People tend to worry about lifestyle diseases like diabetes, hypertension, obesity and joint pain. Very few people give their gums a thought unless they hurt or bleed. Yet, healthy gums are vital for healthy teeth and for overall health. When gum health deteriorates, teeth can loosen, shift or even fall out. Infection can spread, leading to pain, swelling, fever, abscesses and bad breath. Astonishingly, nearly 40 per cent of adults over 40 show some sign of gum disease. Many are unaware of the problem.

Many people brush their teeth only once a day, usually in the morning. Ideally, teeth should be brushed twice daily, once upon waking and once before sleeping. Night-time brushing is particularly important because it removes food debris trapped between teeth and along the gum line. Overnight, these particles break down, producing acids that erode enamel and irritate the gums. This leads to the formation of plaque, a sticky film that harbours bacteria. If neglected, plaque hardens into tartar, which cannot be brushed off and needs to be removed by a dentist.

Unhealthy gums may appear bluish or purplish rather than a healthy pink. They can appear swollen, puffy and be tender to the touch. Pus may collect between the teeth and gums. Chewing can become painful, and the breath unpleasant. Bleeding while brushing or finding pink stains on the toothbrush or in saliva are warning signs. Bleeding gums are never normal.

Gum disease is not merely a cosmetic or social issue. The bacteria in infected gums can enter the bloodstream or be aspirated into the lungs. This may trigger repeated respiratory infections. Once in circulation, the bacteria cause inflammation, promote clotting and damage blood vessels, contributing to the formation of atherosclerotic plaques. In the long-term, this can be a contributing factor to heart attacks or strokes.

In pregnant women, gum infections are linked to preterm births and low-birth-weight babies. In people with diabetes, gum disease worsens blood sugar control while high sugar levels, in turn, promote gum infection, a vicious cycle.

Studies have also shown a link between chronic gum inflammation and cognitive decline and even the early onset of Alzheimer’s disease. People with Parkinson’s disease often have gum problems because tremors and stiffness make effective brushing difficult.

Bad breath and diseased gums can also lead to social withdrawal, low self-esteem and depression.

Hormonal changes during pregnancy and menopause make gums more vulnerable. Tobacco use — whether smoked, chewed or taken as snuff — is linked strongly to gum disease. Vitamin C deficiency weakens gum tissue, making fresh fruits and raw vegetables, especially citrus, essential for prevention. Certain medications, such as anti-epileptic drugs or blood pressure medications, may also cause gum enlargement or tenderness.

Prevention is simple, inexpensive and effective:

• Brush your teeth twice a day with a soft-bristle toothbrush and replace it every three to four months

• Rinse your mouth after eating or drinking sugary or milky beverages

• Floss daily to remove food debris between teeth

• Avoid all forms of tobacco

• Eat a balanced diet with four to six servings of fruits and vegetables, including some raw items like salads or fresh fruit

• Visit your dentist every six to 12 months, even if you have no symptoms

• Getting your teeth professionally cleaned once or twice a year removes tartar and plaque, preventing cavities and gum disease.

Healthy gums should not bleed, smell or hurt. They hold your teeth firm for a lifetime. Remember, your smile depends not only on your teeth but also on the strength of the gums that support them. A few minutes of care each day can save years of illness, discomfort and dental expenses.

The writer has a family practice at Vellore and is the author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in