Losing teeth once you start to hit your 70s and 80s may be common, but it is not a natural part of the aging process. Tooth loss is primarily caused by disease, plain and simple: periodontal disease, in particular.

Historically, tooth loss has been caused by tooth decay (cavities) as much as periodontal disease, but as dental care has become more prevalent in developed nations, fewer healthy adults and children lose teeth this way. Caught early enough, we can usually restore a decaying tooth with either a filling, root canal treatment, and/or dental crown. Once restored, that tooth has only a very small chance of being re-infected and will function properly for years to come.

Today, when you see a person wearing dentures, the number one cause of such widespread tooth loss is gum disease. Unlike tooth decay, gum disease is a chronic and systemic disease. Tooth decay can affect one tooth and not others. Once gum disease has set in, however, you have the condition for life, and all your teeth may become threatened by infected gum tissue.

Gum disease is caused by bacterial infection, the same as tooth decay, but instead of destroying tooth enamel, the bacteria colonize your gum tissue in the small pockets of space between the gums and tooth roots. As more and more bacteria take over, tissue is destroyed by bacterial excretions and periodontal pockets get deeper. As the condition worsens, gum tissue dies, bacteria damage tooth roots by causing sub-gingival decay, and eventually the jaw bone will suffer damage.

Without healthy gum tissue to support them, tooth roots become unstable—much like a tree that becomes imbalanced from soil erosion. Soon, all the teeth may become loosened and misaligned. As the condition worsens there is a tipping point when extractions and dentures are the only suitable solution.

The Best Way to Prevent Gum Disease

A lot of people have the misperception that flossing is what you do to remove food from between your teeth. In truth, the major oral health benefit of flossing comes from removing bacteria and plaque from the edges of the gum line. If you fail to floss daily, you are harboring microscopic bacteria in your gum tissue and are on a fast road to periodontal disease.

Part of the problem, of course, is that the less you floss, the less likely you are to start flossing daily. When you don’t floss every day, sporadic flossing causes soreness and bleeding gums. It is counterintuitive to floss again the next day when your gums are still sore from flossing yesterday! As a dentist, I know that that’s exactly what you should do, however. If your gums bleed when you floss—keep flossing! Within two weeks the bleeding will subside, if not stop outright.

In America, at least, there is a great disconnect between the importance of tooth-brushing and flossing among the general population. We see advertisements for toothpastes and tooth brushes everywhere—but rarely do we see advertisements for floss. I’ve always thought we could save a lot of teeth if we could just make flossing as visible in the public sphere as brushing is.

If using loose floss is difficult for you, there are a number of flossing alternatives that are equally effective at removing bacteria. Pre-loaded flossing picks, end-tufted brushes, and oral irrigators (water flossers) are all viable options for daily gum disease prevention.

In addition to flossing, seeing a dentist regularly is the best thing you can do for your oral health. If going to the dentist is only something you think of when a toothache arises, you are missing out on the amazing power of prevention and early detection.

Many people are slowly suffering the effects of gum disease and do not even know it, since symptoms can often be "silent." We dentists see things happening in your mouth you do not notice in your daily tooth brushing sessions. We can identify dental and periodontal issues before they become costly and painful situations.

If You Have a Gum Disease Diagnosis

If you are already at the point that you have a positive diagnosis of gingivitis or periodontitis, the best thing you can do prevent losing your teeth is listen to your dentist and follow his or her recommended treatments.

Like many other diseases, gum disease is treatable. By following their dentists’ recommendations, many patients can reduce the amount of bacteria that infect and re-infect the gums. If you comply with recommended treatments (scaling and planing, prescription rinses, gum graft surgery, etc.) you will have a better chance at keeping your teeth for life. The more vigilant you are, the better the damage can be minimized.