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 Gregory C. Dilger D.D.S.           General Dentist            1353 Edgewater St.          West Salem          (503) 378-0466   

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Risk Factors for Gum Disease

There are many risk factors for gum disease development. These risk factors will increase the severity, and speed at which gum disease may occur. The most common risk factors include:


  • Heredity
  • Smoking
  • Diabetes
  • Stress
  • Medication
  • Nutrition
  • Poor oral hygiene
  • Failing dental restorations
  • Hormonal variations
  • Immunocompromised
  • Connective tissue disease
  • Previous history of active periodontal (gum) disease
  • Dry mouth (Xerostoma) (Click here to go to Dry mouth information paper)


All of the above risk factors have different mechanisms of  action, however, they increase the risk for gum disease in one of two ways; increasing the biofilm (plaque/debris film) levels in the mouth, or by diminishing the body’s ability to combat the bacterial challenge. In some cases both mechanisms are contributing to the risk factor.


Heredity is a risk factor for two reasons; it generally increases a person’s susceptibility to having periodontal disease because of the persons immune system function, and also due to the persons learned homecare and perceived ideas about dental care. Patients sometimes have the idea that because their parents, grandparents, etc. lost teeth, had “bad gums/teeth”, and so on; this is ultimately what will happen to them. Dentistry has advanced by leaps and bounds since most peoples parents were young, let alone when there grandparents grew up. Patients have also learned more effective ways to keep their mouth clean, and healthy due to the advances in dental care products, and education. Patients are also a lot more aware of the need for cleanings and check ups at a professional dental practice on a regular basis, to prevent dental decay and gum disease. This is a significant advantage, compared to the times when patients didn’t go to the dentist except when a tooth was causing discomfort. Brushing and flossing wasn’t emphasized like it is now, some didn’t have a tooth brush, or floss (options were very limited), and if they did were not taught how to effectively use them.


Smoking is the second leading risk factor for gum disease. Smoking basically cuts off the blood flow to the tissues in the mouth. Without adequate circulation to and from the tissues they become necrotic, and allow bacterial growth to prevail, therefore causing severe periodontal disease. The burning of the tissues and constant irritation is part of this process, as well as creating a host home for bacteria to colonize on the teeth where tar has been burned onto the tooth surfaces. Smokings mechanism of action is both autoimmune, and by increasing biofilm.


Diabetes is the number one risk factor for gum disease. Because diabetes is an autoimmune disorder the person’s ability to combat the bacteria that cause periodontal disease is decreased. The medications a diabetic person generally takes as well as the diet/nutritional requirements are added risk factors a diabetic patient faces. This exponentially increases person with diabetes likelihood of acquiring gum disease, the severity of gum disease, and progression of the disease. A person on medications, that has nutritional deficiencies, and or a high carbohydrate intake (some diabetics will do this to bring low sugar levels up), that is also a diabetic would be not 3 times more likely, but 27 times more likely to have gum disease, more severe gum disease, or rapidly progressing gum disease.


Stress, nutrition deficiencies, hormonal variations, immunocompromised, connective tissue diseases, and previous history of active perio disease all follow the mechanism of impairing the body’s ability to combat the bacteria involved in gum disease. Poor oral hygiene, high carbohydrate consumption, and failing dentistry are risk factors that involve the increase in biofilm (plaque/ bacteria) in the person’s oral environment. This poses a great risk for gum disease, increasing severity of gum disease, and progression of gum disease.


It is in a person’s best interest to reduce the number of risk factors they potentially have for gum disease. Having optimal homecare, avoiding high consumption of carbohydrates, making sure to meet all nutritional requirements, and seeing your dentist on a regular basis (as recommended by your dentist) are some of the simpler ways to reduce your potential risk factors for gum disease. Stopping smoking, controlling diabetes, reducing stress, improving your immune system, reducing the number of medications taken, and regulating a hormone imbalances, can be very very challenging risk factors to combat. Trying our best to be healthy, hygienic, and happy individuals, can be the best way to combat the possible risk factors you as an individual may face. Don’t hesitate to seek your doctor’s advice, as well as your oral health care team.

September 23, 2009

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Patient Testamonials


Dear Dr. Dilger:


It all started with my initial phone call to Dr. Dilger's office. I felt so comfortable from the start and after I came in for my first visit it's been all about what I want and what Dr. Dilger and his staff recommends for me. All around, it's been the best dental experience I've ever had.


Al P.




Going to the dentist used to be a nightmare experience for me. That's all changed when I came to Dr. Dilger. Dr. Dilger's office staff are so warm and welcoming. Visiting them is like going home. Dr. Dilger's calm and caring manner erased all my dental anxiety and for the first time in my life I found myself relaxed in a dental chair. Dr. Dilger and his staff really took the time to get to know me and my concerns. They talked with me about my fears and helped me address my anxiety. Now I visit the dentist and I'm not afraid. I can not express the difference Dr. Dilger has made in my dental life! Thanks so much Dr. D.


Molly F.




I love my new smile.  It was so easy too.  Nearly pain free.  I am considering my lower teeth at a later date.


Debbie E.