Formation of Biofilm Plaque

What are the Causes of Gum Disease?

There can be any number of causes of gum disease, among them:

  • Poor oral hygiene
  • Aging
  • Poor nutrition
  • Smoking or chewing tobacco
  • Diabetes and other systemic diseases
  • Stress
  • Pregnancy
  • Hormonal fluctuations
  • Medications that lessen the flow of saliva
  • Certain illnesses, such as AIDS, and their medications
  • Genetic predisposition
  • Substance abuse

When the starches and sugars in food interact with the bacteria normally found on the teeth, a sticky film called dental plaque develops.

Dental plaque is a biofilm, or mass of bacteria, that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. This is the initial stage of gum disease, called gingivitis, which causes irritation, redness, and swelling of the gums. There may be no discomfort at this stage.

Professional dental cleaning is required to remove the tartar. If biofilm plaque, or tartar, is not removed in a timely manner:

  • It can spread and grow below the gumline.
  • Toxins produced by the bacteria in the plaque irritate the gingiva, the part of the gums around the base of the teeth.
  • The toxins stimulate a chronic inflammatory response in which the body, in essence, turns on itself.
  • In time, the gums become swollen and bleed easily, resulting in gingivitis.

If treatment is not undertaken to address the gingivitis, the gum disease will progress to the next and most serious stage called periodontitis:

  • The tissues and bone that support the teeth are broken down and destroyed.
  • The gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected.
  • As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed.
  • Tooth decay (dental caries) may result.
  • Although this destructive process can sometimes have very mild symptoms, eventually teeth can become loose and may have to be removed.

Risk Factors

There are a number of risk factors for gum disease, but poor oral hygiene and smoking are two primary ones. Also, it should be noted that gum disease treatment is less successful in smokers. Other risk factors include:

  • Diabetes
  • Hormonal changes in girls and women
  • Medications that lessen the flow of saliva
  • Certain illnesses, such as AIDS, and their medications
  • Genetic susceptibility

In addition to the serious oral conditions that chronic gum inflammation may produce, some research suggests that the bacteria responsible for periodontitis can enter the bloodstream through gum tissue, possibly affecting the heart, lungs, and other parts of the body. Studies are being carried out to determine if there is such a link between chronic gum disease and:

  • Diabetes mellitus
  • Coronary artery disease
  • Stroke
  • Respiratory disease
  • Rheumatoid arthritis
  • Adverse pregnancy outcomes.

To learn more about biofilm plaque and other causes of gum disease, visit

To learn more about the causes and risks of gum disease, visit