Do you think gum disease is something that only happens to people your grandparents' age? Think again! Teens can get gum disease too, and it can cause problems from the simply embarrassing (like bad breath) to the serious — like pain and tooth loss (which is both embarrassing and serious!).

What Is Gum Disease?

Gum disease is also known as periodontal (pronounced: per-ee-oh-don-tul) disease.

Periodontal disease is an infection of the tissues and bone that support the teeth. Untreated gum disease can become very serious, causing teeth to become loose or fall out.

Gum disease is usually caused by a buildup of plaque, an invisible sticky layer of germs that forms naturally on the teeth and gums. Plaque contains bacteria, which produce toxins that irritate and damage the gums.

Hundreds of types of bacteria live in the mouth, so keeping plaque at bay is a constant battle. That's why brushing and flossing every day — and regular trips to the dentist — are so important.

Who Is at Risk?

Certain things can make teens more likely to develop gum disease. Some may inherit this tendency from their parents. The snacks you eat also can put you at risk of developing gum disease — especially if you grab fries and a soda in the mall after school and aren't able to brush immediately after eating them. You probably know that sugar is bad for your teeth, but you may not know that starchy foods like fries also feed the acids that eat into your tooth enamel.

If you have braces, fending off plaque can be tougher. Plus, some medical conditions (including diabetes and Down syndrome) and certain medicines increase the risk of gum disease.

Running yourself down with a lousy diet, too little sleep, and too much stress leaves you more vulnerable to infection anywhere in the body, including your gums.

Girls have a higher risk of gum disease than guys. Increases in female sex hormones during puberty can make girls' gums more sensitive to irritation. Some girls may notice that their gums bleed a bit in the days before their periods.

For severe — and early — gum problems, though, the real bad guy is tobacco. Not only does smoking lead to bad breath and stained, yellowed teeth but recent research also shows that smoking is a leading cause of gum disease.

According to the American Dental Association (ADA), people who smoke cigarettes and chew tobacco are more likely to have plaque and tartar buildup and to show signs of advanced gum disease. They are also more likely to develop mouth cancer in the future.

How It Progresses

Gum disease progresses in stages. Believe it or not, more than half of teens have some form of gum disease.

Do your gums bleed when you floss or brush your teeth? Chances are you already have the mildest form of gum disease — bleeding gums are usually a sign of gingivitis (pronounced: jin-juh-vy-tus). Other warning signs of gingivitis include gum tenderness, redness, or puffiness.

If plaque from teeth and gums isn't removed by good daily dental care, over time it will harden into a crust called calculus or tartar. Once tartar forms, it starts to destroy gum tissue, causing gums to bleed and pull away from the teeth. This is known as periodontitis (pronounced: per-ee-oh-don-ty-tus), a more advanced form of gum disease.

With periodontitis, gums become weakened and form pockets around the base of teeth. Bacteria pool in these pockets, causing further destruction of the gums. As periodontitis spreads, it damages deeper gum tissue and can eventually spread to areas of the jawbone that support the teeth. This can cause teeth to become loose and fall out. Though periodontitis is rare in teens, it can happen. If it's not treated, it can cause real trouble for your teeth.

What should you do to avoid these problems? See your dentist if you notice any of these signs of gum disease:

• bleeding of the gums that occurs regularly when brushing or flossing
• discoloration of gums (healthy gums should look pink and firm, not red, swollen, or tender)
• any sign of gums pulling away from teeth
• bad breath that won't go away
• loose teeth

Tracking It Down and Treating It

Gum disease can be sneaky, sometimes causing little or no pain or irritation before permanent damage is done to your teeth. That's why regular dentist visits are a must. With X-rays and a thorough examination, a dentist or dental hygienist can spot trouble before you know it's there.

The earlier that gum disease is caught, the better. Adopting better brushing and flossing habits can usually reverse gingivitis. Sometimes your dentist will also prescribe antibiotics or a special antibacterial mouth rinse to tackle the problem.

Once someone develops periodontitis, it isn't as easy to control. Usually there is widespread infection of the gums that needs to be treated. This may require several special treatments either by a dentist or a periodontist, an expert who specializes in the care of gum disease.

Some of the ways dentists and periodontists may treat periodontitis are:

• Scaling or root planing. These deep-cleaning measures involve scraping and removing plaque and tartar from teeth above and below the gum line.
• Antibiotics. These and other medications are often used together with scaling and root planing to stop the spread of infection and inflammation in the mouth. They come in several different forms that range from medicated mouthwashes to antibiotic-containing gels or fibers that are placed in gum pockets to slowly kill bacteria and help gums to heal.
• Surgery. Advanced cases of periodontitis may require a dentist to open and clean badly diseased gum pockets, then stitch the gums back into place to fit more snugly around the teeth.
• Gingival grafting. If gum tissue is too diseased to sew back together, a dentist removes healthy gum tissue from another part of the mouth and stitches it into place. The graft replaces the diseased tissue and helps to anchor the teeth, giving them an improved appearance.

While undergoing treatment for periodontitis, it's especially important to take special care of your teeth and gums to see lasting improvement. This includes flossing and brushing every day and quitting habits that mean bad news for the mouth, such as smoking or eating sugary snacks between meals.

Prevention Tips

Fortunately, there's good news: Gum disease is usually preventable. Just take care of your teeth, starting now. Don't wait!

• Brush twice a day for at least 3 minutes each time (about the length of your favorite song) and floss daily. If you're not sure whether you're brushing or flossing properly, your dentist or dental hygienist can show you the best techniques.
• Always brush with a toothpaste that contains fluoride; some dentists also recommend daily mouth rinses containing fluoride.
• Use a toothbrush with soft, polished bristles, as these are less likely to irritate or injure gum tissue. Be sure to replace your toothbrush at least every 3 to 4 months — a worn-out toothbrush can injure your gums. (Some toothbrush brands contain color indicators on the bristles to remind you to replace them when they become worn.)
• Eat a healthy diet. Avoid snacks and junk foods packed with sugar that plaque-causing bacteria love to feed on.
• Don't smoke! Cigarettes and chewing tobacco cause mouth irritation and are very unhealthy for gums and teeth.
• Regular dental care is extremely important in helping to keep your mouth healthy. Visit your dentist for routine care — especially cleaning — at least twice a year. Your dentist can remove hardened plaque and any tartar that you're not getting to with brushing or flossing.

Reviewed by: Charlie J. Inga, DDS
Date reviewed: November 2011