What is gum disease and what causes it?

Periodontal or gum disease affects most people in varying degrees but only becomes serious in around 15% of the population.

It is caused when your body’s reaction to bacteria in the plaque gradually leads to loss of the natural bond or attachment of the tooth to the gum. When this happens small pockets are created which are impossible to clean allowing the bacteria to continue destroying the attachment and eventually leads to loss of bone supporting the teeth. At the same time calculus (tartar) forms in hidden places below the gum.

What are the signs of gum disease?

Gingivitis and poor plaque controlThe early stages of Periodontal Disease are not always easy to identify.

If your gums are;

• Red, instead of pink
• SwollenTender
• Bleeding, especially after brushing
• Receeding then you may have a gum problem.

Other signs may include a bad taste in the mouth, bleeding from the gums or occasionally bad breath. Looseness or separation of the gums from the teeth can occur. You may also notice blood on your toothbrush after cleaning, or even see signs of blood in the water after you rinse your mouth.

The first stage in treating periodontal disease is the consultation appointment, which lasts about an hour. It is important for the ultimate success of any treatment that the severity and extent of the disease are established in advance. This is done by carefully measuring the position of the gums, whether or not spaces have developed between the gums and teeth (these spaces are called “pockets). The depths of these “pockets” are recorded on a special chart, which gives a permanent record of the level of disease present. X-rays are also required. These show the position and height of the bone supporting the teeth.

Once all of the above information has been collected, a plan for treatment can be devised for you. Various treatment options will be presented and discussed. By the end of the consultation you should be fully informed about your problems and have an understanding of the treatment options and likelihood of success.

How can gum disease be prevented?

Prevention is best achieved by following a rigorous oral hygiene routine including, in particular, careful cleaning between the teeth.The types of bacteria that populate plaque change daily so that after 4-7 days colonies of harmful bacteria capable of attacking the gums will build up. Regular brushing will eliminate plaque from the visible surfaces of the teeth and gums but is ineffective in reaching and removing plaque between the teeth. Regular flossing will remove any build-up of plaque between the teeth in mouths where little or no periodontal disease is present.

Where gum disease is present an inter-dental brush is a more effective way of cleaning between the teeth. Screening for signs of gum disease forms part of all our consultations.

Hidden gum problems found at consultation

What if I already have gum problems?

There is an initial treatment phase, which has several main aims:

• The elimination of damaging plaque deposits
• The improvement in oral hygiene to prevent recurrence
• To remove calculus

Elimination of deposits which have accumulated under the gums (and which disturb the bacterial bio-mass) is carried out either by hand or ultrasonic cleaning. As some deposits are deeply buried, this process may be performed under local anaesthetic.

What results can be expected from treatment?

Following initial treatment, pockets are measured again and a case review carried out.

Second stage treatment

Some patients need a further course of scaling and oral hygiene instruction and monitoring of their plaque control.

For other patients, damage to the gums and bone supporting the teeth may have already occurred. In some cases, it is possible to correct the shape of the gums and the bone surgically and you will be advised about this at the time.

Maintenance therapyThe aim of treatment is to stop the destruction to your gums and bone and for most patients this is possible. However, regular follow up and maintenance is required for life to ensure your gum problems have been brought and are kept under control.

Other informationIf you are susceptible to periodontal disease there is every chance that it can be brought under control and that the affected teeth can be saved.

Some basic factors which will affect the spread of gum disease include:

Early diagnosis ­ the earlier the disease is diagnosed the better the chances are of providing effective treatment.
Meticulous oral hygiene ­ make sure that all surfaces of all teeth are scrupulously cleaned on a daily basis
Smoking ­ is now recognised as a major contributory factor as to the severity of gum disease
Regular dental check-ups ­ allows us to monitor progress and give effective treatment when it is needed.Gum disease is not a slow, progressive disease but causes destruction in periodic bursts. These can be triggered by the complex interaction between the bacterial activity and the body’s response and ability to counter it (known as the “host response”).

Periodontal Surgery

In some cases specialist plastic surgery is required to reshape the gums. We will keep you advised if this would help you.

Untreated periodontal disease can cause the premature loss of teeth but much can be done to minimise the risks. If you want to know more, please ask for more information and advice.