Dentist Questions Periodontal Disease

I don't understand how I got Periodontal disease

I brush my teeth regularly, how can I have gotten periodontal disease? I also floss once per day, at night. This runs in my family, but my family also doesn't really take much care of their teeth. Can it be genetic anyway?

29 Answers

There can be a genetic factor to gum disease, though it is not absolute. You did not mention how often you get your teeth checked and professionally cleaned. This can play a major role in preventing gum disease.
No! Have your dentist watch you brush and floss. You are most likely doing it wrong.
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Periodontal disease depends on a number of factors. Genetics is one of them but you can't change that. Make sure you get your mouth healthy by going to your dentist and following his/her suggestions. Also discuss your diet with your dental provider.
You need professional help. Also, your brushing and flossing needs to be reevaluated.
Genetics play some role in perio - gum problems, but you can control it by meticulous oral hygiene with following proper technique of brushing and flossing. Timing plays a super important part. The night brushing has to be meticulous, and long. I recommend to brush for 4 minutes in some cases, taking your time and overlooking yourself in the mirror. It is very helpful to use electric toothbrush that has a timer build in.
As with any other oral condition, the progression of the disease is influenced by a number of factors including genetics, habits, home hygiene, diet, and composition of the oral flora. If identified early enough, periodontal disease does not need to progress to the point of losing teeth.

Increasing dental hygiene recall frequency, proper home hygiene with a few dental adjuncts, smoking cessation, and a proper diet are indicated in a person who is at risk.

A proper dental exam and radiographs would be necessary to more specifically answer your question.
Yes, there is a genetic component to periodontal disease. Keep brushing 2-3 times a day and floss daily, so you stabilize and don't let it get worse.

Lara Bacchelli
While there are genetic factors that predispose people to periodontal disease, the key to managing or preventing it is to keep one’s mouth impeccably clean for the vast majority of a 24 hr. day. As part of the treatment for this disease, we use a pink food coloring to show our patients where they may be missing with their brush and floss. People are often surprised how much plaque (mixture of food, debris, and bacteria) there is on and between their teeth.

To treat periodontal disease, I recommend the following
1. Deep cleaning to remove the calculus/tartar (hard stone like material) stuck on one’s teeth, both above and under the gumline. This is a step that must be done by a dental professional because brushing alone will not remove it.
2. Use of a Oral B Braun motorized toothbrush with instructions and coaching on how to use it optimally. I minimally suggest brushing with a Braun motorized brush and flossing after breakfast in the morning AND at night before bed to remove the soft bacterial plaque. Note that most people brush their teeth before breakfast and go through the entire day with their teeth dirty.
3. Maintenance cleanings by a dentist or hygienist with the frequency determined by the severity of one’s disease.

For more information about periodontal disease, visit my website at

Periodontal disease has several causes including genetic predilection.

It could be any or more of the following common causes that may lead to periodontal disease. I am enumerating more common causes and potential remedies for them below.

- Poor oral hygiene lack of home care like brushing twice and flossing atleast once daily ( try to brush twice and floss twice daily) ,

- improper brushing, improper tooth brush selection and improper brushing technique used, ( try to use soft bristle tooth brush, small headed tooth brush, modified bass technique of brushing or other dentist recommended technique of brushing), use sonicaire or similar tooth brush

- which kind of floss you use ( try to use unwaxed floss if you have all natural teeth and less restorations in mouth, and try to use waxed floss if you have more restorations and multiple veneers , crowns in mouth)

- malocclusion or crowded teeth that makes things difficult to perform optimal oral hygiene, ( straighten the teeth with orthodontics or invisalign or braces)

- areas of mouth that lodges food debris and dofficult to clean or access ( try to get 3 to 6monthly professional dental hygene visits to make sure everything is checked and cleaned more frequently if you have higher risk of developing periodontal disease.

- certain medical conditions make it more susceptible or rapid development of periodontal disease like diabetes or other organic disease. Also there are several studies that shows direct correlation between periodontal disease and heart conditions, and other general health related situations.

There are a lot of other potential reasons that can lead to periodontal disease and that needs to be evaluated for reasons affecting you and your family.

In your case please have yourself evaluated from a dentist or periodontist as to why you have periodontal disease and follow the recommended treatment to help preserve the gums and teeth at an earlier stage.

Hope this helps.

Devang Shah DMD
Yes about 20% of people are genetically predisposed to gum disease. Routine brushing and flossing is not effective in treating PD. You must see your dentist
Yes! Peridontal disease can conme from hereditary. With that said, there are also a lot of factors that can contribute to chronic periodontal disease: smoking, diabetes, pregnancy, trauma from having misalign teeth, genetic, and as well as oral hygiene. Unfortunately, it is something we cannot cure but only to maintain and do what we can to prevent from getting worse. Just to clarify that gingivitis is not periodontal disease. Periodontal disease can mask by smoking since it will show no symptoms in smokers. Periodontal disease is when your underlying bone which support your teeth and gum begin to disintegrate that if serious can lead to infection and tooth loss. What you can only do at this point is to maintain it and best to go to the dentist every 3 months for a maintaince, a daily prescription rinse Peridex can also help, and of course home care and avoid risk factors that correlate to this chronic oral disease. Thanks for your question.
Genetics can definitely be a significant factor in an individuals
susceptibility to gum disease. Other factors include systemic diseases,
particularly diabetes, or other conditions that can trigger inflammation in
the body. Periodontal disease is an infection of the gums and bone around
the teeth and, just like any other infection, the strength of your bodies
immune system can affect your ability to fight the disease.
Having any of these associated risk factors does not necessarily mean you
can't develop and maintain a healthy mouth. Periodontal disease is very
treatable in the earlier stages through effective professional and home
care and maintaining periodontal health may simply mean visiting your
dentist on a more frequent basis for preventive care which might include
cleaning deeper below the gum line in the space between your teeth and gums.
You dont have to feel guilty and so bad. You r not alone by no means. Factors leading to periodontal disease to name a few are plaque and calculus build up, dental work that s not optimal, teeth grinding and clenching or heavy biting and yes genetics. In my opinion and experience though if the other factors are not there genetics alone is less likely to cause trouble.
Thankfully there is advances in the field and there s help to improve.
Hope this helps
There are a variety of reasons people can get periodontal disease and age and genetics play a part. Home care can help keep periodontal disease under control for a while, but a professional should be measuring sulci on a yearly basis. The mouth is constantly changing and with all the things we do with our mouths, there is wear and tear on our teeth and gums. If there is a biological defect (due to an extraction, recession or alignment of teeth), homecare isn't enough to keep those areas healthy. Many adults have periodontal disease and some are more susceptible and have a faster disease process than others.

Hope this helps,
Jossi Stokes, DDS
Periodontal disease is primarily genetic. You can mitigate the damage by
maintaining perfect hygiene, and having your dentist evaluate options,
whether they involve more scaling or prescription rinses.
There is soft build up that accumulates on your teeth called plaque. This soft build up if not removed will turn into calculus. If this is not removed bacteria will start to migrate under the gums. Your body then tries to remove the bacteria but is unable to which results in bone loss. Certain factors can make it easier for periodontal disease to form, and the specific mixture of bacteria that inhabit your mouth can allow for periodontal disease to take hold more easily. Some people even build up plaque and calculus at faster rates. Brushing and flossing alone may not remove these build ups especially in back teeth where our brushing skills tend to fall off. This is why regular dental cleanings are extremely important and if your teeth are being cleaned in 10-15 minutes then you are likely not receiving the level of care you deserve. But also keep in mind how we brush and floss is extremely important. Angling the brush into the gums where the gums meet the teeth so the bristles clean the crevice where tooth and gum meet is important. And when flossing you need to pull the floss around the tooth and move in and under the gum space within reason don't hurt yourself. Simple snapping the floss down and out will not clean the teeth properly. Doing these things will prevent you from having periodontal issues whether your family has had periodontal disease or not. Also if you want to keep your teeth, don't smoke!
Periodontal disease means that you have bone loss. There are a few things
that can cause this. When you look at your xrays you should see root above
the bone level to be sure that this is the condition you have. This is
commonly misdiagnosed. I hope this helps but without seeing xrays I won't
be able to confidently answer.
Dr. Ravi Ramjit D.D.S
Sometimes there can be genetic issues that can make you more prone to periodontal disease. It is important that you get properly examined and treated, to prevent damage to the supporting structures (gums and bone)
Good afternoom and thank you for your qestion. Periodontal disease, I would say have a complex pathogenesis, and a lot factors contribuiting to its etiology, like a myriad of microorganisms. Since 1930 exist the theory that host genetic make-up may act in combination with environmental factors to influence periodontal disease and since 1930, it was concluded that susceptibility and immunity to periodontal disease were "probably inherited. Think in this fact: Not all people who smoke develop cancer. And yet, tobacco smoke contains over 4,700 chemical compounds, over 40 of which are acknowledged carcinogens.
So, the list of acknowledged and proven periodontal risk factors is relatively short and well-understood: smoking, stress, compromised immune system, and poor oral hygiene.
Clinical and laboratory research over the past decade, including family-group studies, the human-twin paradigm, and in-vitro evaluation of human cellular responses to bacteria, have confirmed that there is a strong genetic component of susceptibility to periodontitis and periodontal destruction. This permits adding a fifth risk factor to the list: genetic susceptibility due to the IL-1 genotype. So, exist a genetic predisposition to Periodontal disease.
I hope this answer your qestion.

Dr Suarez
There is a definitive link between periodontal issues and genetics. Great
home care and great dental treatment are also important. Follow all of your
dentist's and hygienists recommendations. Make sure your dental office
is doing a periodontal assessment at least once a year when they measure
all of the areas around your teeth.
It definitely isn't fair, but periodontal disease is a complicated chronic disease. Even if you work harder than most, brushing and flossing regularly, it can still occur. There are many genetic factors that do play a role in the exacerbation of periodontal disease. Several of these include race, gender, diabetes, smoking and body mass index. Another important factor is that family members inadvertently transfer bacteria from sharing cups and silverware. Seeing your dentist regularly is important, because periodontal disease can sneak up on you, and there may not be any pain or other noticeable symptoms at first. Reaching every surface of all your teeth with regular brushing and flossing is impossible. Getting any buildup that develops in those unreachable areas is important in preventing periodontal problems from beginning or getting worse.
Gum disease could be genetic. However, bacterial plaque buildup around teeth is the main factor for gum disease. Other factors are secondary and can contribute to gum disease, these are smoking, systemic disease such as diabetes, and occlusal (bite) problems..

Keep up with the regular hygiene appointments at the dentist office (every 4-6 months ) in addition to good daily oral hygiene to reduce your risk.
Periodontal disease does have a genetic component, so yes that can be a factor. However, there are several reasons that can affect periodontal health. Diet and overall health definitely play a big part. In addition, even though a person may brush and floss, if their technique isn't done properly in order to access the the bacteria, build up and inflammation can still occur. If you have regular hygiene visits, these are things the hygienist and/or dentist can go over with you to make sure your techniques are proper. There are also procedures and therapeutic rinses that can help if you are not in an advanced stage where surgery is indicated. That is why it's important to keep regular checkups and ask questions at your visits to address your concerns.
In answer to your question, periodontal disease in part is hereditary. However, it can be overcome by proper oral hygiene.

Now, I don't know how advanced your periodontal disease is, or what your age is, or the condition of your mouth, but I can tell you that you need to brush correctly a minimum of twice a day, you need to floss, not once a day, but after every meal, and you need to use an affective mouth wash. You also need to come in at least 3 times a year for a regular dental cleaning if you have been diagnosed with gum disease, and initially you will need a deep cleaning, which
is a very thorough cleaning generally done under local anesthesia.

Lastly, there are dental factors that can make you more likely to get gum disease. For example if you have teeth crowding, that makes it more difficult for you to floss & keep the gums healthy. Another factor would be if you have your wisdom teeth, and they are in. That is a perfect place for bacteria to hide & breed, and almost an impossible place for you to keep clean. Gum disease can thrive in a place like that.

I hope I have been helpful. If you have any other questions, please do not hesitate to contact me.

Dr. Saad
There can be some genetic predisposition to certain diseases, however this doesn't mean they can not be avoided. Total plaque removal, custom designed for each patient and regular 6 month hygiene visits including a periodontal exam by the dentist are the best way to avoid the disease.
Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease. Gum disease can be caused by things other than poor hygiene. Tobacco use, pregnancy and menopause, chronic stress and poor diet, diabetes and underlining medical issues, grinding teeth and certain medications. I recommend you discuss these things with your dentist and they should help you figure out a solution.
First, make sure you do have periodontal disease. Periodontal disease causes "pockets" around your teeth which makes it difficult to clean by brushing only since the bristles of the brush don't get deep enough. This is why it is important to see your hygienist more frequently.
Periodontal disease can run in families because the aggressive bacteria can be passed between members of the families especially parents and kids as they grow up. This is a simple answer to your question.
Yes it is genetic. Some inflammatory cells are more active in other people based on genetics and can over respond to plaque in the gums.
Yes, periodontal disease does have a genetic component. Some people are more prone to "grow" more tartar than others. When this happens, you are then susceptible to having gum disease as the tartar causes the gums to bleed as it is recognized by your body as a foreign substance much like a splinter would if it was lodged in your finger. Prolonged exposure of the gums to tartar will result in the gums reacting to the tartar and bleeding and causing a cascade of inflammatory reaction resulting in bone loss or periodontal disease. We recommend that if you have gum disease, you visit your dentist at least every 3 months.