Which of the following is considered a primary cause of gum disease?

The accumulation of plaque is recognized as a primary cause of gum disease due to its direct role in the inflammatory response that leads to gingivitis and periodontal disease. Plaque is a soft, sticky film that forms on teeth and is primarily made up of bacteria, food particles, and saliva. When plaque is not removed through regular brushing and flossing, it hardens into tartar, further exacerbating gum irritation and inflammation. Over time, this ongoing buildup can lead to the destruction of the gum tissue and the supporting structures of the teeth, resulting in periodontitis.

While infrequent dental visits, improper brushing technique, and fluoride exposure can also impact oral health, they do not have the same direct causal relationship with gum disease as plaque accumulation. Infrequent dental visits might lead to plaque buildup but are not the primary cause themselves. Similarly, improper brushing technique may contribute to the retention of plaque but ultimately does not initiate the disease process. Fluoride exposure is beneficial in strengthening tooth enamel and helping to prevent cavities, rather than being a cause of gum disease. Therefore, focusing on the control of plaque is essential for preventing and managing gum disease.