June 8, 2024
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June 8, 2024
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Gum Disease: The Invisible Enemy

“Please Daddy, one more book!” Bedtime with my children Nurit (age 5), Ayla (age 3) and Rami (age 1), is a constant battle. My oldest resists, then the others follow. She doesn’t comprehend that sleep is vital to her growth and overall health. Moreover—smaller picture—she doesn’t register her level of exhaustion until she crawls into her unicorn bed and tucks under the blanket. As a father, there are many “unfun” things I do—and long-term measures I take—that my children don’t like, but I do them because I know what’s best for their well-being. It is a parent’s responsibility to protect children against the seen and unseen. The dentist-patient relationship is remarkably similar.

I always feel that telling a patient they have a gum problem, or “periodontitis,” is difficult. Why? Gum disease is an invisible enemy—you cannot feel it and you cannot see it. Since it is painless and slow to progress, people don’t know they have periodontitis until it is advanced, and they start losing their teeth.

Research has shown that gum disease or periodontitis is caused by your body’s reaction to harmful bacteria in your gums. Tooth loss is not the only consequence. Research has found a link between periodontal disease and other problems including diabetes, heart disease, premature birth and rheumatoid arthritis.

Sounds scary, right? The statistics are even more alarming. According to the National Health and Nutrition Examination Survey, “42% of U.S. adults 30 years or older have periodontitis.” Notably, periodontitis is more prevalent among current smokers, people who don’t floss regularly, and those who have not visited a dentist in the past six months.

Red, Puffy, Bleeding Gums

At the early stages of this disease, your gums will appear red and swollen, and bleed easily. In contrast, healthy gums are pink and firm. If you bleed easily when you brush or floss your teeth, chances are you have gingivitis—which is an early indication of gum disease—and proper oral care is needed.

Bad Breath

There is some suggestion that bad breath can also be an indicator of the early stages of gum disease. If proper care is not taken, food particles can accumulate in your mouth and promote bacterial growth around your tongue, teeth and gums, which can cause bad breath.

Advanced Signs of Gum Disease

If unchecked, the symptoms of gum disease can get worse and progress to periodontitis. Pain when chewing, sensitivity to hot and cold, receding gums and loose teeth are all signs of periodontitis.

Is Gum Disease Contagious?

Surprisingly, the harmful bacteria that causes gum disease can spread through saliva. According to the American Academy of Periodontology, if your loved one has gum disease, “it is a good idea to avoid contact with their saliva by not sharing eating utensils or oral health equipment.”

Why Are Children Susceptible?

Babies are born pure and sterile with no trace of bacteria. In contrast, there is good and bad bacteria in the adult body. If your child is introduced to more bad bacteria than good—think, a simple goodnight kiss—there is a real concern that he or she may be more susceptible to gum disease in the future.

Impact of COVID-19

As a dentist, I am concerned about people who have postponed their dental care due to COVID-19. In our practice, since late 2020 when dental offices reopened, we have seen an uptick in dental emergencies due to people not visiting the dentist in over a year. Health economists have referred to this as “the rebound trajectory of the dental economy” on the demand side as the supply side reopens.

Those with moderate to severe gum disease need to be closely monitored and have periodic cleanings to prevent the disease from reemerging. Now that more of the population has received the COVID-19 vaccination—and that my office has normalized advanced sanitization practices such as our new air purification system and rigorous cleanings of exam rooms—I am eager to resume and start afresh the necessary gum treatment plans for my patients.

COVID-19 has had an unprecedented impact on society, the U.S. economy and the dental-care sector. Back in April 2020 the American Dental Association (ADA) indicated the dental economy was at a virtual standstill along with several other sectors of healthcare. With shelter-in-place orders in effect and face mask mandates, few were eager to visit emergency healthcare facilities, let alone to visit the dentist and expose their mouths. According to the World Health Organization’s recent data in March 2021, the pandemic has increased deaths from other causes, “attributable to the overall crisis conditions,” as a result of fewer people seeking healthcare, disruption to healthcare service delivery and other causes.

Throughout history, the dental economy roughly traced U.S. economic recessions but with subtler effects and quicker recoveries. However, the Great Recession (2007-2009) was different, as the recovery in the dental economy significantly lagged behind the recovery in the U.S. economy. Only in 2015 did U.S. dental spending return to pre-Great Recession levels.

The Health Policy Institute (HPI) of the ADA has modeled two projections for how the dental economy will react to the COVID-19 pandemic in relation to the U.S. economy. “One assumption is that the dental economy will recover fully to pre-COVID-19 projected levels in tandem with the U.S. economy. Under this assumption, the dental economy fully recovers to its long-term trend line either by January 2021 or by May 2021. The second assumption is that the dental economy recovers to 80 percent of pre-pandemic projected levels, meaning the dental economy does not return to its long-term trend line. This second assumption is more akin to the experience around the Great Recession.”

Thank God, as of now, in July 2021 the COVID-19 case numbers have declined and the rules have changed. We have surpassed both economic projection models offered by the HPI. It is now encouraged by both the ADA and CDC for the mainstream population to seek dental care for any urgent, emergent, routine and even elective procedures. It is the grave responsibility of each dental office to weigh the risks and decide for themselves how it is most safe and sustainable for patients to return even if we face new variants of the virus—and this we have taken very seriously during our successful practice reopening and even expansion.

Residual fears of exposure to COVID-19 may still limit people’s willingness to be in crowds or close-proximity settings such as sport stadiums, theaters, airplanes, businesses or dental offices. However, oral health is just as important as healthcare for other parts of your body and should not get sidelined until you have a throbbing toothache or a loose tooth.

Combating Gum Disease

Let’s circle back to our invisible enemy. What can you do to prevent gum disease? Firstly, maintain good oral hygiene with brushing and flossing every day and night. Secondly, visit the dentist. Our door is open six days a week and we are accepting new patients! During a checkup at Tenafly Dental Associates, we constantly evaluate what is happening inside your mouth and assess your risk for developing gum disease. Because of the severity and surprising prevalence of gum disease, the Tenafly Dental Associates staff includes an in-house skilled periodontist.


Treatment recommendations for gum disease vary from person to person. Patients with early stages of gum disease may just need a regular professional cleaning. Those with more moderate cases may need a deep scaling and root planing. For those with severe gum disease, seeing a periodontist would be recommended.

Our Unique Dental Office

We have always been vastly different than franchise/corporate dental offices. We welcome our patients in a comfortable, luxury, technology-driven environment. We do not have quotas, so we never recommend anything a patient does not need. We can take the time to explain oral procedures, offer honest alternative treatment plans, answer questions, and define dental issues with the support of technology—most popular is our Carivu, which uses illumination technology to detect cavities. We make it a priority to have the most advanced equipment in the industry and to offer treatment plans customized to each patient’s needs and circumstances.

I am passionate about seeing the transformation that can happen in our office. It is so gratifying to see someone smile again without worrying about stained, missing or misaligned teeth. Or hear a patient talk about being pain-free for the first time in years. Or treat a patient who was deathly afraid of going to a dentist now discover it was not anything like they thought it would be. The whole team at Tenafly Dental Associates—comprising three dentists and six staff—is dedicated and always working hard to offer truly remarkable customer service.

Whether you need general dental care, cosmetic dentistry, restorative dentistry or emergency care, I would welcome the opportunity to talk with you about how I can help you to build a pain-free, gleaming smile. To make an appointment, visit www.Tenafly.dental/contact  or call 201.871.4505.

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