Periodontal Disease (gum disease):

What is gum disease:

Gum disease is very common, affecting people of all ages. It is the most common cause of tooth loss in adults. Gum disease is very easy to prevent. All it takes is brushing and flossing. But, once affected by gum disease it can be a challenge to reverse the damage. Gum disease can be treated by your dentist or hygienist and if treated in the early stages its effects can be reversed

Gum Disease or periodontal disease is when the gums start pulling away or receding from the teeth. This can eventually lead to bone loss and then tooth loss. The gums start receding when plaque and calculus build up around the base of the teeth. Plaque builds up daily on teeth.  This build up can be controlled by regular daily brushing and flossing. As this plaque builds up overtime it hardens and becomes calculus. Studies show that mouth rinses are effective at inhibiting plaque build-up, but not removing it. Built-up plaque that becomes calculus can only be removed by professional cleaning. Regular cleaning by a dentist or hygienist will, with proper daily brushing and flossing, prevent periodontal disease.

 

Periodontal disease progresses through three stages; gingivitis, periodontitis and advanced periodontitis. Gingivitis can usually be successfully treated by improved dental hygiene (brushing and flossing) and twice annual visits to a dental office for a professional cleaning. Untreated gingivitis will progress into periodontitis (bone loss).

Gum Grafting: Sometimes grafting can be done to cover up exposed roots due to gum disease. Example

The following are examples of the different stages of gum disease and treatments done.

Bone loss, hard to clean areas, inflamed gums

 

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Bone loss due to gum disease. Home care is difficult in hard to clean areas   Red gums & lack of flossing. Notice how inflamed the gums are.

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Deep Cleaning: Before and After

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Notice how raw and red the gums are after the calculus is removed. Calculus/Tartar buildup, with half of deep cleaning done The gums will heal.

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Stains and Tartar buildup.

Gum Grafting to cover root exposure.

Symptoms of Periodontitis (gum disease with bone loss)

- Red, puffy gums

- Gum tenderness and/or pain

- Gums that bleed during brushing and flossing

- Persistent bad breath or bad taste in the mouth

- Changes in the way teeth fit together when you bite

- Teeth that have shifted or loosened

- Pus coming from between teeth and gums

- Gums that have separated from the teeth

- Teeth that look longer because the gums have receded

What makes gum disease more likely?

Gum disease happens when plaque builds up because the teeth are not cleaned properly. This is more likely to happen if you find it difficult to clean your teeth properly, for example if you wear braces, have dentures or have irregularities in your teeth that you can't reach with a toothbrush.

There are other factors that can make you more likely to get gum disease. These include:

smoking - this reduces the blood flow to the gums, which slows healing
diabetes - this can also delay gum healing
hormonal changes, for example during pregnancy
having close relatives who suffered from gum disease

In all of these cases though, the cause of the gum disease is the build up of plaque.

Symptoms of gum disease

You may not know if you have gum disease. Often it is not painful and some people with gum disease have no symptoms.

Usually the first sign of gum disease is bleeding from the gums when you brush your teeth. Your gums may also be red and swollen and you may have bad breath and an unpleasant or metallic taste in your mouth.

If gum disease has been left untreated, your teeth can become wobbly and you may get gum abscesses (pus collecting under the gum).

Preventing gum disease

Preventing gum disease involves controlling the amount of plaque and tartar that builds up on your teeth. Regular visits to your dentist or hygienist, brushing and flossing your teeth regularly and stopping smoking will help to do this.

Your dentist or hygienist can show you the correct way to brush, floss and use inter-dental brushes. Dental floss or inter-dental brushes are used to remove plaque and particles of food from between the teeth and under the gumline. These are areas that a toothbrush cannot reach. Even thorough brushing and flossing cannot remove every trace of plaque. Most people have irregularities in their teeth where plaque can build up out of reach and harden into tartar. This can only be removed by a dentist or hygienist using special scraping tools in a process called scaling.

How is gum disease treated?

Treatment needs to be given by a dentist or hygienist. The type of treatment depends on how severe the gum disease has become.

If you have gingivitis, your dentist or hygienist will clean your teeth thoroughly using a scaler and an electric toothbrush with gritty toothpaste. He or she may also recommend an antiseptic mouthwash such as chlorhexidine (eg Peridex) that helps prevent plaque forming. He or she will also teach you how to brush and floss your teeth properly.

If gum disease has progressed to periodontitis, you may need more extensive scaling to remove plaque and tartar from the pockets that have formed. This can take several appointments with the dentist or hygienist. You may need to have your gums numbed with an injection of local anesthetic before the scaling, and you may feel a little discomfort afterwards.5 Your dentist or hygienist will monitor the size of the pockets during the following months to make sure the treatment has been successful and the periodontal disease is not getting any worse.

If your gum disease is more serious, the pockets may be too deep for a dentist or hygienist to clean simply by scaling. You may then need gum surgery, which can be carried out by your dentist. Alternatively you may be referred to a periodontist, a dentist who specializes in treating periodontitis. He or she will push the gums away from the teeth to get access to the roots and clean them.

For any of the treatments to be successful you need to put time and effort into cleaning your gums and teeth. You will have to follow what your dentist has taught you to make sure you remove plaque every day. If you smoke, it is likely that treatment will be less effective.