilitre of saliva contains over one hundred billion bacteria. Fortunately, these are not all harmful. However, a number of types are known to be more commonly linked to periodontal bone loss, such as Actinobacillus actinomycetemcomitans, Treponema denticola, Porphyromonas gingivalis and Prevotella intermedia. In principle, our mouth is bacteria-free when we are born, but it is soon colonized by bacteria through our diet and the people in our environment. Therefore, there’s a chance that, at some point in your life, you will become infected with bacteria that are harmful to the periodontium (the tissues that surround and support the teeth).
Due to a combination of factors
However, the composition of bacteria in your saliva is not the only thing that determines the degree of damage to your periodontium. A notorious bacterium like Actinobacillus Actinomycetemcomitans also seems to occur in people who do not suffer from periodontitis. This emphasizes that it is a combination of factors that determines whether and to what extent someone starts experiencing periodontal breakdown. Let’s take a look at some influential factors.
Jawbone destruction occurs twice as fast in smokers
Apart from the well-known health risks, smoking also has an adverse effect on your gums. Smoking causes blood vessels to constrict. The gums of smokers thus look paler and bleed less quickly, although they may still be inflamed. If you smoke, your gums aren’t able to recover as well from inflammation and jawbone degradation can occur twice as quickly as normal. The theory is: gums don’t want to grow where there’s no blood, so they begin to recede. Smokers also suffer more often from receding gums. The treatment of periodontitis is much less effective for smokers. All in all, there are plenty of reasons to quit smoking if you have or wish to prevent periodontitis.
Dry mouth from medicine use
Because the Dutch population is taking more and more medication, side effects are also on the rise. Some medications have a direct effect on bone quality. Also, one side effect that is often reported is a dry mouth, which impedes the self-cleaning function of your saliva.
Diabetics more sensitive to inflammation
Approximately ten percent of the Dutch population suffers from a moderate to severe form of periodontitis, but in people with diabetes, this rate is twenty to thirty percent. In addition, diabetics are more sensitive to inflammation and infections, and their bodies also have more trouble quelling infections. High blood sugar levels confuse your immune system, which means that intruders are less likely to be dealt with. People whose diabetes is not well-controlled especially have an increased chance of developing periodontitis. Good oral hygiene can have beneficial effects for diabetics because this contributes to stable blood sugar levels.
Periodontitis can also be genetically determined
Although removing plaque from your teeth plays a major role, it is also true that plaque can cause inflammation and bone loss much more easily in some people than in others. Periodontitis occurs more frequently in some families. Certain people produce more inflammatory proteins in cases of periodontitis than others. This makes the inflammatory response more intense than normal, which also means that more jawbone and ligament fibres (fibres that secure teeth in the mouth) will break down.
Women are more prone to inflammation in the mouth due to the hormonal fluctuations they go through. Hormonal changes affect not only the blood supply to the tooth tissue, but also one’s physical reaction to the toxins released by dental plaque. Because of these changes, women are more prone to developing periodontitis in certain phases of their lives, stages in which there are any hormone fluctuations. This includes during puberty, certain times during the menstrual cycle, when using birth control pills, and during pregnancy and menopause. After menopause, women can—and don’t be alarmed—count on experiencing 1% bone loss per year. The first clinically visible signs of this emerge at 10% bone loss.
Pregnant women at a higher risk for periodontitis
Pregnancies have an important impact on a woman’s life. During pregnancy, you have a greater chance of experiencing gum issues. The shift in hormone activity makes your gums react more severely to plaque. It is vital to pay extra attention to oral hygiene during pregnancy. If you carefully remove all plaque, your pregnancy doesn’t have to mean facing any additional risks for gum inflammation. Yet, in practice, many pregnant women end up suffering from pregnancy gingivitis, especially during the second and third trimesters. A pregnant woman is more likely to develop periodontitis because of the various changes her body goes through. First, there is a change in bacterial composition due to hormonal changes. In addition, blood volume increases by 40-50%, which affects the blood vessels. Thirdly, an immunological adjustment takes place in response to the ‘foreign’ fetus (so it is not rejected), and this also impacts your mouth. The body finds itself in a pro-inflammatory state (sorry for this difficult term!), which basically means that there is an increase in and activation of inflammatory cells. This, in turn, can lead to pregnancy complications, such as premature birth (< 37 weeks), preeclampsia (high blood pressure and organ damage), and a low infant birth weight. So, it’s very risky!
Osteoporosis also causes bone loss in your jaw
Just as osteoporosis causes a loss of bone density in your body, the same can happen in your jaw, where your teeth are nicely anchored. This is a disease that occurs mainly in women (one in four women over 55). Research shows that only about a third of osteoporosis cases are caused by calcium deficiency. Much more often, it’s due to a disruption of calcium absorption linked to a deficiency of vitamin D and/or magnesium, as well as high acidity levels (pH) in the body. It is important to avoid smoking, exercise sufficiently, and ensure you get enough calcium, magnesium and vitamin D.
Stress linked to higher risk of periodontitis
Nowadays everyone experiences some degree of stress. Modern society exposes us to countless stimuli, which means that we’ve all had to deal with high stress at some point. However, this can become a problem when periods of stress last longer than normal. Stress can suppress the body’s natural defences (and therefore also affect the gums). Your body also requires more vitamins and minerals when stressed. People who are often stressed have a greater chance of contracting periodontitis, and the effects may be more severe. Many people lose their appetites when they suffer from stress. Others are real emotion-eaters and will binge on candy and snacks and generally eat more unhealthily. This is despite the fact that good nutrition is actually so important in helping to reduce your stress level.
Your body uses up a lot of magnesium if you are suffering from stress. This mineral is necessary for the production of hormones; it helps with muscle and bone development and enables muscles and nerves to relax. Magnesium is therefore also known as the ‘anti-stress mineral.’ If you are dealing with prolonged stress, you can end up with a magnesium deficiency. However, you can increase your magnesium intake by eating more leafy greens, beans, legumes, bananas, whole grains, dark chocolate and especially nuts. Cashews, almonds and peanuts contain lots of magnesium, as does peanut butter. Research has shown that vitamin C also helps combat stress, leading to a decrease in bodily stress reactions. This vitamin lowers the amount of cortisol (a hormone your body produces under stress), in the bloodstream. Moreover, your body uses up more vitamin C than normal when you’re stressed. So, it’s wise to eat some extra fruit if you’re stressed or take a nutritional supplement for the time being.
Do you suffer from stress? Use the right dietary supplements
The nutrients that are usually consumed in times of stress are the antioxidant vitamins A, B, C and E and the minerals zinc, selenium, calcium, magnesium, iron, potassium, sulphur and molybdenum. Through speeding up metabolism and increasing energy consumption, stressed bodies require higher levels of carbohydrates, proteins and fats, and especially the ever-important fatty acids. Minerals are also important, with the best anti-stress ones being calcium, magnesium and potassium. Calcium is essential for transmitting nerve impulses and the proper functioning of the immune system. It also aids in relaxation and relieving muscle tension. Magnesium is a soothing mineral that helps with muscle cramps and bringing the nervous system into balance. Potassium is essential for the body’s most vital physiological processes.
What can you do to prevent bone loss?
Have you ever suffered from bleeding gums? There’s no need to be scared that your teeth will start falling out right away, but it is important to take action. Your dentist or dental hygienist can instruct you on improving your oral hygiene. Here are a few tips to get you started:
- Remove as much plaque as possible from your teeth each day using a toothbrush, toothpicks, interdental brushes or a water flosser.
- Of course, make it a daily habit to use oral care products from blue®m. The active oxygen, lactoferrin and xylitol in the toothpaste and mouthwash will help restore gums to optimal condition.
- Remove bacteria and bits of food that accumulate on your tongue with a tongue brush or tongue scraper. You’ll immediately feel fresher.
- The less plaque you have, the less tartar. Tartar is hardened plaque that you can no longer remove on your own. To have tartar thoroughly removed, we recommend you see a dental hygienist, who will perform a dental cleaning with special instruments. I go myself at least once a year!
And what should you do if have inflamed gums?
If you have bleeding or inflamed gums, you should take immediate action to restore your gums to a healthy condition. For faster healing, use blue®m oral gel, which contains a higher concentration of oxygen. Apply the gel directly to the sensitive, bleeding spot in your mouth. This allows for a faster recovery.
Being conscious of your daily oral hygiene and combining this with periodic cleaning by a dental hygienist can really make a difference. In this way, your gum inflammation will settle down and your gums will be healthy again. During the healing process, the gums may recede a little, but removing plaque on a daily basis will prevent new inflammation from occurring and can stop the process of bone loss.
Tessa Hagen has many years of experience as a dental hygienist and is a guest blogger for blue®m. She knows better than anyone the relationship between good nutrition, a healthy lifestyle and oral health. Her goal is to make as many people as possible (both dental professionals and patients) more aware of this relationship. That is why she speaks at fairs and congresses, gives training in training centers and gives presentations in dental practices.