It is important to understand that risk factors do not cause gum disease but they increase the likelihood of the disease occurring. Therefore the main reasons to consider risk factors are heredity, smoking, diabetes, stress, medication, nutrition, poor oral hygiene, faulty restorations, immunosuppression diseases, connective tissue diseases, hormonal problems, and prior incidence of active gum disease.
It is also important to understand that all risk factors are not created equal. The most common cause of systemic disease which increases the susceptibility to gum disease is diabetes. Poorly controlled diabetes increases the incidence of diabetic complications like heart attack, stroke, blindness, kidney failure, and gum disease. The increased glucose in the blood causes the gum tissue to break down, and increases the ability of the disease-causing bacteria to damage the gum tissue and reduces the ability of gum tissue to repair. Unfortunately gum disease also causes poor blood glucose control causing a vicious cycle.
Smoking is the primary environmental and behavioral risk factor for gum disease increases the rate of bone destruction, chronic inflammation, and suppression of the antibodies and this in turn helps bacterial growth. Heredity and stress can reduce immune system function. Hormonal variations during pregnancy and menopause increase the inflammation in the gums. In addition poor oral hygiene and broken restorations or cavities in the teeth and the roots increases the accumulation of plaque and progression of gum disease. Patients having multiple risk factors at the same time increase the risk of gum disease exponentially.
Therefore it is important to control the risks to reduce the chances of gum disease. Smoking cessation, dietary counseling, getting the teeth checked regularly at the dentist helps to modify the risk factors and reduce the chance of periodontal disease. Identifying the risk factors at the earliest gives a better chance of achieving favorable treatment results to gum disease as we already know having gum disease increases the risk of heart disease and other problems in the rest of the body.