Gum disease is a common condition affecting millions of people. Most only have mild gum disease, but about 30% suffer from severe gum disease that causes loss of the bone support for a tooth.
Gum disease is caused by inflammation of the gums as a result of bacteria in “plaque”, a sticky film that forms on your teeth. Gum disease can progress to affect the bone and ligaments that support the teeth, and can cause eventual tooth loss.
Healthy Gums vs. Unhealthy Gums
If you have healthy gums, they will look firm and pink. Some signs of unhealthy gums include redness and swelling, gums that bleed when you brush or floss your teeth, and gums that appear to be pulling away from the teeth.
It’s important to remember that healthy gums aren’t just important for your oral health. Maintaining healthy gums can also be important for your overall health. Numerous research studies suggest an association between periodontitis and other more serious chronic health conditions such as diabetes and heart disease. In fact, there are now several studies that suggest an association between advanced gum disease and heart disease or stroke.
Types of Gum Disease
There are several types of gum disease but they can be classified into two main forms, or stages.
In its mildest form, gum disease is known as gingivitis. In this stage there is some inflammation of the gums but no lasting damage to the bone and connective tissue. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line. When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue. There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue. Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.
Here are some of the most common types of periodontal disease:
- Chronic periodontitis –it results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
- Aggressive periodontitis– This form of gum disease occurs in an otherwise clinically healthy individual. It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
- Necrotizing periodontitis– This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition. Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
- Periodontitis caused by systemic disease– This form of gum disease often begins at an early age. Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.
Common Causes of Gum Disease
There are genetic and environmental factors involved in the onset of gum disease, and in many cases the risk of developing periodontitis can be significantly lowered by taking preventative measures.
Here are some of the most common causes of gum disease:
- Poor dental hygiene– Preventing dental disease starts at home with good oral hygiene and a balanced diet. Prevention also includes regular dental visits which include exams, cleanings, and x-rays. A combination of excellent home care and professional dental care will ensure and preserve the natural dentition and supporting bony structures. When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacteria toxins and can cause gingivitis or periodontitis, which can lead to tooth loss.
- Tobacco use– Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) build up on teeth, deep pockets in the gingival tissue and significant bone loss.
- Genetic predisposition– Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
- Pregnancy and menopause– During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
- Chronic stress and poor diet– Stress lowers the ability of the immune system to fight off disease, which means bacterial infections may possibly beat the body’s defense system. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
- Diabetes and underlying medical issues– Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.
- Grinding teeth– The clenching or grinding of the teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
- Medication– Many drugs including oral contraceptive pills, heart medicines, anti-depressants and steroids affect the overall condition of teeth and gums; making them more susceptible to gum disease. Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.
Complications of gum disease
If you have untreated gum disease that develops into periodontitis, it can lead to further complications. The gum pockets trap food and plaque and become infected, affecting the neighboring tissue and bone. As periodontitis progresses, the pockets deepen and gum tissue and bone are destroyed. In its last stages, so little bone and connective tissue are left around the tooth to support it that the tooth becomes loose and may have to be extracted.
Seeing your dentist
You should make an appointment to see your dentist if your gums are painful, swollen or if they bleed when you brush your teeth. Your dentist can carry out a thorough dental examination to check the health of your gums, which may involve inserting a thin metal stick with a bend in one end (periodontal probe) beside your teeth.
In some cases, a number of X-rays may be needed to check the condition of your teeth and jaw bone.
Treatment for gum disease
There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone. A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.
Here are some of the more common treatments for periodontal disease:
Scaling and root planning
In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed. The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection. A prescription mouthwash may be incorporated into daily cleaning routines.
When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures. A membrane may be inserted into the affected areas to assist in the regeneration process.
Pocket elimination surgery
Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums. Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.
When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone. Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.
How to Maintain Healthy Gums and prevent gum disese?
Because a healthy mouth starts at the gums, maintaining an oral health routine focused on the health of your gums in crucial to the overall health of your mouth. When you have healthy gums, your teeth are well-supported by the tissue in your gums and your chances for long-term oral health are significantly increased. If you don’t maintain healthy gums, you are more likely to have gum disease, which can progress to a number of problems with your teeth and oral health. And as we talked about above, other long-term, chronic health conditions can be associated with periodontitis, a serious form of gum disease.
In order to help keep your gums healthy, there are several easy steps you should take on a daily basis. Here is a checklist you need for healthy gums:
When selecting a toothbrush for healthy gums, look for a soft-bristle brush that has bristles of varying heights to reduce irritation. This will help the toothbrush stimulate your gums and get into hard-to-reach areas.
dentists recommend brushing twice a day with an accepted fluoride toothpaste. Comprehensive all-in-one formulas can provide a number of benefits that help care for your teeth and gums for a healthy mouth. You may also want to consider a toothpaste which is formulated specifically for you gums. It can reach and neutralize the plaque bacteria built up around the gum line that can cause bleeding gums and even gum disease.
Flossing may be one of the most important things you can do to help prevent gum problems and maintain healthy gums. There are also types of soft floss that make flossing easier, so people with sensitive gums can have healthy gums. Another option: interdental devices such as dental picks and flossers can be used to clean between the teeth and promote healthy gums.
Using an anti-gingivitis mouthwash as part of your oral care routine can help kill the bacteria that cause plaque to maintain a healthy gums and teeth. And mouthwashes may offer you additional benefits like whitening, enamel protection, or cavity protection.
Available at most drug stores, a gum stimulator can help you keep clean and healthy gums. This simple device features a rubber tip that is used to gently clean and stimulate gums for good circulation and to help prevent gum disease.
Regular dental check-ups
It’s important to have regular dental check-ups so any problems with your teeth and gums can be detected and treated early. If you’ve never had gum disease and have good oral health, you may only need to visit your dentist every one to two years for a check-up.
You may need to visit your dentist more frequently if you’ve had problems with gum disease in the past. At each appointment your dentist will advise when you need your next appointment.
If you have an increased risk of developing gum problems – for example, if you smoke or have diabetes – you may be advised to visit your dentist more often so your teeth and gums can be closely monitored.