What is Gum disease?
Gum disease is a very common condition affecting most adults in some form. It can be described as swelling, soreness or infection of the tissues that support the teeth.
There are two main types of gum disease: Gingivitis and Periodontitis.
Gingivitis; This is the inflammation of your gums, the gums will become red and swollen and may bleed when you brush. If left untreated this can lead to periodontitis.
Periodontitis; This is when the bacterial plaque destroy the gums, soft tissue and eventually the bones that hold your teeth causing the teeth to become loose.
It is important to diagnose gum disease early. Gingivitis (the early stage of gum disease) is completely reversible, however, periodontitis cannot be reversed but can be maintained. This means that your dentist or hygienist can stop it getting any worse but if you stop following oral hygiene instructions the the disease will return.
Did you know that periodontal disease is the main reason why adults lose their teeth?
What causes Gum Disease?
Gum disease is caused by plaque which is a film of bacteria which forms on the surface of the teeth every day when you eat and drink. Many of the bacteria in the plaque are harmless, but there some that have been shown to cause gum disease. To prevent and treat gum disease you need to ensure that you remove all the plaque from your teeth every day. If plaque is not removed it hardens to form calculus or tartar which sticks more firmly to the teeth and can only be removed by your dentist or hygienist.
How Can I Prevent Gum Disease?
Brushing two times a day is not always enough. Some areas are likely to be missed every time you brush, even with excellent brushing it is impossible to clean in between the teeth as the bristles of your brush just won’t reach these areas. Cleaning in between the teeth (interdentally) is just as important as brushing. Interdental cleaning is done using floss, tape or interdental brushes such as tepe brushes. Your dentist or hygienist will show you how to use these effectively.
Periodontal disease will affect different people in different ways. There is a genetic element to the disease, this means that some people may not clean their teeth very well but may not develop severe periodontal disease. Other people who may have a lower resistance to periodontal disease have to spend longer cleaning and may need to see their dentist or hygienist more regularly.
Symptoms of Gum Disease
Healthy gums should be pink and firm and should not bleed when you touch or brush them. Gum disease is not always painful and many patients are unaware that they have it.
- Red and swollen gums
- Bleeding gums after brushing or flossing
- Bad breath (Halitosis)
- Unpleasant taste in the mouth
- Loose teeth that can make eating difficult
- Gum abscesses (collection of pus that develops under the gums or teeth)
- Receding gums
- Movement of the teeth/spaces appearing in between your teeth
The following factors increase the risk of you developing problems with your gums;
- Smoking — has a significant impact on the health of your gums
- Age —gum disease becomes more common as you get older
- Family history of gum disease (Genetics)
- Diabetes — poorly controlled diabetes may increase your risk of gum disease
- Weakened immune system — eg. HIV/AIDS or chemotherapy
- Certain medications
- Hormonal changes — such as those related to pregnancy
Treatment for gum disease
The best way to treat gum disease is to practice good oral hygiene on a daily basis.
- Brush your teeth 2-3 times a day for 2 minutes each time, preferably with an electric toothbrush.
- Clean interdentally using floss or tape of tepe brushes at least once a day.
- Visit your dentist regularly.
Your dentist may recommend that you use a mouthwash, this helps to control the build up of plaque on your teeth.
Scale and Polish
This is a professional clean carried out by either the dentist or hygienist to remove any plaque and calculus that has built up. If there is a lot of calculus built up you may need more than a scale and polish. You will also be shown how to clean your teeth effectively to help prevent plaque build up in the future.
Root Planing/ Root Surface Debridement
This is a deeper clean under the gums and removes bacteria form the roots of the teeth. This usually involves local anaesthetic to numb the area in order to make the treatment more comfortable and allow the dentist or hygienist to do a thorough job. You may experience some pain and discomfort for up to 48 hours after having root surface debridement.
If you have severe gum disease you may need to have periodontal surgery and in the worst cases the affected teeth may need to be extracted. Your dentist can refer you to a specialist in the treatment of periodontal surgery. Occasionally treatment with antibiotics may be necessary.
Acute Necrotising Ulcerative Gingivitis(ANUG)
In rare cases a condition called Acute Necrotising Ulcerative Gingivitis can develop suddenly. Symptoms are usually more severe than gum disease and include;
- Bleeding, painful gums
- Painful ulcers
- Receding gums in between your teeth
- Bad breath
- Metallic taste in your mouth
- Excessive saliva in your mouth
- Difficulty swallowing or talking
- High temperature (fever)
For this specific type of gum disease treatment with antibiotics such as metronidazole and amoxicillin may be recommended. In addition mouthwash that contains chlorhexidine or hydrogen peroxide may be prescribed.
Smoking and Gum Disease
People who smoke are more likely to have gum disease. Smoking can change the bacteria in dental plaque, increasing the number of bacteria that are more harmful. It also reduces the blood flow in the gums and supporting tissues of the tooth and makes them more likely to become inflamed. Gum disease in smokers will become worse more quickly compared with non smokers. Because of the reduced blood flow smokers may not get the warning symptoms of bleeding gums as much as non smokers.
Once I have Periodontal Disease, can I get it again?
Periodontal disease is never cured but it can be controlled, as long as you keep up the home care regime you have been taught. Any further loss of bone will be very slow and it may stop altogether. However you must make sure you remove plaque every day and go for regular check ups.
Gum Disease has been linked with other health conditions.
In recent years gum diseae has been linked with general health conditions such as diabetes, strokes, cardiovascular (heart) disease, poor pregnancy outcomes and even dementia. More research is needed to understand exactly how these links work however there is increasing evidence that having a healthy mouth and gums can help improve general health.
How gum disease can affect Diabetes
The latest research into diabetes and gum disease found that; in people with diabetes, those that have severe gum disease have higher blood sugar levels compared to those with healthier gums. Even if you don’t have diabetes your body’s control of blood sugar levels is not as good as it should be when you have severe gum disease. The worse the gum disease the more likely the person is to go on to suffer damage to other organs in their body because of their diabetes, these include heart and kidney disease. Having severe gum disease might actually increase your chance of getting type 2 diabetes.
Patients with WELL CONTROLLED DIABETES are NOT at any higher risk of periodontal disease when compared with non diabetics.