Gum (Periodontal) Disease

Gum disease, clinically known as periodontal disease, is estimated to affect twenty percent of Australian adults and is the number one cause of tooth loss.

What is gum disease?

Gum disease is an infection of the tissues and bone that support your teeth. It is typically caused by the build-up of plaque, a sticky, colourless film that forms on your teeth and along the gum line, causing bacteria.

Plaque can be managed by maintaining a good oral hygiene routine. This includes brushing twice a day and flossing once a day. When plaque isn’t removed, it builds up over time and the bacteria within plaque can infect your gums, teeth and in more severe cases your gum tissue and bone.

The development of gum disease is split into two stages; gingivitis and periodontitis.

Gingivitis

Gingivitis is a mild and common form of gum disease, representing the infection in its earliest stage. At this stage, only the layers of gum are affected, in particular where the gum meets the tooth. As the plaque builds up, it produces toxins which irritate the gums and bone, causing inflammation.

At this stage, people will commonly notice bleeding while brushing and flossing, yet not feel any pain or discomfort.

Inflammation from gingivitis when it goes untreated, can then cause the gums to separate from the tooth and bone, forming spaces between the teeth and gums, leading to a more serious form of gum disease, known as periodontitis.

Gingivitis is reversible with improved oral health care and a visit to your dentist.

Periodontitis

The second stage of gum disease is called periodontitis. Periodontitis develops if gingivitis remains untreated or is treated incorrectly. This latter stage of gum disease is irreversible as the bone and fibres that hold your teeth in place, are damaged. Your gums form spaces or pockets below the gum line, which trap food and plaque. When left untreated, periodontitis can cause your teeth to loosen and may have to be removed.

Periodontitis is irreversible, however with improved brushing and flossing and correct dental treatment, you can avoid further damage to your teeth and gums.

What causes gum disease?

While plaque is the main cause of gum disease, there are other factors that can contribute to its development. These factors include:

  • Poor oral hygiene habits – Irregular brushing and flossing can lead to an increase in plaque, making it easier for gingivitis to develop.
  • Inadequate nutrition
  • Hormonal changes – Gums are often more sensitive during puberty, pregnancy, menopause and menstruation, which can make it easier for gingivitis to develop.
  • Medication – Medications often reduce the flow of saliva, which helps to protect teeth and gums. As a result, teeth are more exposed to bacteria and plaque.
  • Smoking
  • Diabetes
  • Family history – If your family has a history of gum disease, you are more likely to develop gingivitis.
  • Aging
  • Stress
  • Systemic diseases
  • Substance abuse and HIV infection

What are the symptoms of gum disease?

People are often unaware that they have gum disease, as it can progress painlessly with very few obvious symptoms. However, there are some symptoms to look for, including:

  • Gums that bleed during and after brushing
  • Red, tender or swollen gums
  • Receding gums
  • Persistent bad breath or bad taste in your mouth
  • Formation of deep pockets in between teeth and gums
  • Loose teeth

How is gum disease treated?

There are a variety of treatments for gum disease, with the goal being to control the infection. Depending on the severity of the gum disease, your overall health and your history with past gum disease treatments, your dentist will recommend a suitable treatment.

In mild cases, the dental practitioner will deep-clean (scale and root plan) your teeth. Scaling removes plaque from the above and below the gum line, while root planing removes rough spots on the tooth root. In some cases, your dentist may prescribe a medication to be used in conjunction with a deep-clean. These nonsurgical options aim to control the bacteria growing in the mouth and reduce the size of periodontal pockets.

Surgical treatments are required for extreme cases of gum disease or periodontitis. Flap surgery may be necessary if deep pockets and inflammation remain after deep cleaning and medications. This surgery commonly involves the dentist lifting back the gums to remove tartar. Once removed, the gums are stitched back in place and the gums heal snugly around the tooth.

Bone and tissue grafts aim to regenerate the bone or gum tissue that has been lost. Bone grafting involves a natural or synthetic bone replacing the lost bone. Tissue is regenerated through a procedure using a mesh-like material which is inserted between the bone and gum tissue. This stops the gum tissues from growing into the space where the bone should be.

During you consultation, your dentist will run through the options and advise which treatment plan works best for you.

Disclaimer: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.