Why do some people get gum disease and others don't?

Some patients come in having brushed and flossed twice a day for thirty years with serious bone loss. Others barely clean their teeth and show no significant disease. That disparity is real, and it matters to understand why.

Daily hygiene is still the foundation. But gum disease risk is shaped by factors that sit outside what a toothbrush can reach.

Age is one of them. Data from the Centers for Disease Control and Prevention shows that over 70% of Americans 65 and older have some form of gum disease. That does not mean it is inevitable, but it does mean the risk compounds over time and makes regular periodontal monitoring more important as people get older.

Genetics is another. Research has shown that some people are genetically susceptible to gum disease, meaning they are more likely to develop it despite consistent home care. If a parent or sibling has had significant periodontal disease, that family history belongs in your periodontist's records. It changes the monitoring schedule.

Tobacco use is among the most significant risk factors the American Academy of Periodontology identifies. Smoking compromises blood flow to the gums, reduces the body's ability to fight infection, and masks symptoms like bleeding that would otherwise prompt someone to seek care earlier.

Stress affects the immune system in ways that extend to the gums. Certain medications, including some oral contraceptives, antidepressants, and heart medicines, can alter gum tissue response. Clenching or grinding teeth puts excess mechanical force on the bone and ligament that hold teeth in place, accelerating any existing disease. Systemic conditions including diabetes and rheumatoid arthritis are also associated with increased periodontal risk.

None of this is a reason to feel helpless about the outcome. It is a reason to know your actual risk level rather than assuming that good brushing habits make a periodontal evaluation unnecessary. Understanding what applies to your situation is what allows treatment, when it is needed, to be precisely targeted.

A comprehensive periodontal evaluation looks at all of these factors alongside the clinical picture. Gum disease treatment starts with knowing exactly what you are dealing with. New patients are welcome. (310) 903-7674.

Dr. Sharyar Baradaran, DDS, MS is a periodontist in Beverly Hills and a member of the American Academy of Periodontology. He has been in practice for more than 32 years.