Smoking - Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment.
Hormonal changes in girls/women - These changes can make gums more sensitive and make it easier for gingivitis to develop.
Diabetes - People with diabetes are at higher risk for developing infections, including gum disease.
Other illnesses - Diseases like cancer or AIDS and their treatments can also negatively affect the health of gums.
Medications - There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep teeth and gums clean. Genetic susceptibility. Some people are more prone to severe gum disease than others.

People usually don’t show signs of gum disease until they are in their 30s or 40s. Men are more likely to have gum disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.

Symptoms of gum disease include:

• Bad breath that won’t go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Receding gums or longer appearing teeth

Any of these symptoms may be a sign of a serious problem, which should be checked by a dentist. At your dental visit the dentist or hygienist should:

Ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to gum disease.
Examine your gums and note any signs of inflammation.
Use a tiny ruler called a “probe” to check for and measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters. This test for pocket depth is usually painless.

The dentist or hygienist may also:

Take an x-ray to see whether there is any bone loss.
Refer you to a periodontist. Periodontists are experts in the diagnosis and treatment of gum disease and may provide you with treatment options that are not offered by your dentist.