June 6, 2023

Every kid needs a healthy smile — and strong teeth are just part of the equation. While a cavity affects only the tooth, gum disease can inflame the gums and damage the bones and surrounding tissues of the mouth. Although you might associate gum disease with older people, it can be a problem for children and teens, too. We asked Boston Children’s dentist Rosalyn Sulyanto and dental hygienist Victoria Grady to share their most important tips for families.
Dental plaque — the sticky film that forms when bacteria in the mouth release acids that break down the carbohydrates of foods and drinks — is the root of both cavities and gum disease. Everyone has plaque, but whether it becomes a problem depends on how well you brush and floss. When plaque builds up and hardens, it becomes tartar, which is hard to remove with a toothbrush and can lead to chronic irritation of the gums.
Gingivitis is the most common type of gum disease in children. It’s also the mildest form and can be treated without surgery or medication. Symptoms are easy to detect: Your child’s gums may look red, feel swollen and tender, and bleed easily during brushing and flossing. The good news? With consistent brushing and flossing — and regular cleanings by a dental hygienist — gingivitis is treatable.
Gum disease isn’t always a matter of inadequate oral hygiene. Other conditions can contribute to gingivitis and periodontitis, a more serious form of gum disease, in both kids and adults. Crowded teeth are harder to clean and can lead to tartar. Malocclusion, the irregular contact between the upper and lower jaws, can also cause foods to get stuck in gums. Open-mouth breathing can dry the mouth and change the composition of natural bacteria, leading to gum disease. 
Some studies have shown the bacteria that inflames gums might do the same to the heart and lungs. Gum disease is also associated with poor control of blood-sugar levels, and in diabetics, a weakened immune system might exacerbate the effects of periodontitis.
Advanced periodontitis is uncommon in children — but it can occur. Gums receding from teeth, loose teeth, and persistent bad breath are signs of moderate-to-severe gum disease. Treatments include a deep cleaning of the teeth and gums to remove plaque and tartar, or may involve one of several kinds of grafts to restore gum tissue.
Consistent dental care at home and regular dental exams and cleanings will prevent gum disease in most children. With your help or on their own, have your child floss daily. Also have them gently brush in a circular motion each tooth and the gumline, at a 45-degree angle, with a soft-bristled toothbrush dabbed with fluoride toothpaste at least twice a day. It also doesn’t hurt to brush and floss after every meal. Children who care for their teeth on their own can also use an antibacterial mouth rinse. If your child has an oral condition that prevents thorough brushing and flossing, or has a disease that inflames their gums, talk with your dentist. 
Learn more about Boston Children’s Department of Dentistry or make an appointment.
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