Eighty percent of American adults have some form of periodontal (gum) disease, but the beginning symptoms are usually painless, so many who are at risk do not recognize the signs and stages, according to a report in the September/October 2003 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD).

"Gum disease is a silent teeth killer because you can have it without knowing it," says AGD spokesperson Elwood Streeter, DDS.

Healthy gums appear coral pink, firm and form a sharp point where they meet the tooth. When excessive amounts of bacteria and food debris build up in the spaces between the teeth and gums, a sticky material called plaque is formed.

A plaque build-up can develop and harden into calculus (tartar), which irritates the gums. Bacterial byproducts (or toxins) in the tartar cause gums to become infected, red and tender, a condition called gingivitis. Gingivitis is the beginning stage of periodontal disease.

If you do not receive professional cleaning to halt the spread of gingivitis, the infection will spread from the gums to the ligaments and bone supporting the teeth. The tissues and ligaments will be destroyed; infections are likely to develop, causing a gum abscess, a collection of pus and swelling of gum tissues. Teeth may become loose and the gums may recede, creating increased spaces between teeth.

Dentists treat gingivitis by cleaning teeth to remove plaque and tartar and prescribing special mouthwashes or topical treatments. Treatment for periodontal disease involves more serious action such as antibiotics and antimicrobials, deep scaling of the root surface, removing infected gum tissue or extracting teeth. To avoid these potentially painful symptoms and treatments, it is important to catch the disease in its earlier stages.

"Gum disease can develop within weeks," cautions Itzhak Brook, MD, MSc, lead author of the journal report. He reminds patients to prevent periodontal disease by regular flossing, brushing and dental checkups. In addition, maintaining a healthy diet and low levels of stress boost the body's natural immune system, which fights bacteria in the mouth.

Early warning signs of gum disease:

•   Bleeding gums when brushing or flossing
•   Mouth sores
•   Bright red, red-purple or shiny gums
•   Gums that are tender to the touch