Gum Disease

Gum Disease

What do healthy gums look like?

Healthy teeth and gums are maintained by daily plaque removal from all surfaces of the tooth (through tooth brushing and interdental cleaning)

Visiting the hygienist regularly will help you to maintain your gums.

Healthy gums are characterized by the following features:

pink or coral pink colour, (normal variations in colour depend on race and complexion)

firm, resilient tissues

'orange-peel' texture (known as stippling)

shape that follows the contour of the teeth and forms a scalloped edge

no areas of redness, swelling or inflammation, no bleeding during daily plaque removal no discomfort

What is Plaque?

Plaque is the accumulation of bacteria, micro organisms and their products which sticks to the tooth surfaces. Dental plaque is soft and easily removed by brushing and flossing the teeth. Accumulation of plaque can lead to gum disease (gingivitis) and periodontal disease, as well as tooth decay.

What is Calculus (Tartar)?

Calculus is dental plaque that has mineralised. Calculus can form when plaque is not removed from the tooth surfaces. This plaque becomes old and eventually forms into calculus. Calculus can form above or below the gumline. The bacteria that sticks to calculus can cause gum disease (gingivitis) or periodontal disease. Calculus cannot be removed by brushing and flossing. A dental hygienist checks for calculus formation at each visit. It is removed with special instruments designed to adapt to the tooth surface affected without causing trauma to the soft gums.

What is gingivitis?

Gingivitis is inflammation of the gum tissue. The gums are irritated and swollen due to a plaque or calculus (tartar) build-up along the gumline. 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 interdental tooth cleansing). On the other hand, if oral hygiene habits are poor, gingivitis may progress to periodontitis.

What happens to my gums?

Gingivitis and periodontitis can be considered one disease complex, with gingivitis leading to periodontitis in some cases. Gingivitis often goes unnoticed in the early stages and may cause no symptoms until it is fairly advanced.

When gingivitis is advanced, it spreads to the bony tissues, which lie under the gums and support the teeth. This is called periodontitis which is much more serious than gingivitis.

In later stages of periodontitis, the teeth can become loose and severely infected with pus oozing from around the sockets. In very advanced periodontitis, the teeth can actually fall out or may have to be removed because of infection. Gum disease is the major cause of premature tooth loss.

Gingivitis and periodontitis are caused by bacteria, which are incorporated into dental plaque. Plaque begins as a soft and sticky substance, which forms constantly on all areas of the teeth. This soft material gets into every area in the mouth. It is especially harmful in areas where it is hard to see and hard to remove, such as between the teeth, and in the crevices between the gum and the tooth surface.

The longer this material is allowed to settle in the mouth, the more difficult it is to remove. At some point, this plaque hardens into calculus (tartar) and has to be scraped off the teeth. Calculus is best removed by the hygienist.

The bacteria in this plaque material are the primary cause of gum disease. The bacteria in plaque or tartar produces irritating substances that cause gingivitis and periodontitis.

What is periodontal disease?

Periodontal disease is a progression from gingivitis, and is a destruction of bone and the structures supporting the teeth. Unfortunately advanced periodontitis is irreversible, but you can stop its progression through good oral hygiene and regular visits to the hygienist.

Eight Warning Signs of Periodontal Disease

· gums that bleed when you brush or floss your teeth

· gums that are red, swollen or tender

· gums that have pulled away from teeth

· infection including purulence(pus) between the teeth and gums when the gums are pressed

· permanent teeth that are loose or separating

· any changes in the way your teeth fit together when you bite

· any changes in the fit of your partial denture

· bad breath

What are the signs and symptoms of the disease?

There are no symptoms in the early stages of gingivitis. Symptoms of gingivitis and periodontitis include: · blood on the tooth brush when brushing the teeth · swelling of the gums · redness of the gums · tenderness when the gums are touched · tenderness when chewing · pus around the teeth · bad taste in the mouth · change in the bite · visible deposits of tartar or calculus on the teeth

What are the risks of the disease?

If untreated, periodontitis can lead to abscess formation, acute pain and the loss of teeth. It is the biggest single factor of tooth loss in adults. If treated early in the gingivitis stage, loss of teeth is usually preventable.

What can be done to prevent the disease?

Gingivitis and periodontitis are preventable diseases. Simple attention to everyday oral hygiene and regular visits to the dentist and hygienist are all that is necessary to prevent this disease process.

Specific oral hygiene measures are

Brush with a soft toothbrush at least twice a day.

Change toothbrushes whenever the bristles begin to wear out. · Use a fluoride toothpaste.

Use special tips or devices to clean between the teeth or around bridges as suggested by a dentist or hygienist.

Keep removable denture appliances just as clean as the teeth.

Clean around orthodontic appliances or retainers.

Stay on a common-sense diet to keep oral tissues healthy. A diet high in sugars and starches has been shown to support higher levels of bacterial growth.

Have teeth examined every six months by your dentist and visit the hygienist every three to six months for cleaning.

How is the disease diagnosed?

Your dentist will make the diagnosis of gingivitis or periodontitis by examination, gum probing, and dental X-rays.

What are the long-term effects of the disease?

If untreated, gingivitis and periodontitis can lead to the loss of the teeth. With preventive care, there is no reason that the teeth should not last a lifetime. This disease process is almost always preventable or controllable if simple oral hygiene and regular dental checkups are followed.

What are the treatments for the disease?

Depending on the stage of the disease, treatment can range anywhere from simple cleaning, called prophylaxis, and home care to complex deep scaling and application of antibiotics under the gum line.

In very advanced cases, some teeth with a poor prognosis may have to be extracted.

Your dentist/hygienist will recommend appropriate treatment, which may vary considerably from person to person. Full patient cooperation is essential and will be stressed by the dentist or hygienist. Treatment without good oral hygiene practices at home will not be successful.

Heathy Gums Gingivitis Periodontal Diseases Advanced Disease

Good Brushing and homecare

Flossing and cleaning between teeth

Professional cleaning with the hygienist at 3, 4, or 6 monthly intervals