Gum disease is a progressive condition where damage occurs in the gums and/or bone around the teeth. There are two main terms that you may hear used: gingivitis and periodontal disease.
Gingivitis simply means inflammation of the gums. This is when the gums around the teeth become red and slightly swollen. The inflamed gums will often bleed when they are brushed or flossed, although this may be less noticeable if you are a smoker. Gingivitis is very rarely painful and it is not an infection which you have caught. It arises because of inadequate tooth brushing and flossing so that plaque is not removed well enough from around the teeth and gum edges. Adequately cleaning the teeth and gums will completely eliminate gingivitis.
Periodontal disease affects the gum and bone supporting the teeth. It can occur in two out of ten people who have a genetic susceptibility (but it is avoidable by adequate prevention). As the disease progresses, loose pockets form between the teeth and gums, and the bone anchoring the teeth in the jaw gradually shrinks back so that the teeth lose their firm support and eventually may begin to loosen. If this is not treated, teeth may eventually be lost.
Quite possibly. Most people have some degree of gum disease, and it is the major cause of tooth loss in adults. However, the condition affects people at different rates, and in most people develops very slowly. In most people the rate of progress can be slowed down with good dental treatment and good home care so that you can usually keep most of your teeth for life. However, if you are more susceptible to gum disease, your bone loss may be more rapid and specialist dental care may be necessary to manage the disease. In some severe cases tooth loss cannot be averted.
All gum disease is caused by inadequate removal of plaque, combined with each person’s individual susceptibility to the disease. Plaque is a film of bacteria which forms on the surface of the teeth and gums all the time. Many of the bacteria in plaque are completely harmless but others have been shown to be causal in gum disease. To prevent and treat gum disease you need to make sure you remove all the plaque from around and between your teeth every day. This is done by brushing and flossing.
Unfortunately, gum disease progresses painlessly on the whole so that you do not notice the damage it is doing in the earlier stages. However, as the disease progresses, the bacteria can become more active, making your gums sore and leading to gum abscesses. Pus may ooze from around the teeth. Over a number of years the bone supporting the teeth shrinks back, and teeth may be lost. If the disease is left untreated for a long time, management and treatment become more difficult.
If you notice blood on the toothbrush or in the rinsing water when you clean your teeth or when you are eating, you may have gingivitis. If you notice a bad taste in your mouth, your teeth feeling loose, pus coming from between the gums and teeth or bad breath, you may have periodontal disease. Your dentist will be able to advise on how far the disease has progressed.
The first thing to do is to visit your dentist for a thorough check-up of your teeth and gums. The dentist will examine your mouth to assess the extent of the problem and to see if there are any signs that periodontal disease has started. X-rays will be needed to assess the amount of bone that has been lost. This assessment by your dentist is essential so that the correct treatment can be recommended for you.
Your dentist will usually recommend an initial course of treatment with a dental hygienist. Your hygienist will assess the extent and severity of the gum pocketing between the teeth and gums. They will carry out thorough professional cleaning of your teeth, removing the deposits on your teeth and disinfecting the pockets. They will show you how to remove plaque successfully yourself, cleaning all surfaces of your teeth thoroughly and effectively. The purpose of the treatment is to thoroughly disinfect the tooth/gum conjunction, reducing the plaque bacterial level and inflammation and to allow the gums to heal. Several sessions with the hygienist may be necessary.
If the extent of the gum disease is severe or if the disease is not responding to the treatment provided by the hygienist, your dentist may recommend you to see a specialist periodontist for further treatment and advice.
Periodontal disease is never cured, because once bone has been lost it cannot grow back. But, provided you keep up the home care you have been taught, any further loss of bone is likely to be very slow and may stop altogether. To achieve this result it is essential for you to make sure that you remove plaque every day, see your dentist for regular check-ups, and see the hygienist regularly, as your dentist advises.
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