I f you had an infection on your arm or leg that was eating away at your bones and ligaments, you wouldn't rest until it was cured. Unfortunately, many people allow this situation to exist in their mouths -- putting not just their teeth but their lives at risk. The longer gum disease is present, the more damaging it will be to your health. As we age, other health issues appear, so those who have had gum disease the longest are at greater risk.

Problem: When the bacterial infection associated with gum disease moves into your mouth's bony tissue -- a condition called periodontal disease -- it quickly causes inflammation and triggers the liver to release C-reactive protein (CRP) into the bloodstream. Elevated levels of CRP have been linked to arterial damage and plaque. Worse still, this same circulating bacteria increases risk of stroke, diabetes, respiratory ailments, osteoporosis and digestive problems, and puts constant stress on your immune system, lowering your resistance to other infections.

Good news: Even advanced gum disease can be reversed with regular visits to a dentist and a lifetime program of careful oral hygiene.

Spotting Gum Disease

Healthy gums are firm and pinkish in color and form a collar-like rim around the teeth. They are not tender and don't bleed when you brush or floss. If your gums are red, tender or swollen or if they bleed when you brush your teeth, you probably have early-stage gum disease, known as gingivitis.

Left untreated, gingivitis eventually progresses to periodontal disease, marked by tooth and gum sensitivity to heat, cold, sugar or acidic foods... bad breath... chronic gum bleeding (when eating, brushing, flossing or when any pressure is applied to gums)... sudden throbbing pain or deep, dull pain in the teeth and gums... and loose teeth.

If you have any of these symptoms, see a dentist immediately. Even if you think your teeth and gums are healthy, you should visit your dentist at least once a year for an oral checkup. During this checkup, a registered dental hygienist should evaluate your gums by using a small metal device to gauge the depth of the "pockets" at the base of each tooth. The severity of gum disease depends on the pocket...

Pockets of between 1 millimeter (mm) and 3 mm may indicate gingivitis, which can typically be cared for by your hygienist. These pockets usually respond to regular cleanings and careful home oral hygiene.

Pockets deeper than 3 mm -- your hygienist may also perform a scaling procedure, scraping away unhealthy gum tissue, plaque and tartar to allow new, healthy tissue to form.

Pockets deeper than 5 mm usually indicate more advanced periodontal disease. In this case, you should consider seeing a periodontist for special care. Typically, treatments are scheduled every one to two months until the disease clears up. Early periodontal disease is treated the same as gingivitis -- but you must floss, use an irrigator and have frequent deep cleanings.

For advanced periodontal disease, the periodontist may cut away part of the gum to reduce the pocket size, thus shrinking the available breeding ground for bacteria.

Home Care for Gum Disease

For home care, brushing, flossing and a water irrigator are the king, queen and crown prince of oral hygiene. Here are some tips for using these tools effectively...

Brushing. When brushing, work on the gums as well as the tooth surface. Follow this pattern -- the insides of your teeth, the outsides of your teeth, the back sides of your back teeth and, finally, the chewing surfaces. After brushing, rinse your brush with warm water to remove as much bacteria as possible. Let your toothbrush dry completely before reusing.

Use a soft-bristle brush, and replace it every few months. If you've been sick, such as with a cold or the flu, replace your toothbrush or sterilize it in boiling water. To minimize buildup of bacteria-filled plaque, brush in the morning after waking, as soon as possible after every meal and before going to bed.

Flossing. Floss at least once a day. If you brush and floss together, always brush first.

To floss properly, wrap the floss around the middle fingers of each hand, then use your forefingers to manipulate the floss. Pull the floss up or down the side of one tooth until it presses against the gum, then slide it up and down six to eight times while pulling it back and forth against the tooth surface, as if shining a shoe. Next, do the same on the opposite side. Finally, rub the floss back and forth over the gum tissue in the crevice of the teeth several times. You can either use a fresh area of the floss for each tooth or wipe the floss with a tissue prior to flossing each tooth.

Mouthwash. If you have gum disease, you should use an antibacterial mouthwash, such as Listerine or Tom's of Maine, after every brushing or flossing session. Your dentist may recommend a prescription mouthwash, such as Peridex, instead of over-the-counter mouthwash. Rinse your teeth vigorously for at least 20 seconds, being careful to suck the liquid between your teeth, then finish by gargling.

Water irrigators. For pockets deeper than 4 mm, you may want to add a water irrigator to your home regimen.

Reason: This device, which emits a pulsing stream of water, reaches deep into the pockets to remove bacteria that brushing, flossing and mouthwash can't reach. I recommend the Teledyne Water Pik with the Pik Pocket Subgingival Tip (about $80) or the Braun Oral-B 7900 DLX OxyJet 3D Center (about $140). Use the irrigator after every brushing and flossing session. Fill with either antibacterial mouthwash... a half-and-half mixture of mouthwash and water... or water to which a half teaspoon of salt has been added. The liquid should be body temperature. Start on the machine's lowest setting, and concentrate on the areas where the pockets are deepest. Ask your dentist's office for a copy of your periodontal pocket chart and guidelines for using the device

Diet and Nutrition

Avoid foods containing sugar, which is a favorite food for bacteria. Also include in your diet raw or lightly steamed vegetables and fruits and whole grains.

Reason: Unlike refined sugar, the particles in whole grains and rice are too large for bacteria to ingest. If you eat foods that contain sugar, finish your meal with something raw and fibrous, such as an apple. Rinse your mouth or brush your teeth immediately afterward.

Nutritional supplements that support gum health: A good multivitamin (preferably one that requires taking two capsules a day to get the full dose -- one with breakfast and one with dinner)... 3,000 mg per day of the ascorbate form of vitamin C (taken in three 1,000-mg doses, with breakfast, lunch and dinner)... 500 mg per day of the powerful antioxidant N-acetyl cysteine, sold in health-food stores as NAC (two 250-mg pills taken with breakfast and dinner work best).