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Gum Disease: The Facts
Gum disease is the 6th most common disease in the world. It’s caused by a build-up of plaque bacteria and can be influenced by a number of risk factors such as poor oral hygiene, smoking and genetics. This page is here to tell you everything you need to know about it and how you can treat it as well as the best way to prevent it!
What is Gum Disease?
Gum disease, or periodontal disease as it is referred to by dental professionals, is a collective name for many different conditions that affect the structures that support and hold the teeth in place. These are the
- gums
- bone
- cementum – the outer surface of the tooth root
- periodontal ligaments – these attach the teeth to the bone
Types of Gum Disease
There are two main types of gum disease: Gingivitis and Periodontitis.
Gingivitis is characterized by inflammation of the gum. This early stage of gum disease is typically caused by a buildup of plaque, a sticky film of bacteria that forms on the teeth. It can usually be reversed with good oral hygiene, which includes brushing and flossing regularly and receiving professional dental cleanings.
However, if left untreated, it can progress to periodontitis which is a more severe form of gum disease. The gum inflammation persists and the gums start to pull away from the teeth creating spaces called periodontal pockets. Connective tissue and bone that holds the teeth in place are destroyed and structural changes to the cementum and ligaments occur.
There are two types of periodontitis, chronic periodontitis and aggressive periodontitis where onset usually starts in the teenage years.
Other types of gum disease include gestational gingivitis, where hormonal changes during pregnancy make you more susceptible to gum disease. There are other rarer forms such as necrotizing periodontal diseases.
Prevalence
Gum diseases are a very common problem around the world.
According to the Centers for Disease Control and Prevention (CDC), 47.2% of adults aged 30 and over in the United States have some form of the disease. The prevalence increases with age, with 70.1% of adults aged 65 and over having gum disease.
The world health organisation, estimate that severe periodontal diseases affect around 19% of the global adult population, representing more than 1 billion cases worldwide.
It is slightly more common in men than women.
Signs and Symptoms of Gum Disease
The common signs of gingivitis include
- red, swollen gums that bleed easily when brushing or flossing
- bad breath
- a metallic taste in the mouth
As the disease progresses the following symptoms may develop:
- Periodontal pockets
- Bone loss
- Gum recession which exposes the tooth roots causing sensitivity
- Abscesses
- Changes in bite
- Loose, wobbly teeth
What Causes Gum Disease?
Gum diseases are caused by harmful species of bacteria found in the mouth.
Over 500 bacteria reside in the mouth, not all of these are harmful, some are beneficial. Harmful bacteria cannot be eliminated because the mouth is not a sterile place. It’s a moist, warm place – the perfect breeding ground for pathogens.
How Do The Bacteria Cause Gum Disease?
The bacteria affect the mouth in two ways. The bacteria and products they release can damage the structures that support the teeth – they have a direct effect. The bacteria also cause damage indirectly to the structures by causing inflammation and immune response by the body.
Direct Bacterial Affect
The bacteria release enzymes such as proteases, collagenases, fibrinolysin, and phospholipase which cause damage to the gum tissue. Some parts of the bacterial cell wall are endotoxins which induce inflammation and immune response by our body – which has an indirect effect on our jaw as described below.
When the disease progresses, the bacteria become trapped under the gumline and enter the bloodstream. They also cause the jaw bone to be reabsorbed.
Indirect Affect
The inflammation and cells of the body’s immune response (initiated by harmful bacteria) cause the structures supporting the teeth to be destroyed. The body tries to eliminate the bacteria, but when it fails (because it needs help from us and dentists to disrupt the bacteria above and below the gum) it accidentally causes damage and destruction to the supporting structures.
Risk Factors
Gum disease can affect anyone, but certain factors can increase the risk of it developing.
These include:
- Poor oral hygiene
- Incorrect tooth brushing
- Food impaction
- Ill-fitting dental appliances
- Smoking
- Diabetes
- Poor dietary choices
- Obesity
- Certain medications – for example, Dilantin (seizure control), Cyclosporine (anti-rejection drugs for organ transplantation), and calcium channel blocking drugs (hypertension control) can affect your oral health
- Ill health – leukaemia, HIV
- Hormones – hormonal changes that happen during puberty, pregnancy and menopause
- Genetics
- Trauma to the gum – chemical injury, physical injury, and internal injury as well as by embedding of foreign body reactions
- Stress
Diagnosis
If a dentist suspects you have some degree of gum disease during a routine examination (they can tell when they look if your mouth if you have gingivitis) they will formally diagnose the condition in the following way:
- Measuring the depth of the space between the teeth and gum. Healthy gums have a gap of 1-3mm. The pocket depth is measured using a dental ruler called a probe or measure. This test is usually painless.
- Take a full medical history to identify if there is any family history or factors which put you at increased risk of gum disease
- X-rays may be taken to determine if there has been any bone loss.
- If you have severe periodontal disease you will be referred to see a periodontist for specialist treatment.
Can You Tell If You Have Gum Disease?
Yes, you can tell if you have gum disease. Take a close look in the mirror – if your gums are red, swollen and bleed when you floss or brush your teeth you have the telltale signs of gingivitis. If periodontal pockets have started to form it’s indicative of periodontitis.
Here’s some more information on what gum disease looks like.
Please note, if you smoke, the nicotine and tobacco can cause the blood vessels in the gums to vasocontrict. They get narrower. This prevents blood flow in the area. This can cause the signs and symptoms to be masked. You may not be able to tell if you have gum disease until it becomes quite advanced and your teeth are at risk of falling out.
Complications
If the disease is left untreated it can lead to a number of complications. Some of the potential complications include:
- Tooth loss: the destruction of the tissue and bone that support the teeth can lead to tooth loss. Does tooth extraction cure gum disease? Find out.
- Bone loss: Gum disease can lead to the loss of bone in the jaw, which can affect the stability and function of the teeth.
- Gum recession: as bone is destroyed the gums can recede – the gum tissue pulls away from the teeth, exposing the roots and making the teeth more prone to decay and tooth sensitivity
- Abscesses: pockets of infection can form in the gums or in the bone around the teeth.
Gum Disease Has Been Linked With Systemic Health Conditions
The bacteria and consequential immune response has been shown to contribute to the development of diseases distant from the body. This is because they can enter the bloodstream and travel throughout the body. They don’t just act at the site of the initial infection.
There is evidence to suggest that gum disease may increase the risk of developing the following health conditions:
- Heart disease
- Cancer
- COPD
- Stroke
- Rheumatoid arthritis
Severe periodontitis has been shown to have an effect on pregnancy – it has been linked to an increased risk of preterm birth and babies with a low birth weight.
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Treating Gum Disease
Treatment options depend on the severity of your gum disease.
Gingivitis can often be reversed with daily performed self-care and regular professional cleaning. Dental hygienists can remove plaque and tartar that build up above and below the gum line.
Periodontitis may require more intensive treatment. Treatment options for periodontitis may include:
- Improved oral hygiene: the dentist will start by giving you information on how best to clean your teeth so plaque is disrupted and any professional treatments are effective.
- Scaling and root planing: This procedure involves cleaning the teeth and the roots of the teeth below the gum line to remove plaque and tartar.
- Secure loose teeth: splits can be used to secure any wobbly teeth whilst the health of your gums improves
- Remove ill-fitting dental appliances: badly fitted crowns can make cleaning your teeth difficult and can be a breeding ground for bacteria
- Mouth guards – Bruxism (clenching and grinding has been linked with bone loss in the jaw)
- Antibiotics: Your dentist may prescribe antibiotics to help kill bacteria and reduce inflammation.
- Gum surgery: In more advanced cases, surgery may be necessary to remove infected tissue.
- Gingival Graft: repair damaged tissue, or to regenerate lost bone.
- Receding gums: if the recession is causing sensitivity or aesthetic concerns composite resin, porcelain veneers, or fluoride varnishes may be used. Special toothpaste can be used to help with sensitivity.
- Lifestyle changes: Making changes to your diet and quitting smoking can help improve the health of your gums.
Can I Treat Gum Disease at Home?
You can treat gum disease at home. In fact, the single most important thing you can do in the treatment of gum disease is daily performed self-care. This includes:
- Twice daily brushing to disrupt the plaque on the surface of your teeth – Use a soft-bristled toothbrush and fluoride toothpaste.
- Cleaning the spaces between the teeth with interdental brushes or single-tufted toothbrushes to disrupt the sticky plaque that can get trapped between the teeth
If your gum disease has advanced it can be difficult to disrupt bacteria hiding within periodontal pockets, so professional help is needed. There’s good news – you can now disrupt the bacteria and food debris in periodontal pockets with the revolutionary gum pocket brush!
If you’re wondering how long it takes for gum disease to go away you can read more on this here.
Preventing Gum Disease
Prevention is better than treatment! There are several things you can do
- Have excellent oral hygiene
- Look out for warning signs of gingivitis – is you notice your gums are becoming red and inflamed take action with the advice above
- Eat a balanced diet
- Quit smoking
- Control diabetes
Don’t ignore gum disease – it’s won’t go away.
Get access to our Interactive Video Course
Gum Disease: Solved features 3 hours of direct access help to dentists to solve your gum disease