Updated on February 22, 2024
6 min read

Do You Know the Risk Factors for Gum Disease?

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When someone develops gum disease, there’s generally more than one contributing factor.

In the past, it was thought that everyone was equally at risk of gum disease if they had poor oral hygiene.1 Now, we know that various contributing factors play a role in the development of gum disease.

Some risk factors, like oral hygiene, are within your control. Others are not, making some people more susceptible to gum disease than others.

This article will define gum disease and discuss important risk factors. We’ll start with the ones you can’t change and then move on to the ones you can.

Uncontrollable Risk Factors

The risk factors you cannot control stem from your genetics or specific health concerns.

Gum Diseases comparisons


Genetic factors can make you more susceptible to the bacteria that cause gum disease. You’re at a higher risk if you have a parent with severe periodontal disease.

However, a genetic predisposition is not a guarantee of developing periodontal disease. It simply means that if certain oral bacteria are present, you’re more vulnerable to gum infection than the average person.

Your genes may also make it more likely that your immune system will overreact to those oral bacteria. In either case, taking care of your teeth and gums is key.

If you maintain great oral hygiene and see your dentist or periodontist consistently, you can fight any predisposition you may have and avoid gum disease. 


Hormonal changes during puberty and pregnancy can contribute to gum disease, usually mild gingivitis. The gums become highly sensitive, reacting strongly to even a small amount of plaque buildup.

People going through these hormonal changes may notice that their gums are bright red, puffy, tender, and bleed when they brush or floss.

Oral contraceptives can also have this effect. During the first few weeks after starting birth control, women may notice that their gums and teeth are more sensitive than usual.

The key to battling this risk factor is keeping your teeth as clean as possible and ensuring your gums don’t have any plaque to overreact to.


Diabetes can have devastating effects on various parts of the body, including your gums. Over the long term, it causes nerve damage and loss of blood flow to extremities. This is why diabetic patients sometimes lose toes or suffer from blindness.

Gum tissue can be similarly affected. Diabetes makes gum disease progress faster because your body cannot send important healing cells to the inflamed gum tissue.

Technically, diabetes is both a risk factor that you can control and one that you cannot. You cannot control your diabetes, but you can do your best to keep it in check.

People with controlled diabetes are better able to control their gum disease and vice versa. Diabetes can be managed by:

  • Closely monitoring your blood sugar
  • Taking medication
  • Following your doctor’s nutritional guidance

Other Systemic Conditions

Other systemic diseases can play a role in gum disease as well. They involve similar chronic inflammation and take a toll on your immune system. For example, cardiovascular disease and severe periodontal disease make each other more likely to occur.

Rheumatoid arthritis (RA) has also been linked to gum disease. The bone loss caused by RA can affect oral bone tissue, and similar bacteria may be involved.

Some autoimmune diseases can also directly affect the soft tissue lining inside your mouth, such as pemphigoid and oral lichen planus.

Controllable Risk Factors

Now that we’ve looked at the risk factors you can’t control, here are the ones you can.

Poor Oral Hygiene

The root cause of all gum disease is plaque. This soft buildup collects on your teeth, containing bacteria, food debris, and exfoliated cells from the tissue lining your mouth. 

As plaque accumulates and hardens, it provides shelter for additional bacteria, which may be more aggressive than those originally causing the plaque. These bacteria can then begin destroying gum tissue.

Disrupting and removing plaque with daily brushing and flossing is crucial. Poor oral hygiene is the strongest risk factor for gum disease. 

Lack of Dental Care

For excellent oral health, getting additional care from your dentist is best. Regular brushing and flossing typically aren’t enough to completely prevent plaque buildup.

Visiting your dentist twice yearly for deep cleaning will ensure that any remaining plaque or tartar is fully removed. These visits are also occasions for your dentist to treat any other oral health issues you may have.

People who only go to the dentist when something hurts have a higher risk of gum disease. Routine dental care can significantly lower your risk.


Poor nutrition can also lead to an increased risk for periodontal disease. Like the rest of your body, your gums rely on adequate nutrients to stay healthy.

A diet low in vitamins and micronutrients can weaken your immune system, making your gums more vulnerable to infection. In addition, a diet high in sugar and low in fiber can fuel plaque-forming bacteria.

While rare or unknown in most developed countries, extremely aggressive periodontal diseases can result from severe malnutrition and poor sanitation.

Dry Mouth

Dry mouth is another important risk factor for gum disease. Like diabetes, this factor isn’t always entirely controllable, but you can mitigate it to an extent.

For example, you may take prescription medication that causes dry mouth as a side effect. In this case, you can manage it but not prevent it entirely.

Many people suffer from dry mouth due to dehydration, as they may not drink enough water. Alcohol consumption, smoking, and excessive caffeine intake can also dehydrate you, leading to a decrease in saliva flow.

Saliva is essential to oral health. It hydrates your teeth and gums, remineralizes your enamel, and balances your mouth’s pH. Without adequate saliva flow, your mouth is drier and more acidic, making it more hospitable for destructive bacteria.


Smoking anything, tobacco or not, can cause your mouth to become dry. In addition, nicotine can reduce blood flow to your gums. This can cause them to recede and make them more vulnerable to bacterial infection.

It’s best to avoid or quit smoking for these and other reasons. If you continue to smoke, taking other steps to maintain good oral health is even more important.

What is Gum Disease?

Gum disease (periodontal disease) refers to several inflammatory conditions that can affect your gums and other nearby tissues. It’s ultimately caused by a bacterial infection and your body’s immune response to it.

Gingivitis inflammation of the gums dental 3D illustration

Gingivitis vs. Periodontitis

Mild gum disease, or gingivitis, refers to gum inflammation. Fortunately, gingivitis is reversible and usually doesn’t lead to more severe gum disease. Sometimes hormone fluctuations play a role in making your gums more sensitive than usual.

In more advanced gum disease, known as periodontitis, gum tissue is at risk of being permanently destroyed. The underlying bone and connective tissues are also affected, which can eventually lead to tooth loss.

Gingivitis can be reversed with proper oral hygiene and/or professional cleaning. Periodontitis, on the other hand, involves tissue damage. It requires additional periodontal treatment to prevent it from getting worse.


Since you can control some of the risk factors for gum disease, take matters into your own hands by following our recommendations here.

Other risk factors, like hormonal shifts and certain genes, can’t be controlled, but proper oral hygiene can mitigate their effect.

Gum disease can be expensive to treat and can affect your overall health. By taking charge of your oral health now, you can avoid paying unnecessary costs in the future.

Last updated on February 22, 2024
7 Sources Cited
Last updated on February 22, 2024
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Van Dyke, T.E., and Sheilesh, D. “Risk Factors for Periodontitis.” Journal of the International Academy of Periodontology, 2005.
  2. Alear et al. “Risk Factors for Periodontal Diseases.” Journal of the Faculty of Dentistry of the University of Antioquia, 2010.
  3. Koshi et al. “Risk assessment for peridodontal disease.” Journal of Indian Society of Periodontology, 2012.
  4. Relvas et al. “Study of Prevalence, Severity and Risk Factors of Periodontal Disease in a Portuguese Population.” Journal of Clinical Medicine, 2022.
  5. Gayatri et al. “Behavioral risk factors and periodontal disease in Malang, Indonesia.” Gaceta Sanitaria, 2021.
  6. Liccardo et al. “Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease.” International Journal of Molecular Sciences, 2019.
  7. Bingham et al. “Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions.” Current Opinion in Rheumatology, 2013.
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