What is gum disease (periodontal disease)?
How does gum disease get started?
What are the signs of gum disease?
What are the stages of gum disease?
How can I prevent gum disease?
How can I tell if I'm brushing and flossing properly?
What if I am already in the early stages of gum disease?
What does root planing accomplish?
Are there any other methods for treating gum disease?
Why can't I just clean my teeth?
Is there a link between gum disease and other health concerns?
In the broadest sense, the term gum disease, or periodontal disease, describes bacterial growth and production of factors that gradually destroy the tissue surrounding and supporting the teeth. "Periodontal" means "around the tooth."
Gum disease begins with plaque, which is always forming on your teeth, without you even knowing it. If the plaque is not removed on a daily basis it will form tartar (also called calculus) which is the breeding ground for the germs which cause gum disease.
Anyone at any age is susceptible to gum disease. You can lose your teeth from gum disease because this disease attacks the gums as well as the bone which are the foundation in which your teeth rest. Your teeth become loose and eventually fall out as the bone literally dissolves away from around your teeth.
Gum diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of gum disease that only affects the gums. Gingivitis may lead to more serious destructive forms of gum disease called periodontitis
Gingivitis is inflammation of the gum tissue. The gums are irritated and swollen due to a plaque or calculus (tartar) buildup along the gum-line. The gums may be sore, bleed easily and appear puffy, soft and swollen. No bone structure is lost around the teeth at this stage of gum disease.
Blood on the toothbrush or dental floss is one of the earliest and most common signs of gingivitis. Your gums should never bleed while brushing or flossing. The good news about gingivitis is that it is preventable and reversible through good brushing and flossing techniques (or other dental tooth cleansing). On the other hand, if oral hygiene habits are poor, gingivitis may progress to periodontitis.
Periodontitis results from the progression of gingivitis, involving inflammation and infection of the ligaments and bones that support the teeth. Periodontitis occurs when inflammation or infection of the gums is untreated or treatment is delayed. Infection and inflammation spreads from the gums to the ligaments and bone that support the teeth. Loss of support causes the teeth to become loose and eventually fall out. Periodontitis is irreversible but you can stop its progression through good oral hygiene and visiting your dentist.
Gum disease begins when plaque adheres at and below the visible edge of your gums. If plaque is not removed every day by brushing and flossing, it hardens into tartar. Tartar promotes a bacterial infection at the point of attachment. In these early stages, gum disease is called gingivitis.
Your gums may be a bit red but you may not notice anything. As gingivitis gets more serious, tiny pockets of infection form. Your gums may be puffy and may bleed a little when you brush but it is not painful. Over time, the infection destroys the gum tissue. Eventually, you may be at risk of losing one or more teeth.
Gum disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Then one day, on a visit to your dentist, you might be told that you have chronic gum disease and that you may be at increased risk of losing your teeth. That is one reason why regular dental check ups and periodontal examinations are very important.
Although the symptoms of gum disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. Visit our participating dentists immediately if you notice any of the following signs of gum disease:
Even if you don't notice any symptoms, you may still have some degree of gum disease. Some people have gum disease only around certain teeth, such as those in the back of the mouth, which they cannot see. Only a dentist can recognise and determine the progression of gum disease.
Gingivitis and periodontitis are the two main stages of gum disease. Each stage is characterised by what a dentist sees and feels in your mouth, and by what's happening under your gum line. Although gingivitis usually precedes periodontitis, it's important to know that not all gingivitis progresses to periodontitis.
In the early stage of gingivitis, the gums can become red and swollen and bleed easily, often during tooth brushing. Bleeding, although not always a symptom of gingivitis, is a signal that your mouth is unhealthy and needs attention. The gums may be irritated, but the teeth are still firmly planted in their sockets. No bone or other tissue damage has occurred at this stage. Whilst gum disease in Australia remains a serious public health concern, it is a situation that is far from hopeless.
When gingivitis is left untreated, it can advance to periodontitis. At this point, the inner layer of the gum and bone pull away from the teeth (recede) and form pockets. These small spaces between teeth and gums may collect debris and can become infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed.
At this point, because there is no longer an anchor for the teeth, they become progressively looser, and the ultimate outcome is tooth loss.
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| Normal, healthy gums Healthy gums and bone anchor teeth firmly in place. |
Periodontitis Unremoved, plaque hardens into tartar (calculus). As plaque and tartar continue to build up, the gums begin to recede (pull away) from the teeth, and pockets form between the teeth and gums. |
Advanced periodontitis The gums recede farther, destroying more bone and the periodontal ligament. Even healthy teeth may become loose and need to be extracted. |
The main cause of gum disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like the following also affect the health of your gums.
During a periodontal exam, your gums are checked for bleeding, swelling, and firmness. The teeth are checked for movement and sensitivity. Your bite is assessed. Full-mouth X-rays can help detect breakdown of bone surrounding your teeth.
Periodontal probing determines the severity of your disease. A probe is like a tiny ruler that is gently inserted into pockets around teeth. The deeper the pocket, the more severe the disease.
In healthy gums, the pockets measure less than 3 millimetres and no bone loss appears on X-rays. Gums are tight against the teeth and have pink tips. Pockets that measure 3 millimetres to 5 millimetres indicate signs of disease. Tartar may be progressing below the gum line and some bone loss could be evident. Pockets that are 5 millimetres or deeper indicate a serious condition that usually includes receding gums and a greater degree of bone loss.
Following the evaluation, your dentist or periodontist will recommend treatment options. Methods used to treat gum disease vary and are based on the stage of the disease.
Very. According to Dr Peter Lavelle of the ABC, gum disease is the fifth most common health condition in Australia. Gum disease can progress quite painlessly until you have a real problem. That's why it is so important to prevent gum disease before it becomes serious. Chairman of the ADA's Oral Health Education Committee, Dr Don Wilson said that 90% of tooth loss could be attributed to tooth decay or gum disease which meant it was preventable.
Gum disease is usually preventable. Just take care of your teeth starting now - don't wait!
Gum disease will not go away by itself or with improved home care. The only way of removing plaque deep under the gums is with professional cleanings. Once you have had a gum problem you will always be susceptible to recurring problems, so be sure to see your dentist on a regular basis - every three to four months, unless he or she recommends otherwise.
Brushing - Brush your teeth gently, paying special attention to the areas where your teeth and gums meet. Clean every surface of every tooth. Use the tip of your brush to clean behind your upper and lower front teeth.
Flossing - Take a piece of floss and wrap it around your middle fingers. Using a clean section of floss each time, wrap the floss into a C shape around a tooth. Wipe it over the tooth, from base to tip, a couple of times. Repeat on each tooth.
If you have gum disease, getting rid of plaque and tartar gives your gums a chance to get better. That's why in the early stages of gum disease, the best treatment is:
When gum disease is more serious, your dentist may refer you to a dental specialist called a periodontist. A periodontist has extra training in treating gum disease and in restoring (or regenerating) bone and gum tissue that have been lost because of gum disease.
A periodontist also treats serious forms of gum disease that do not get better with normal dental care. When serious gum disease is found, brushing and flossing become even more important.
The goal of periodontal treatment is to control any infection that exists and to halt progression of the disease. Treatment options involve home care that includes healthy eating and proper brushing and flossing, non-surgical therapy that controls the growth of harmful bacteria and, in more advanced cases of disease, surgery to restore supportive tissues.
Opinions about which treatment methods to use vary in the periodontal field. For some people, certain procedures may be safer, more effective, and more comfortable than others may be. Which treatment your dentist or periodontist chooses will most likely depend on how far your disease has progressed, how you may have responded to earlier treatments, or your overall health.
Normal tooth cleanings remove plaque and calculus deposits from above the gum line. Root planing is necessary when these deposits extend below the gum line.
Root planing is performed with the same tools as normal cleanings but the procedure is more aggressive. Often it is necessary to numb the affected area before the procedure. Once the accumulated plaque and calculus have been removed, the gums will heal, tightening around the teeth.
Depending upon the extent of disease found in the examination, root planing may be done over several practice visits. In this way, your dentist can assess the progress of treatment and alter tactics if necessary.
Simply stated, root planing may be considered as an extension of a "routine cleaning". A "routine cleaning" is intended to clean harden deposits that form above the gums. Over time, these deposits often form below the gums, on the roots. It is at this point that we recommend root planing.
During this procedure the root surfaces are literally planed. This accomplishes several things:
Gum disease is a serious infection. Evidence now links gum disease to a variety of health concerns, including heart disease, stroke, diabetes, and other degenerative diseases that are life threatening. It's not just about your teeth anymore.
Gum disease can be a disfiguring disease. Your gums swell in size and become red. They may bleed very readily. Your teeth may shift and dark spaces between your teeth may start showing. The teeth then become loose and may need to be removed.
Early detection as with other diseases is the key to successful treatment. Your dentist or hygienist should routinely perform a gum disease screening exam. The results of this examination will determine your periodontal status. If you have gum disease, your treatment will be personalised for you and your level of infection. A routine cleaning is not enough by itself to treat gum disease.
The link between poor oral hygiene and poor overall health is well documented. The mouth is the
gateway to the rest of the body and disease and infection can enter via the mouth. The
oral bacteria found in patients with gum disease can enter into the blood stream. From
here the bacteria can travel throughout the body. Inflammation sets in but your body's
immune response sometime falls short. These bacterial colonies can cause serious
problems such as:
A chronic inflammatory disease of the gingiva (gums) results in damages of gingival connective tissues, periodontal ligaments, and bone in alveola. Iinflammation, clinically speaking, is seen as redness, swelling, and bleeding upon probing. Butt at molecular and cellular levels, the inflammatory process is defined by cellular infiltrates and the release of a variety of cytokines.
Gingivitis is an infection that is an early sign of a serious gum disease. It develops when plaque builds up in between the teeth and gums. Plaque is a layer that sticks to your teeth coming from drinks and food, bacteria or germs and mucus. Over time these can build up can lead to infection of the gums. The gums often do not hurt with gingivitis, so it is important to have a gum check from dentists. Treatment as early as possible is very important. People who do not have good oral hygiene by brushing or flossing their teeth often are prone to gingivitis. If not treated properly, the gum infection will happen again and may cause serious gum disease or tooth loss. The major provoking factor that invokes inflammation of gum tissues is the presence of bacterial biofilm or dental plaque on the teeth or gum/gingival interfaces.
Our mouths are full of different forms of bacteria. The food we eat makes it favourable for the bacteria to survive and reproduce rapidly in our mouth. These bacteria, together with mucus and other particles, regularly form a sticky, colourless "plaque" on our teeth. Cleaning the teeth through brushing and flossing help get rid of plaque. However, plaque that is not removed can eventually harden and form bacteria-harbouring matter called "tartar". Tartar sticks to teeth that ordinary brushing can't clean. These tartar can only be removed by a professional dentist or dental hygienist.
Flap Surgery. A periodontist may perform a "flap surgery" to clean tartar deposits in deep pockets of the teeth or to reduce the periodontal pockets to make it easier to keep the pockets clean and avoid tartars from forming. Flap surgery is only necessary if inflammation and deep pockets persists following medications and treatments of deep cleaning. Flap surgery involves lifting back the patient's gums and removing all the tartar. Afterwards, the gums will be sutured back in its original place so that the tissue fits well around the tooth again.
Tissue and Bone Grafts. Aside from flap surgery, a periodontist may also recommend bone or tissue grafts. Grafting is a process to replace or encourage new bone or gum tissue growth previously destroyed by periodontitis. A technique called guided tissue regeneration can be done with bone grafting. This process involves a small piece of mesh-like fabric to be inserted in between the bone and gum tissues. This will keep the gum tissue from growing into the area wherein the bone should be growing, allowing the bone and connective tissue to regrow. More info about Dental Surgery
See your dentist if you have any signs. Your dentist will clean and remove plaque from your teeth. To prevent gum infections, brush and floss your teeth at least two times each day to remove plaque before it builds up. See your dentist every six months to have your teeth checked and cleaned.
Please see reduced dental fees for cost of gingivitis treatment. Each state has its own rates for gingivitis treatment. Please review the appropriate dental cost or contact a local dentist for more information.
Please see our dentists and dental clinics list to find participating dentists providing gingivitis treatment services in Sydney, Melbourne, Brisbane, Perth, Adelaide, Canberra and other Cities. For best gingivitis treatment please make sure you have all the information about gingivitis and understood the process of getting the service from a dentist.
Source: Periodontal - Gingivitis (http://www.nidcr.nih.gov/NR/rdonlyres/1B30D2C4-4DBD-4400-B993-A18B58F22A97/0/Periodontal_spreads_Final.pdf)
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