Periodontal disease, commonly known as gum disease, is an inflammatory condition affecting the tissues surrounding a tooth. It is caused by the build-up of plaque.
Plaque is a sticky film that contains a mixture of bacteria, saliva and food debris and constantly forms on the teeth within hours of brushing. After eating, food particles accumulate around the teeth and gums. If these particles are not removed, bacteria in the mouth begin to grow. Most bacteria in the mouth are harmless but some cause damage to the teeth and gums by releasing chemicals. Therefore it is very important to remove the plaque by brushing twice daily and flossing or using interdental brushes at least once a day.If plaque is not removed then it begins to harden as the calcium present in saliva gets deposited onto the plaque. This hardened plaque is called tartar or calculus. Tartar protects the bacteria within the plaque but also creates a rough surface that allows new plaque toad here. This cycle of tartar formation and further plaque build-up can continue unless the tartar is removed. Unlike plaque, tartar can only be removed by your dentist or hygienist using specialised instruments.
Plaque and tartar contain numerous bacteria and these release chemicals that can damage the gums and jaw bone. In addition, the presence of plaque and tartar causes your own body to mount an inflammatory and immune response to try to combat the bacteria. This response involves your body releasing cells and chemicals but as well as killing the bacteria, these cells and chemicals cause damage to the gums and jaw bone. The jaw bone can start to shrink away from the teeth and this means there is less support for the teeth. Therefore, plaque and tartar has a double effect in causing gum disease.
One of the main problems with gum disease is that it does not cause pain until there is significant damage. However, there are some tell tale signs of the effects of plaque andtartar. In the early stages you may notice some or all of the following:
If the above have only recently been noticed then it may indicate the gum disease is at an early stage in which case removal of the plaque with optimum home plaque control, and removal of tartar by a dentist/hygienist will reverse the damage. The gums will then return to a healthy state as long as the plaque and tartar are not allowed to re-accumulate.
If the gum disease is allowed to progress then you may notice:
If you see us for the treatment of your gum disease we will take detailed measurements to assess the severity of the problem. This includes a measurement of the gum pocket which is the vertical gap between the gum and the tooth. A healthy gum fits snugly around the teeth but gum disease can lead to a larger gap forming, and the gum measuring probe will produce a bigger reading.
Gingivitis is an inflammation of the gums and usually represents the early stages of gum disease. Gingivitis can be reversed by eliminating any plaque or tartar deposits with thorough scaling of the teeth. The gums will then return to a healthy condition. However, if gingivitis is not treated then it may progress to periodontitis. In periodontitis it is the underlying jaw bone that is affected and starts to dissolve away. This jaw bone shrinkage cannot be reversed by home plaque control or by scaling the teeth.
The key to the management of gum disease is removing any plaque or tartar build up. In the vast majority of patients, removing plaque and tartar and preventing it from building up again will stabilise the gum disease. Plaque can be removed by cleaning all surfaces of each tooth with effective toothbrushing and the use of floss or interdental brushes. Other cleaning aids such as a water flosser or irrigator can also help. The removal of tartar however, requires specialised instruments and seeing your dentist or hygienist.
In some situations, advanced techniques can be utilised to treat your gum disease. At Distinguished Smiles we offer these advanced treatments which include procedures to regenerate lost jaw bone or to treat gum recession. It is important a thorough assessment is performed to ensure these advanced techniques are appropriate for you and we will ensure we do this. It is essential your plaque control is very good and we can help you achieve this to make sure such treatments have the best chance of success.
Most people suffer from some form of gum disease and it is still a major cause of tooth loss in adults. A simple home care routine that effectively removes plaque, and regular monitoring with measurements and x-rays by your dentist/hygienist is fundamental in the management of gum disease. Professional cleaning may also be necessary. Some patients however, are more prone to gum disease than others. Conditions that affect your immune system, such as diabetes, can mean you are more likely to suffer from gum disease. In other patients a small amount of plaque build-up can cause significant and advanced gum disease leading to early tooth loss. In these situations there can be a genetic element which allows the small accumulation of plaque to cause excessive damage to the gums.
It is well known that smoking can cause many diseases of the body. The gums can be particularly susceptible to smoke from tobacco products including e-cigarettes. Smoking reduces the amount of blood flowing through the gums and so fewer healing cells are available to combat the bacteria in plaque and tartar. Whilst completely stopping smoking would be ideal, even reducing the amount of smoking that is undertaken can significantly improve your gum health. When people stop smoking they often experience more gum bleeding than when they smoked. This is completely normal and is caused by more blood and oxygen flowing through the gums. Over a period of a few weeks this should stabilise as long as there is no plaque or tartar build-up.
Recently, gum disease has been linked with other health conditions such as heart disease, diabetes, strokes and poor pregnancy outcomes. There is a lot of research at the moment to understand how gum disease is linked to other systemic conditions but there is plenty of evidence to suggest that having a healthy mouth can help improve your general health.
An effective toothbrushing technique in combination with flossing or using interdental brushes is key in the prevention of gum disease. It is possible to maintain high oral hygiene levels with manual toothbrushes and if this is the case, an electric toothbrush is not needed. However, many people find it is easier to use an electric toothbrush to keep their teeth and gums clean. If you are struggling to remove all of the plaque then you may find an electric toothbrush beneficial. We can easily check the effectiveness of your brushing technique and advise you which brushing technique will be best for you.