It is possible to have periodontal diseases and not know it. In it’s early stages it is usually painless and often without noticeable symptoms. The unfortunate truth is that 4 out of 5 people have active periodontal disease and are not aware of it. Poor oral hygiene is the most common cause, but there are many other contributing factors, including-
Smoking or chewing tobacco
Certain medications- Steroids, cancer therapy drugs, oral contraceptives, blood pressure drugs, and others that cause dry mouth.
Pregnancy, puberty, menopause, oral contraceptives- all cause changes in hormone levels resulting in increased gum tissue sensitivity to bacteria.
Systemic diseases- Diabetes, blood cell disorders, HIV, etc.
Possible genetic role- patients with a family history of tooth loss may be predisposed to gum disease. They should be extra attentive to their gum health.