Gum disease, also known as periodontal disease or periodontitis, is a condition that affects the tissues surrounding and supporting the teeth. It’s caused by bacterial growth in the mouth and is typically preceded by gingivitis, which is inflammation of the gums.
Periodontitis is a more severe form of gum disease where the inflammation spreads deeper into the supporting structures of the teeth, including the gum tissue and bone. In periodontitis, the gums may recede from the teeth, forming pockets that become infected. Over time, the bone and connective tissues that hold teeth in place can be destroyed, leading to tooth loss.
What is gum disease caused by?
The main causes and risk factors associated with gum disease include:
- Poor Oral Hygiene: Inadequate brushing and flossing allow plaque to build up on teeth and gums, leading to gum inflammation and disease.
- Tobacco Use: Smoking or chewing tobacco increases the risk of gum disease. Tobacco users are more likely to have sticky plaque on their teeth that is difficult to remove.
- Genetics: Some individuals may be more genetically predisposed to gum disease. Genetics can affect the body’s immune response to bacteria, influencing the likelihood of developing periodontal disease.
- Health Conditions: Certain systemic diseases such as diabetes can impair the body’s ability to fight infection, including gum infections. Other conditions that can contribute to gum disease include HIV/AIDS and certain autoimmune disorders.
- Hormonal Changes: Changes in hormones during puberty, pregnancy, menstruation, and menopause can make gums more sensitive and susceptible to gum disease.
- Medications: Some medications, such as certain anti-seizure drugs and antihypertensive medications, can affect oral health by causing dry mouth (reduced saliva flow), which can contribute to gum disease.
- Poor Nutrition: A diet lacking in essential nutrients, particularly vitamin C, can weaken the immune system and make it harder for the body to fight off infections, including gum infections.
- Stress: Stress can weaken the immune system and make it harder for the body to fight off infection, including gum infections.
- Teeth Grinding (Bruxism): Grinding or clenching teeth can put excessive force on the teeth and supporting tissues, which can contribute to gum recession and damage.
Gum disease symptoms
- Gums that bleed easily: You may notice bleeding when brushing, flossing, or even eating hard foods.
- Swollen or red gums: The gums may appear swollen, tender, and redder than usual.
- Gum recession: The gums may pull away from the teeth, making the teeth look longer than before. This can expose the roots of the teeth.
- Bad breath (halitosis): Persistent bad breath that does not go away even with brushing and mouthwash can be a sign of periodontitis.
- Pus between gums and teeth: You may notice pus coming from between the teeth and gums when pressure is applied or when brushing.
- Loose or shifting teeth: As the bone supporting the teeth is damaged, teeth may become loose or shift in position.
- Changes in bite: You may experience changes in the way your teeth fit together when you bite down.
- Painful chewing: Discomfort or pain when chewing can occur as the gums and supporting structures become more damaged.
- Sensitive teeth: Teeth may become more sensitive to hot or cold temperatures.
- Abscesses: In severe cases, abscesses (localized collections of pus) may form around the teeth or gums.
Is there a way to stop gum disease?
Gum disease can be prevented by taking proper care of your gums and teeth. Following are some ways to prevent gum disease:
- Good Oral Hygiene: Brush your teeth at least twice a day and floss daily to remove plaque and prevent its buildup.
- Regular Dental Visits: Schedule regular check-ups and professional cleanings like scaling with your dentist or dental hygienist.
- Healthy Lifestyle Choices: Avoid smoking and maintain a balanced diet to support overall oral health.
- Use of Mouthwash: Antiseptic mouth rinses can help reduce plaque and prevent gum disease.
Gum disease treatment
The treatment of periodontitis (advanced gum disease) typically involves both professional dental care and improved oral hygiene practices at home. The goals of treatment are two fold:
- Eliminate the bacterial infection causing the disease
- Reduce inflammation, and prevent further damage to the gums and supporting structures of the teeth.
Treatment options may vary depending on the severity of the disease. The common approaches include:
Scaling and Root Planning or Deep Cleaning
This is a non-surgical procedure performed by a dentist or dental hygienist to remove plaque and tartar (calculus) from above and below the gumline. Scaling removes plaque and tartar from the surfaces of the teeth, while root planning smooths the root surfaces to help the gums reattach to the teeth.
Local anesthesia may be used to ensure comfort during the procedure, especially if the pockets between the gums and teeth are deep.
Medications
Antibiotics
Antibiotics may be prescribed to help control bacterial infection, especially if the periodontitis is severe or if there are signs of systemic involvement.
Antimicrobial mouth rinses
Antimicrobial mouth rinses can help reduce bacteria and plaque.
Antiseptic chips or gels
These are placed in deep pockets after scaling and root planning to help control infection and promote healing.
Surgical Treatments
Flap surgery/pocket reduction surgery
In cases where deep pockets persist after scaling and root planning, surgical intervention may be necessary. During flap surgery, the gums are lifted back and tartar is removed. The gums are then sutured back in place to fit snugly around the teeth.
Soft tissue grafts
Tissue grafts are used to augment or replace gum tissue that has been lost or damaged due to periodontal disease, trauma, or other factors. They can also be used to improve the appearance of the gums, especially in cases of gum recession . It involves taking a small piece of tissue from under the top layer of the roof of the mouth (palate) and stitching it to the area where gum recession has occurred. This helps to thicken the gum tissue and cover exposed tooth roots. Soft tissue grafts can reduce tooth sensitivity caused by gum recession, protect exposed tooth roots from decay, improve aesthetics by restoring a more natural gum line, and help prevent further gum recession.
Bone grafts
This procedures may be performed to regenerate bone or gum tissue that has been lost due to periodontitis. The graft material which may be a bone taken from any part of the body or synthetic bone material is placed into the area where bone loss has occurred. Over time, the patient’s own bone cells grow into the graft material, replacing it with new bone. Bone grafting restores bone volume and density necessary for supporting teeth and prevents tooth loss.
Guided tissue regeneration
After cleaning the root surfaces, a barrier membrane is placed between the gum tissue and the tooth root. This membrane acts as a physical barrier to prevent unwanted tissue (such as epithelial cells from the gums) from growing into the area where new bone and ligament should form.
Ongoing Maintenance
Once periodontitis is treated, ongoing maintenance is crucial to prevent recurrence. This typically includes
- Regular dental cleanings every 3-4 months to monitor and maintain oral health.
- Improving oral hygiene habits at home, such as brushing twice a day with a fluoride toothpaste and flossing daily, is essential.
- Quit smoking and maintaining a healthy diet can also support gum health.
Summary
It’s important to note that gingivitis is an initial stage of gum disease and can often be reversed with proper oral hygiene habits, such as regular brushing, flossing, and professional dental cleanings. On the other hand, periodontitis requires more intensive treatment from a dental professional to manage and prevent further damage.
Addressing gum disease promptly is important to prevent complications such as tooth loss and to maintain overall oral health. If you suspect you have gum disease or have concerns about your oral health, consult your dentist for an evaluation and personalized treatment plan.
FAQs
What is gum disease caused by?
Periodontitis is primarily caused by bacterial plaque buildup on teeth and gums which is mainly due to poor oral hygiene.
Can gum disease kill you if not treated?
Yes, in some cases if untreated it can damage your heart. Periodontitis can lead to significant damage to the gums and bone supporting the teeth. Chronic inflammation and the presence of periodontal pathogens have been linked to systemic health conditions such as diabetes, cardiovascular disease, respiratory infections, and adverse pregnancy outcomes. Treating periodontitis can help reduce these risks.
What causes periodontitis?
Periodontitis is primarily caused by bacterial plaque buildup on teeth and gums which is mainly due to poor oral hygiene.
Can gum disease be cured?
Periodontitis is not necessarily curable in the sense that once the damage to the gums and bone has occurred, it cannot always be fully reversed. However, with appropriate treatment and ongoing maintenance, periodontitis can be managed effectively to prevent further progression and maintain oral health.
Who is a periodontist and when to see a periodontist?
Periodontists are dentists who are specialized in treating and preventing gum disease. If you notice any signs of gum disease, such as red, swollen, or bleeding gums; persistent bad breath; receding gums; or loose teeth, it’s important to see a periodontist promptly. Early detection and treatment of gingivitis can prevent it from progressing to periodontitis.