As we mentioned last time, a healthy mouth isn’t a 100% “germ-free” mouth – something that’s impossible to achieve anyway – but one with a healthy balance of oral flora. For most Americans, maintaining that is a bit of a struggle – to put it mildly. But hey, red, swollen gums or a little blood when you floss is no big deal, right?

Wrong. They’re signs of periodontal (gum) disease. Other symptoms include bad breath, gum recession, loose teeth and sores in your mouth. It’s been estimated that up to 75% of US adults have some degree of gum disease. It’s the 6th most prevalent health problem in the world.

And bleeding gums are just the start.

As the disease progresses, the normal space between the teeth and gums (the sulcus) gets deeper. These “pockets” become perfect little harbors for bacteria and other pathogens to proliferate: dark, wet and lacking oxygen. The immune system goes on red alert to fight the infection. Unless treated and successfully managed, the disease process ultimately breaks down connective tissue and supporting bone.

Eventually, with less structure there to support them, teeth will loosen and come out.

And that’s just the damage that happens in the mouth. Through recent years, a vast amount of research has shown links between gum disease and all manner of other inflammatory disorders, including diabetes, heart disease, stroke, Alzheimer’s, kidney disease, rheumatoid arthritis and cancer.

Fortunately, periodontal disorders are not only treatable but largely preventable. How?

1. If you smoke or otherwise use tobacco, quit. Tobacco use is the number one risk factor for gum disease.
2. Get enough good quality sleep and take steps to manage stress. Lack of sleep and chronic stress have both been shown to make you more vulnerable to perio problems.
3. Eat a whole foods-based diet, rich in fresh produce, low in added sugars. Avoid soft drinks.
4. Exercise – or at least stay physically active. Those who are regularly physically active are at lower risk of gum disease, even if they used to smoke.
5. Practice optimal oral hygiene at home – brushing and flossing regularly – and have dental visits at least twice a year for exams and professional cleanings.

And yes, the flossing part really does matter. A lot. Remember: Brushing only reaches about 60% of the total surface area of your teeth. You need floss to get the rest, as well as below the gumline. And you need to floss effectively:

Here are a few tips to help you not forget – or to push past excuses for not flossing:

1. Floss before you brush.
2. Floss in the shower.
3. Keep floss nearby where you usually watch TV or video so you can floss while you watch.
4. If you really don’t like the feel of traditional floss, try using flossers. The handle makes them a little easier to maneuver well. Other alternatives include interproximal (proxy) brushes and oral irrigators. Some suggest these last two may be even more effective than traditional floss.

And if you have gum disease already? Typically, treatment includes frequent deep cleanings from a dentist or periodontist (a dentist who specializes in the health of the gums and other supporting tissues). Antibiotics – pharmaceutical, natural or homeopathic – may be used, as well. Both ozone and laser therapy can be extremely helpful for disinfection. There’s been some suggestion that these may even stimulate bone growth in the jaw.

The most important thing is to do something. Left unaddressed, gum disease never gets better, only gets worse. The earlier we spot it and help you manage it, the better – and easier and less expensive – the outcome.

Image: Patricia H. Schuette