Gum disease: Causes, Symptoms and Treatments

What is gum disease?

Gum disease or periodontal disease is generally a slow, chronic infection and inflammation of the gums and bone that support a person's teeth. It occasionally can flareup to become acute and painful or rarely be rapidly progressive, but most of the time people are not aware of the presence of the disease until its more advanced. It is caused by plaque or biofilm - a thick sticky film of bacteria that builds up on your teeth especially around the gum line. Plaque can harden over time to become calculus otherwise known as tartar. When a person's ability to clean his or her own teeth is inadequate and plaque is left undisturbed, the bacteria in the plaque matures, becomes more aggressive and starts invading into the gums.

During the early stages known as gingivitis, the inflammation is superficial and the gums can resolve back to a healthy state without any permanent damage. However when the disease becomes moderate or advanced, the damage to the underlying gums and bone becomes irreversible leading to deep pockets between the teeth and gums, bone loss, gum recession. This can then lead to further problems such as loose teeth, food packing between affected teeth, tooth decay and abscess formation, and ultimately the demise of teeth.

Signs of periodontal diseases to look out for:

• red, swollen, bleeding gums
• receding gums
• bad breath or bad taste in the mouth
• developing gaps between teeth or teeth drifting apart

It is worth noting that two other major risk factors that make a person susceptible to periodontal disease are smoking and medical conditions such as diabetes. Rarely can genetics also play a part in a person's risk in developing this disease.

Treatment of periodontal disease should involve the following:

• Long term and consistent good personal oral hygiene is a must especially to prevent the disease from recurring This means that patients affected by the disease has to ensure that they make the effort and time to clean their teeth and gums every day to a good standard where there is minimal plaque left behind. Patients' brushing techniques has to be refined or modified such that as many surfaces around the teeth and gum lines are cleaned effectively.
• Use of an electric toothbrush, flossing, or interdental brushes are helpful tools in attaining this goal. Your dentist or hygienist can usually help you in this area.
• Professional scaling to remove plaque and tartar around the gums and under the gums (where deeper pockets are located). This can sometimes be done in one visit, other times may require multiple visits. If patient finds this procedure uncomfortable, a local anaesthetic can be administered.
• If tartar is present deep inside the gum pockets, root planing is usually required where an instrument is used to scrape the root surface to remove the tartar deposits. This usually require multiple visits as well as a local anaesthetic.
• The use of mouthwashes can help enhance patient's oral hygiene but must not be relied on as a sole weapon to fight gum disease.
• Sometimes fillings that are helping to trap food and plaque may have to be replaced or reshape to aid personal oral hygiene access in those areas.
• Patients also have to address their risk factors mentioned earlier such as quitting cigarette smoking or controlling their diabetes to minimise risk of recurrence of this disease over time.
• If the gums have not responded well to initial treatment or the disease is too extensive or difficult to manage, a referral to a periodontist is recommended.

Especially if the disease is well advanced, trying to save the tooth is not possible and the affected tooth may have to be removed.

Your dentist or periodontist can further discuss with you options to replace lost or missing teeth such as dentures, bridges or implants. However the long term success of these teeth replacement options also depend on how successful patients can control their gum disease through their oral hygiene.

As periodontal disease can easily recur, it is important that patients undergo regular long term visits to their dentist, hygienist or periodontist for professional cleaning and maintenance. Depending on the patients' ability to clean their teeth and the severity of the disease, this may mean 3 monthly, 4 monthly or 6 monthly visits.

If you are unsure if you have gum disease or require treatment, come down for a friendly consult. It is always better to prevent than to fix these concerns from the start.