What is gum disease?

Gum disease is often overlooked as a benign condition. This disease is also known as periodontal disease. There are two common conditions, gingivitis (inflamed gums) and periodontitis (gum inflammation including bone break down around the teeth). One of the signs of gum disease is bleeding gums and in the more severe form,periodontitis, loose teeth. Bad breath is also associated with this condition.

The cause of the disease is multi-factorial. Gingivitis is the milder form of the two conditions. This is often the result of plaque build-up around the gum line. When plaque is left at the gum line for more than 2 days the gum starts to swell and become inflamed. The severity of the inflammation is dependant on the immune system of the individual and also the amount of plaque at the gum line. In acute and severe cases there may be pain.

Periodontitis is a form of gum disease which involves the underlying bone supporting the teeth in the jaws. In addition to the presence of gingivitis, there is also evidence of bone break down around the teeth. The severity of the disease dictates the extent of bone loss and subsequent loss of the tooth. Periodontitis is a multi-factorial disease. Predisposing factors include a genetic predisposition to the condition, presence of certain type of bacteria, lack of good oral hygiene, immune response, and other factors like smoking and diabetes.

How common is gum disease?

Gum disease is very common. The longer this is left untreated the worse the inflammation. In the case of periodontitis there is irreversible damage to the bone surrounding the teeth. The loss of bone around teeth causes gum recession. This in itself leads to other teeth issues like root decay, wearing down of the root surface, sensitivity to cold foods and drinks, loose teeth in extreme cases.

Signs and indicators of gum disease.

Bleeding gums. Healthy gums do not bleed. Brushing with a hard bristle brush incorrectly will traumatise the gums. Healthy gums will hurt before they bleed. Diseased gums will bleed with the slightest touch. Also overgrown large gums which look distorted are also a sign of chronic gum disease.

What can I do if I think I have gum disease?

Areas which bleed when flossed or brushed gently need more focused cleaning.  However with periodontitis the bleeding seldom resolves as the issue is located deep past the gum line. The presence of tartar or calculus will require professional management for the gums to heal. Mouth rinses may be used in acute cases of gingivitis to act as an aid to proper tooth brushing and flossing. Regular visits to the dentist is also a good idea so gums can be assessed to rule out periodontitis.

What happens if gum disease is not treated?

If gum disease is not managed, especially in the case of periodontitis, the loss of teeth is inevitable. It may take a short time in some individuals but longer for others. The sooner this disease is managed the better.

Gum disease is linked to other health conditions. 

There is growing medical evidence of a close association between periodontitis and cardiovascular disease, like strokes and heart attacks. Periodontitis is partly an inflammatory disease. The inflammation releases biochemicals at the site of the gums which enter the circulation. The chronic nature of the disease leads to inflammatory biochemicals being in the circulation for extended periods. This is thought to cause damage to blood vessel walls and disease. Uncontrolled diabetes can make periodontitis worse.

Gum treatment involves periodic cleaning to reduce and disrupt dental plaque build-up beneath the gum line . This reduces the inflammatory events which cause bleeding gums and episodes of bone break down. The cleaning of the teeth involves the use of ultrasonics and hand instruments which can access the deeper parts of the gum pocket beneath the gum line. Unless the plaque and calculus (Calcified, hardened plaque) are removed, gums will continue to bleed and bone will be lost.

Management of the gums involves regular cleaning of teeth by the dentist. Good dental cleaning habits at home is also very important. This involves good tooth brushing and flossing. The frequency of cleans depends on the type of gum condition but also the level of oral hygiene. The initial management often requires the use of local anaesthetic. This allows for a more comfortable experience during the teeth cleaning.