Gum (periodontal) disease

Gum disease, also known as periodontal disease, is thought to affect approximately 20% of Australia adults and can range from gum inflammation through to serious disease that results in soft tissues and bone damage that causes tooth loss.

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What is gum disease?

Mouths are full of bacteria and if you don’t maintain good oral hygiene this bacteria may form a sticky substance known as plaque. If this plaque isn’t removed by brushing and flossing it will harden on the tooth surface and become tartar. Tartar can only be removed by your dentist so it is best to regularly brush and floss your teeth to avoid it getting to this stage.

When plaque and tartar are not removed they can cause damage and the longer they are left on the teeth the more significant the damage will become. Eventually this bacteria will infect the gums and in more serious cases can damage the gum tissue and bone. The development of gum disease divided into two stages; gingivitis and periodontitis.

Gingivitis

Gingivitis is a mild form of gum disease, where patients will notice their gums become red, swollen and are likely to bleed while brushing and flossing. Gingivitis is the result of toxins that are produced by built up plaque. These toxins irritate the gum tissue causing it to become inflamed. Luckily at this stage the tissues and bone that hold the teeth in place are not yet affected and therefore the damage can be reversed. Regular cleans by your dentist or hygienist as well as daily brushing and flossing at home will help minimise the issue and eventually your gums will be return to normal.

Periodontitis

If gingivitis goes untreated it may lead to periodontitis. Periodontitis is a serious form of gum disease that can result in tooth loss. When a person has periodontitis the bone and fibres that hold their tooth in place have been damaged, which often leads to pockets below the gum line forming. Food and plaque get trapped within these pockets causing the issue to worsen. At this stage teeth are at risk of shifting or falling out. While irreversible, periodontitis can be managed with dental treatment and improved oral hygiene. This will ease any discomfort and help prevent further damage.

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What are the causes of gum disease?

While the main cause of gum disease is poor oral hygiene which leads to an increase in plaque, it is not the only reason. There are several other factors that can contribute, including:

Diabetes - Those with diabetes are more at risk of developing infections, including gum disease.

Family history – A family history of gum disease puts you at a higher risk of developing gingivitis. As a result, it is important to maintain good dental hygiene and visit your dentist for regular check-ups.

Medication – Many medications can cause a reduction in saliva, which helps to protect the gums. Without enough saliva, the mouth is more vulnerable to various issues including gum disease.

Poor nutrition – Sugary and unhealthy foods can lead to an increase in plaque and bacteria which, if not removed correctly, may lead to gum disease.

Smoking – smoking is a major cause of gum disease as it affects the attachment of the bone and soft tissue with the teeth, reduces the flow of saliva and increases the build-up of plaque and tartar on the teeth. All of which have a high risk of resulting in gum disease

Weak immune system – A weakened immune system often as a result of cancer treatment or HIV can make the gums more susceptible to disease.

What are the symptoms of gum disease?

Gum disease can often progress painlessly and with few noticeable symptoms which often leaves patients unaware that there is any issue, particularly if they haven’t visited their dentist in a while. However gum disease may present itself in the following ways:

Tender, red or swollen gums
Gums that bleed during or after you brush your teeth (don’t let this bleeding stop you from brushing!)
Formation of gaps in between the teeth and gums
Loose teeth
Persistent bad breath
Constant bad taste in your mouth
Receding gum line
A change in the way your teeth fit together when you bite.

If you are experiencing all of any of these symptoms it is important to consult your dentist as early detection is vital.

Treatment

The first point of call for treating gum disease is a professional clean by your dentist or dental hygienist. During the cleaning all hardened plaque and tartar will be removed from above and below the gum line. If your dentist believes that you are at risk of gum disease they may suggest that you go back for a cleaning once or twice a year.

If your gum disease has progressed to periodontitis and there is a significant amount of plaque and tartar, particularly below the gum line, scaling and root planning may be required. This is a non-surgical procedure, done under local anaesthetic whereby all plaque and tartar is scraped away from below the gum line and any rough spots on the tooth root, where the germs gather, are smoothed out (planning). This smoothing of the tooth root helps to remove all bacteria and provides a clean surface for the gums to reattach to the teeth. Depending on the extent of plaque and tartar, this may need to be carried out over several appointments.

While a deep cleaning can help to remove the majority of plaque and tartar, some people will require surgery to remove all of the bacteria. The most common surgery is flap surgery or pocket reduction surgery. This surgery is carried out to remove the tartar from the deep gum pockets and reduce the size of the periodontal pocket, which will decrease the area that the bacteria can grow and make it easier for the patient and their dentist to keep clean. The surgery involves the dentist making a few small cuts in the gum tissue and pulling back the gums to expose the deep pockets where the tartar is built up. Once the tartar is removed the gums are put back in place to fit neatly around the tooth.

During your consultation your dentist will be able to advise whether a deep cleaning will suffice or whether surgery will be needed.

If you believe that you may be developing gum disease or would like to discuss any information shown here in more depth please call us to book a consultation.