WHAT IS GUM DISEASE

What is gum disease?

Gum disease (periodontal disease) is an inflammatory disease of the gums and the supporting structures of your teeth. It is the body’s natural reaction to harmful bacteria and the toxins they produce. It is a major cause of tooth loss. Periodontal disease was once known as ‘pyorrhoea.’ Fifty years ago it was not uncommon for people to have all their teeth out because of ‘pyorrhoea of the gums.’ Fortunately we now know a lot more about the disease and how to treat it.

Periodontal disease is caused by plaque. It can be divided into gingivitis and periodontitis.

Plaque and Calculus

Plaque is a film of bacteria that grows on your teeth. Calculus (tartar) is hardened plaque. If plaque is left for more than two days, it starts to mineralise and form calculus. This chalky substance often grows on the inside of your lower front teeth.

Calculus cannot be removed by flossing or brushing but has to be ‘scaled’ off by a dental professional

What is Gingivitis?

Gingivitis is inflammation of the gums. It is the earliest stage of periodontal disease and is caused when plaque is allowed to accumulate around the necks of your teeth. The bacteria in plaque are treated like a like a foreign body, the same as if you had a splinter in your finger. Your body tries to fight the bacteria and the gum gets red, swollen and bleeds easily. Unfortunately gingivitis is often painless and only identified during a dental examination.

Early gingivitis is usually completely reversible with regular hygienist treatment and improved home care

What is Periodontitis?

Untreated gingivitis may progress to periodontitis. The bacteria rich plaque grows down below the gum line causing the breakdown of the tissues that support the tooth. The tooth separates from the gum and a gap or pocket forms providing a sheltered place for more bacteria to grow. As the periodontitis advances, bone and tissue is destroyed and the pocket gets deeper. Because the gums are the foundations for your teeth, in severe cases the teeth may become loose or need to be extracted.

While advanced periodontitis is not reversible, regular dental care can restore gum health and stop disease progression

What are the Symptoms of Gum Disease?

Bleeding gums to touch, brushing or flossing
Red or swollen gums
Receding gums (becoming ‘long in the tooth’)
Loose or floppy gums
Painful gums
Loose adult teeth
Persistent bad breath

Remember, healthy gums don’t bleed. If you have any of these symptoms, see your dentist

What Are the Risk Factors for Gum Disease?

Inherited or genetic predispostion
Poor home care
Smoking
Diabetes
Heart disease
HIV
Other diseases and conditions
Inadequate nutrition
Hormonal changes
Puberty
Pregnancy
Aging
Certain medications
Substance abuse
Stress

Diagnosing Gum Disease

Gum disease assessment forms part of a routine examination. We start with a check of known risk factors and overall dental health. Then we do a periodontal screening, measuring the depth of the gum pocket around each tooth. We use a probe with a small ball on the end and it is not painful. This gives us a grading from 0-4. The mouth is split into 6 areas (sextants) and we record the worst score for each area.

Grade 0

Healthy gums should have a pocket 1-3mm deep and have no bleeding on probing. Note there the bone around the tooth is healthy and there is no loss of bone height.

Grade 1

Gums that bleed when brushing or flossing will also bleed to gentle probing. This is given a grade 1. It indicates the gums are inflamed. Note there the bone around the tooth is still healthy and there is still no loss of bone height.

Grade 2

If there is any plaque or tartar on your teeth in that particular sextant then they get a grade 2. This is early periodontal disease.

Grade 3

If the pocket is greater than 3mm deep then it is given a grade 3. This indicates the presence of established gum disease. The inflammation will be starting to cause the loss of the supporting bone. Once this bone is lost, it's ability to repair and grow back is very limited.

Grade 4

If the pocket is greater than 6mm deep then it is given a grade 3. There is usually calculus (tartar) extending down the root surface inside the pocket. This is accompanied by bone loss which can be seen on x-rays. Gums are often receding and teeth may be loose. It indicates the presence of advanced periodontal disease.

If you have bleeding, swollen or sore gums, any loose adult teeth or suffer from bad breath, you probably have gum disease. Come in and see us. Our team would love to help you get your gums back to good health