August 6, 2020
Oral health during Covid-19 lockdown.
Welcome to issue 23 of our newsletter. In this issue we will discuss gum disease in two parts. The first of two articles will deal with-What is gum disease? And the second will address- How to manage gum disease?
Gum disease is a disease which affects the gums around the teeth. It is caused by a build-up of plaque on the tooth surface at the gum line. As the plaque film increases in thickness, as a result of a lack of tooth brushing, the type of bacteria in the plaque mass changes to favour harmful bacteria to increase in number. The body will try to contain the build-up of bacteria at the gum line and consequently the gums become inflamed. What you will notice is the gums will bleed every time you touch it. When the condition worsens the bleeding increases in volume and there may be some discomfort.
Figure 1. This shows a poorly maintained mouth with significant gum disease. The black areas around the gum line is the heavy plaque build up which has calcified to become calculus.
In most cases bad breath will also be present as the bacteria causes fermentation and releases certain odours.
Figure 2. Different types of gum disease. Courtesy of My Houston dentist.
There are two main types of gum disease, gingivitis and periodontitis. Gingivitis only affects the gums. The name defines the disease as inflammation of the gum tissue only. However, Periodontitis is a more severe form of gum disease which involves the loss of bone height surrounding the teeth. When too much bone is lost the tooth starts to become loose and in extreme cases fall out.
Periodontitis is a condition which has a multifactorial cause. Some individuals are genetically primed to develop the disease. These individuals will often have a specific type of bacteria in their mouths which causes the bone to break down. In addition individuals with the disease have an immune system which causes the bone to break down as it tries to contain the disease.
When the bone breaks down around the teeth, the gum line recedes. The recession of gums leads to exposure of the root surface. This leads to cold sensitivity and sometimes sensitivity to sweet and sour foods as well. The root surfaces of the teeth are prone to developing dental decay as they are not as acid resistant as the enamel of the teeth.
There are some systemic diseases like diabetes which can make the condition worse. Also diabetics with poorly controlled diabetes will be more susceptible to the condition. Smoking also increases the risk of developing periodontitis. Smoking makes managing the condition difficult and recurrence is likely.
Chronic gum disease has now been linked to other diseases in the body. Conditions such as cardiovascular diseases and strokes have a close association with chronic periodontitis. Low birth weights in infants are also linked with periodontitis. It is likely the biochemicals released during inflammation at the gum level, travels in the blood and cause mischief elsewhere. However having periodontitis does not guarantee development of cardiovascular disease or strokes. The incidence of these diseases are higher if an individual has uncontrolled chronic periodontitis.
In our next article we will discuss the methods of treating gum disease.
Till then keep on smiling.