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Gum disease is a prevalent problem among many adults. It is an inflammation of the gums, bones and tissues surrounding the teeth and gives support to teeth. Teens can also get minor to severe gum diseases including bad breath, tooth ache and tooth loss. Gum disease is not so easy to diagnose in its early stages as it develops slowly without any visible pain.
Gums are important to maintain the health of your mouth. Healthy gums have certain characteristics:
- Pink gum; not red in color
- Firm
- Free from inflammation or swelling
- Resistant to bleeding during brushing and/or flossing
Gum disease is also called Periodontal (gum) disease which is an infection of the tissues and bones that support the teeth. If left untreated the diseases like gingivitis and periodontitis may become serious infections and can lead to tooth loss. The word periodontal plainly means \”around the tooth\”. Periodontal disease may affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes gum inflammation.
What Causes Gum Disease?
Plaque is the main cause of gum dis
Plaque is the main cause of gum disease. However, other factors can cause periodontal disease as well. These include:
Hormonal changes occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, and thus allows gingivitis to develop.
Some ailments may harm your gums causing diseases such as cancer or HIV that affect the immune system. Patients with diabetes are at higher risk of developing infections, including periodontal disease as this disease affects the body’s capability to make use of blood sugar.
Medications can also put negative influence on oral health because some reduce the flow of saliva, which protects teeth and gums. Some drugs, like the anticonvulsant medication Dilantin and the anti-angina drug Procardia and Adalat may result in abnormal growth of gum tissue.
Harmful habits such as smoking make it difficult for gum tissue to repair itself. Smokers are 2-7 times more likely to develop periodontitis than nonsmokers due to a weak immune response and less oxygen in the mouth.
Diabetes deteriorates periodontal disease. If a person\’s blood sugar level is poorly controlled, a worse infection, poor healing, and a greater loss of bone and connective tissue may occur.
Stress increases certain hormones making a person more vulnerable to infection.
Pregnancy and birth control pills can also heighten hormone levels.
Poor maintenance of oral hygiene such as not brushing and flossing on a daily basis, make teeth susceptible to gingivitis.
Family history of dental diseases can contribute to the development of gingivitis.
Gingivitis
Gingivitis is the initial stage of gum disease which is characterized by the inflammation of the gum tissue. Gingivitis begins with the formation of plaque on your teeth. Plaque is a sticky material formed due to bacteria, mucus, and food debris that accumulate on the exposed portion of the teeth. It is a chief reason of tooth decay. If you do not remove plaque, it transforms into a hard deposit called tartar that remains trapped at the base of the tooth. These plaque and tartar irritate the oral health and cause inflammation to the gums.
Gingivitis is characterized by:
- Red and swollen (puffy) gums
- Pain in the gum area
- Blood on your toothbrush or floss
- Persistent bad breath
Exams and Tests
The dentist will examine your oral condition and look for soft, swollen, red-purple gums which are not the signs of a healthy gum. Deposits of plaque and tartar may be detected at the base of the teeth. The gums usually appear painless or slightly tender.
No further testing is required. But in some cases dental x-rays and dental bone measurements may be performed to ensure whether the inflammation has affected the supporting structures of the teeth.
Treatment
Strict oral hygiene is advised after professional tooth cleaning. The dentist or hygienist will instruct you the process of brushing and flossing. Professional tooth cleaning along with brushing and flossing may be suggested twice per year or more frequently for severe cases. Antibacterial mouth washes or other useful aids may be prescribed in addition to regular, careful, tooth brushing and flossing.
Complications
- Recurrence of gingivitis
- Periodontitis
- Infection or abscess of the gingiva or the jaw bones
- Trench mouth
Prevention
You can prevent Gingivitis maintaining oral hygiene including regular brushing and flossing. For people prone to gingivitis, brushing and flossing is essential each time having meal and at bedtime. Consult the dentist or dental hygienist for proper instructions on how to brush and floss.
Regular professional tooth cleaning is required to eliminate plaque that may form even with careful brushing and flossing. Many dentists recommend professional teeth-cleaning at least every 6 months.
Anti plaque or anti tartar toothpastes or mouthwashes may be recommended by the dentist or dental hygienist.
Periodontitis
Untreated gingivitis can lead to periodontitis. With time, plaque can spread and develop below the gum line. Toxins produced by the bacteria in plaque irritate the gums and stimulate a chronic inflammatory response to which the body essentially turns on itself and the tissues and bone supporting the teeth break down and get destroyed. Gums separate from the teeth, form v-shaped sulcus /pocket (spaces between the teeth and gums) and become infected. As the disease advances, the sulcus/pocket gradually deepens and more gum tissue and bone get affected. Often, this disparaging process has very mild symptoms. Consequently, teeth can become loose and may have to be eliminated.
There are many forms of periodontitis:
- Aggressive periodontitis is evident in patients who are otherwise clinically healthy. Common features include:
- Rapid attachment loss
- Bone destruction
- Familial aggregation
- Chronic periodontitis is characterized by:
- Inflammation within the supporting tissues of the teeth
- Progressive attachment and bone loss
- This is the most common form of periodontitis and is also characterized by
- Pocket formation
- Recession of the gingiva
Although it is rampant in adults, it can take place at any age. Advancement of attachment loss usually occurs gradually, but periods of rapid progression can also occur.
Periodontitis as a sign of systemic diseases often occurs at a young age. Some of the systemic conditions including heart disease, respiratory disease, and diabetes are related to this form of periodontitis.
Necrotizing periodontal disease is an infection that causes necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly found in persons with systemic conditions including HIV infection, malnutrition and immuno suppression.
Symptoms
Symptoms resemble with Gingivitis are listed below:
- Breath odor
- Gums that appear bright red or red-purple
- Gums that appear shiny
- Gums that bleed easily (blood on toothbrush even with gentle brushing of the teeth)
- Gums that are tender when touched but are painless otherwise
- Loose teeth
- Swollen gums
Treatment
Some of the ways the dentists may treat periodontitis are listed below:
Scaling or root planning:
These deep-cleaning measures are followed by scraping and removing plaque and tartar from teeth above and below the gum line.
Antibiotics:
Antibiotics and other medications are often used together with scaling and root planing to prevent the progress of infection and inflammation in the mouth. Antibiotics come in various forms ranging from medicated mouth rinses to antibiotic-containing gels or fibers that are placed in gum pockets to slowly destroy bacteria and help gums to heal.
Surgery:
Severe periodontitis may need a dentist to open and clean badly diseased gum pockets, and then stitch the gums to fit more tightly around the teeth.
Gingival grafting:
If gum tissue is too diseased to sew back together, a dentist generally prefers to remove healthy gum tissue from another part of the mouth and stitches it into affected place of the gum. The graft thus replaces the diseased tissue and helps to attach the teeth, giving them a better appearance.
While undergoing periodontitis treatment, it\’s essential to give special attention to your teeth and gums to see a significant long lasting improvement. This requires regular flossing and brushing and quitting habits, such as smoking or eating sugary snacks between meals.
Prevention Tips
Fortunately, gum disease is generally preventable. It just needs to take proper care of your teeth.
Brush twice a day for at least 3 minutes each time and floss regularly. If you\’re not sure about the technique, your dentist or dental hygienist can help you showing the proper technique.
Brush with a toothpaste containing fluoride; some dentists may also recommend daily mouth washes that contain fluoride.
Use a soft, polished bristled toothbrush, as these are less likely to affect or injure gum tissue. Replace your toothbrush at least every 3 to 4 months because a worn-out toothbrush can damage your gums. It is useful to use those brands of toothbrush that contains color indicators on the bristles to remind you when to change them.
Have a healthy diet. Stay away from snacks and junk foods containing sugar that plaque-causing bacteria love to feed on.
Quit smoking! Cigarettes and tobacco cause mouth irritation and are very harmful for gums and teeth.
Needless to say that regular dental care is extremely vital as it helps keep your mouth healthy. Visit your dentist for routine check up. Go for cleaning at least twice a year. Your dentist can remove hardened plaque and any tartar that you can’t remove by brushing and flossing.