Gum disease is caused by plaque, the sticky, invisible film that forms on the teeth and consists of bacteria.  Most cases of gum disease are caused by plaque accumulation due to poor oral hygiene. However, even with the presence of minimal plaque, additional factors may contribute to gum disease. Some of these contributing factors include the following: 

• Tobacco use – Research has indicated that smoking and tobacco use are some of the most significant factors in the development and progression of gum disease.  In addition to smokers experiencing a slower recovery and healing rate, they are far more likely to suffer from calculus (tartar) build-up on teeth, deep pockets of the gingival tissue, and significant bone loss. 
• Genetic predisposition – Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease.  These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. 
• Pregnancy and menopause – During pregnancy, hormonal changes can cause the gum tissue to become more susceptible to gum disease. 
• Chronic stress and poor diet – Stress lowers the ability of the immune system to fight off disease, which means bacterial infection can beat the body’s defense system.  Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
• Diabetes and underlying medical issues – Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis.  Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to combat.
• Grinding teeth – The clenching or grinding of teeth can significantly damage the supporting tissue surrounding the teeth.  Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth.  When someone suffers from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
• Medication – Many drugs including oral contraceptive pills, heart medicines, anti-depressants, and steroids affect the overall condition of teeth and gums, making them more susceptible to gum disease.  Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.

*Please note the people depicted in the photographs are models and not real patients.*