Understanding Gum Disease and the Causes

Many patients attending dental practices will already have a fairly good understanding of tooth decay but they are often somewhat unclear when it comes to gum disease. This article will give you a better understanding of the subject and explain a few basic facts about what is known in the profession as periodontal disease – gum disease to most of us.

Gum disease is caused by bacteria, which is present in our mouths. For various reasons the quality of mouth bacteria can vary. The bacteria stick to the tooth surface. If our brushing and cleaning between each tooth is not very effective, the bugs will irritate the gums and eventually find their way below the gum line. As a result, the fibers of ligament that hold the tooth in the socket will be affected – and the formation of a "periodontal pocket" will begin. It is important to remember that very potent bacteria, which do not require oxygen, can survive below the gum line for a long time and destroy not just the ligament but subtly the bone, which is structurally needed to hold the teeth in their place. In the long term some teeth can become loose and tooth loss can also occur.

What are the main factors contributing to this process?

As mentioned before, poor oral hygiene, ie not brushing or flossing regularly or using a mouth wash, stress, genetics, smoking (although non smokers can also develop very severe disease), and diabetes (especially if not controlled well).

Gum disease is considered by many to be a silent disease. There is often no pain involved to begin with. That is why regular checks with the dentist are recommended. In many cases, the dentist will probably refer the patient for a further thorough assessment. This will involve a very detailed examination of the patient's gums and sometimes even x-rays.

It is very common among dental practices to see patients who have been referred to a hygienist by the dentist for treatment and probably a good 80% of them would say: 'I never knew I had this problem'.

Symptoms may include the following: bleeding on brushing, blood on the pillow, or in case of advanced disease it would be pain or mobility or even some visible tooth movement.

Can the disease be treated?

Yes, it can in the vast majority of cases. The treatment will focus on controlling the bacteria responsible for the damage to the ligaments or the supporting bone. The treatment objective is to arrest the disease – and to prevent it from causing any more damage. It is not possible to replace the missing bone.

One of the benefits of seeing a hygienist is that not only will they help clean teeth and remove bacteria from under the gum line but they can help with teaching patients techniques to clean their teeth really effectively. It is extremely important to remember that the success of the treatment will depend on your home care. Initially this process may seem daunting, however, even patients with some limitations in their manual dexterity can manage fairly well with the right help from the professional oral health educators.

Once the initial phase of the treatment is completed, patients are usually advised upon appropriate recall times for their maintenance appointments. Periodontal disease must be monitored and support therapy delivered periodically to prevent it from fairing up.

Specialist periodontists agree that the impact of not having treatment will depend upon the severity of disease.

In moderate to advanced cases, no treatment could mean developing pain, disease getting worse or premature tooth loss.

Main Points to remember

If you notice the following: blood on brushing, gums appear swollen or red, there are signs of gaps between the teeth, a tooth shows looser or there is persistent bad breath, then you should contact your dentist and tell them about your concerns.

It is also important to tell your dentist about any problems with your general health or medication you are taking, as this might have an effect on your gums.

Gum disease is treatable!