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When you’re a kid, you fear cavities. When you’re an adult? Well, where to buy generic tribulus paypal payment no prescription clues for cavities are still on your radar—but early sigs of gum disease should be, too.

You’re likely familiar with the concept of gum disease from talking to your dentist, but if you’ve assumed it’s an older person’s disease, you’d be wrong. Gum disease can affect adults of all ages. Even the early signs and symptoms can cause significant discomfort.

Here, a dentist breaks down what to watch out for and how to reduce your risk.

What is gum disease?

Gum disease, also known as periodontal disease, is caused when plaque (bacteria) builds up between the gums and teeth, says Vera W. L. Tang, DDS, a clinical assistant professor of periodontology and implant dentistry at NYU College of Dentistry.

“When the bacteria begin to grow and increase, the gums surrounding the tooth initially become inflamed, [causing] gingivitis,” Dr. Tang explains. ”When left untreated, this inflammation can continue to invade and break down the bone supporting the teeth, causing what’s known as periodontitis. This can cause gums to recede or even continue to cause tooth loss.”

What causes gum disease?

According to Dr. Tang, there are a long list of factors that may contribute to early gum disease (gingivitis): diabetes, smoking, aging, genetic predisposition, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and the use of certain medications.

Research has [also] shown that gum disease may be associated with other systemic diseases, such as diabetes, heart disease, rheumatoid arthritis, low birth weight babies, respiratory diseases, osteoporosis, cancer, and Alzheimer’s disease,” she says.

Gum disease isn’t limited to older adults, either. According to data from the Centers for Disease Control and Prevention (CDC) on the prevalence of periodontal disease, about one out of two American adults over the age of 30 have periodontal disease.

“In adults over the age of 65 years, the prevalence jumps to 70 percent,” Dr. Tang says. “People with a genetic predisposition, smokers and people with diabetes have a significantly higher risk.”

What are the symptoms of gum disease?

Gum disease is often silent and signs and symptoms may not show up until much later, Dr. Tang says. Still, here’s what to watch out for:

  • Bleeding while brushing or flossing. This is commonly due to plaque or tartar build-up. The American Dental Association advises brushing teeth twice a day and cleaning in between teeth (like flossing) once a day.
  • Red, swollen or tender gums. Gums that appear swollen, irritated and sensitive is a sign of mild gingivitis.
  • Receding gums. Gum recession exposes more of the root of teeth, making them appear longer than normal.
  • Loose teeth. Gum disease can lead to loose teeth or even eventual tooth loss, so this is definitely not a symptom to ignore.
  • Increasing gaps between teeth or shifting teeth. This is also often caused by swollen gums due to bacterial build-up.
  • Gum and/or tooth infection. You’ll notice throbbing tooth pain that may come on suddenly and gradually get worse. (Call your dentist asap.)
  • Halitosis, or bad breath. It lingers long after the morning malodor. Persistent bad breath and an unpleasant taste in your mouth can also be a sign of gum disease.

How can you prevent gum disease?

The good news is that you’re not destined to get gum disease, though prevention is key, Dr. Tang says. “Brush and floss your teeth to remove food debris and plaque trapped between your teeth and gums, especially along the gum line,” she advises. “Mouthwash can help reduce plaque and can remove remaining food particles that brushing and flossing may have missed.

Finally, ask your dentist how often you should make an appointment for a cleaning. While insurance often covers twice yearly cleanings, if you’re particularly at risk for periodontal disease, have gingivitis, or have had either condition, your dentist may advise coming in more often. This schedule is important to stick with, as seeing your dentist will catch symptoms sooner (where they’re not as severe and can be more easily addressed) a determine if you’re dealing with a more serious issue.

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