Gum disease is very common but not normal. There are two main forms of gum disease:
- Periodontitis, where we recognise Aggressive and Chronic types
Both can affect adults and children, although periodontitis in children is usually related to an underlying systemic condition. The main difference between these two forms is that gingivitis is a reversible condition as it affects superficial layers of the gums. Periodontitis is irreversible as the underlying tooth supporting tissues (bone and periodontal ligament) are lost, eventually leading to tooth mobility and loss.
When gingivitis is present, gums are swollen, red in colour and bleed easily. It can happen on tooth brushing or biting into something hard such as an apple. In severe cases gums can bleed spontaneously.
Periodontitis is a painless condition, until a very advanced stage. Patients with periodontitis may get the same symptoms as gingivitis, but also bad taste and/or breath, tooth sensitivity, gum recession, drainage of pus, mobility, spaces opening between the teeth, teeth changing position and in advanced stage pain, recurrent abscesses and ultimately tooth loss. Adults lose more teeth to gums disease than to decay.
The major cause of gum disease is dental plaque (sticky, cream coloured mass of bacteria), which starts building up on our teeth the moment we stop brushing. It takes about to 2-3 weeks of constant missing the part of the gum for gingivitis to develop there, but it can take only 48 hours for calcium salts from the saliva to harden to form tartar (hard, rough creamy/dark looking substance), which is inevitably covered by plaque and aggravates the condition. Tartar cannot be eliminated from the teeth with ordinary tooth brushing, and requires professional use of ultrasonic scalers and/or hand instruments to remove it.
Gum disease varies form person to person, as the response to the challenge from the bacterial plaque depends on an individual genetic makeup.
Periodontitis can affect just a few teeth at the front or back, or all teeth. It can progress in episodes, which means there are short periods of time when tissues are destroyed that alternate with phases when the disease does not progress and the tissues can even recover a bit. However, if left unattended it will progress and progress leading ultimately to tooth loss.
It is thus paramount to have regular dental examinations, when a screening test (BPE) is performed to detect presence of gum disease in its earliest possible stage, so an appropriate treatment can be initiated immediately to, in case of gingivitis reverse, or in case of periodontitis, prevent, further irreversible destruction of the tooth supporting tissues (bone and periodontal ligament).
There is a link between periodontitis and systemic conditions, like diabetes or heart disease. Treating gum disease improves glycaemic control in people with diabetes 3-4 months after treatment. In clinical practice, continuing professional periodontal support is needed to maintain clinical improvements beyond that time.
People with periodontal disease are almost twice as likely to have heart disease. There are still on going investigations in that area. The link between the two diseases is thought to be due to the same bacteria. Bacteria found in infected gum tissue break down the barrier between the gums and the underlying tissue, causing inflammation. During normal chewing or brushing, bacteria can enter the bloodstream and move to other parts of the circulatory system, contributing to the formation of cardiovascular disease. Inflammation, or swelling, is the body’s natural response to infection. It is possible that oral bacteria traveling through the body trigger a similar response, which then leads to the formation of arterial plaque. Oral bacteria have been found in the fatty deposits of people with atherosclerosis. These deposits can narrow arteries or break loose and clog them entirely, leading to heart attack or stroke.
Treating gum disease can save more than just teeth!
The treatment advertised may not be appropriate for every patient and that it is conditional on a satisfactory assessment being carried out.
Forge House Dental will assess the patient, obtain appropriate consent, obtain a medical history and explain all the options before carrying out any work.