Gum disease ... silent danger

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A person can know his pulse rate and blood pressure range as well as his cholesterol count but never learn the importance of his periodontal score.

That may be his downfall, given what researchers are learning about the impact of gum disease on a person's overall health, and how, in many cases, a person's health is reflected in the condition of the mouth.

A periodontal number tells the health, or lack of it, of each tooth tested by a probe in a dentist's office. The higher the number, the worse off is the gum that supports the tooth. The likelihood is that bacteria found in plaque, the sticky, whitish film attached to tooth surfaces -- what dental experts prefer to call "oral biofilm" -- are eating away at the pockets between tooth and gum.

Left unchecked, it could cause loss of the tooth. The problem erroneously is assumed to be associated only with people of advancing age. Some portion of the population, however, ends up with infections in their gums in spite of following the recommended daily routine of brushing and flossing.

Dr. Sally Cram, a District periodontist, says only a small subset of her patients probably have a genetic predisposition to gum disease.

"Most don't do preventive care, and the great thing about periodontal disease is that it is preventable," she says. "It just takes five minutes a day to do a good job: two or three minutes in the morning and again before bed saves you a tremendous amount of time in dental care."

Thirty-five percent of people with periodontal disease may walk around not knowing they have it, she estimates.

"Fifty percent come in as referrals and have no clue. 'My dentist thinks I have a problem,' they say. And you may not know it unless you have a good dentist picking up that probe, measuring the gum and taking X-rays to check the bone levels."

The trouble is that most people don't know they have a problem until there is pain or swelling , she says.

"It's amazing, despite the fact we live in a very educated area, that we still see periodontal disease at a young age because people don't take care of their teeth. ... We see more people in their forties developing problems. Maybe it's just a trend in Washington, where we have a lot of high-pressure people."