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What causes gum disease?

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Gum disease is always initiated by the presence of bacteria on the tooth surface, which builds up through insufficient cleaning. The bacteria stimulate the gums to become inflamed resulting in gingivitis. For many people the process stops here. Gingivitis is a reversible condition and causes no lasting damage to the gums.

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For some people, the inflammation process progresses to periodontitis. In these cases there are usually risk factors at play (discussed below). Periodontitis causes irreversible damage to the gums and underlying bone. The extent of the damage depends on the severity of the condition. Extensive periodontitis is one of the leading causes of tooth loss. The changes that occur during periodontitis can be summarised by the diagram below:

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Periodontitis is characterised by periodontal pockets, which accumulate bacteria and debris under the gum, making it impossible to keep clean with home care. As the disease progresses, the pocket becomes deeper and the bone around the tooth starts to disappear, resulting in loose teeth.

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What causes gum disease?

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As mentioned above, insufficient and/or improper cleaning of the mouth initiates in gum disease. There are well recognised factors called risk factors, that can cause gum disease to worsen. The most common ones are:

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Smoking: Smoking reduces blood supply and affects healing of the gums. Gum disease especially periodontitis is one of the most common conditions smokers suffer from.

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Diabetes: Poorly controlled diabetics are at increased risk of severe periodontitis.

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Genetics: Individuals whose immediate family members have gum disease are more susceptible to to the condition. 

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Puberty, Pregnancy & Menopause: Hormonal changes around these events cause the gums to bleed more easily.

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Medication: Certain drugs such as blood pressure and epilepsy medication can cause the gums to swell.

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Stress & Poor Nutrition: These can affect healing of the body and thereby lead to worsening gum disease.

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Bite problems and Grinding/Clenching: These can affect the gums around select teeth and make periodontitis worse.

 

Teeth factors: Fillings, crowns and bridges, malpositioned teeth amongst other factors can affect the gums around these teeth.

 

 

What are the symptoms of gum disease?

 

Painful/Swollen Gums: ​On the whole gum disease does not cause pain as it is a long standing condition. Gum pain is usually a sign of an acute flare up of infection of the gums.

 

Bleeding: This is the most common symptom of gum disease. Heavy smoking can actually mask the presence of gum disease. You may have heard of people mentioning their gums to bleed when they stopped smoking. This happens as blood supply improves and the effects of gum disease are more noticeable.  

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Bad breath: A common symptom of gum disease but sometimes can be through hydration.

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Loose teeth: Teeth do not loosen with age. Loose teeth are generally due to very severe periodontal disease. Other conditions such as infections, grinding of teeth, broken teeth or loose crowns can result in loose teeth.

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Movement of teeth: Periodontal disease affects the foundation of the teeth and makes the more liable to move.

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Gum recession: Periodontal disease usually causes the gums to recede between the teeth. Recession around the front of the teeth is usually caused by aggressive brushing, orthodontic treatment or grinding/clenching of the teeth.

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Food packing: This can be due to periodontal disease, decay or broken teeth/fillings.

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What is the treatment for gum disease?

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Gingivitis can be remedied through improving oral hygiene and regular visits to the hygienist.

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Periodontitis requires in depth treatment, which starts with oral hygiene education and the control of risk factors such as smoking.

 

Professional treatment starts with non-surgical (initial) treatment, which is a thorough "deep clean" of affected areas. The treatment aims to remove the bacteria and debris that cannot be cleaned off through home oral hygiene measures. The gums are allowed to settle and re-checked after 3 months. Further sessions of deep cleaning may be required to achieve a complete result. The aim of this modality of treatment is to reduce the inflammation and depth of the periodontal pockets. Well performed non-surgical treatment is highly effective in majority of cases.

 

However, in a small number of cases especially for severe periodontitis there may be a need for additional complex treatment such as pocket reduction or regenerative surgery. 

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Periodontal disease, like other chronic diseases such as diabetes, has no cure. Hence it is vital to continue seeing the dentist and hygienist on a long-term basis for monitoring and maintenance of periodontal stability.

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How comfortable is periodontal treatment?

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Routine hygiene and mild periodontal treatment can usually be carried out without any local anaesthetic. The treatment of more extensive periodontal treatment is carried out with local anaesthetic, thereby ensuring patient comfort. There will be some minor discomfort and soreness after the procedure, which can be easily controlled with painkillers if needed. Patients are generally okay to start brushing straight away after the treatment unless otherwise advised.

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How can periodontal treatment benefit you?

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Reduced Tooth Loss: There is nothing like what nature has given us and hence it is preferable to maintain natural teeth as long as possible. Modern periodontal treatment is able to achieve a lot more in the way of prolonging the longevity of affected teeth.

 

Prerequisite to & Success of Dental Work: The gums form the foundation of the teeth. Most advance dental work such as implants, aesthetic work and orthodontic treatments can only be started once the gums are healthy. The long term success of all dental treatments relies on healthy gums. 

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Lifestyle: Improved gum health will mean no more bad breath, missing teeth and help prevent gum recession which is a key part of your smile.

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Healthier body: Gum disease has been linked to a number of other conditions and diseases namely heart disease, stroke, Parkinsons, diabetes and arthritis. It can also contribute to premature, low-weight babies in pregnant women. It has been proven that improving gum health helps to prevent these conditions and improve diabetic control and vice versa.

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For more information about gum disease visit https://www.dentalhealth.org/gum-disease

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