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ABC of Gum Disease

By  ,  Onlymyhealth editorial team
Jul 25, 2011
4.8 / 5(4 Ratings)

What is Gingivitis

 

Gingivitis is inflammation of the gums. Gingivitis is caused if plaque (a sticky substance that is constantly formed when bacteria present in the mouth get deposited along with saliva, food particles and other natural substances on the surface of the teeth) is not removed by daily brushing and flossing. Plaque deposited on the teeth and under the gumline irritates the gum tissue, and causes gingivitis.

 

As this is initial stage the gum disease (gingivitis), it is easy to treat. The bone and connective tissue that hold the teeth in place are not yet affected at this stage. If gingivitis is not treated it can lead to periodontitis and cause permanent damage to the teeth and jaw.

 

Do I Have Gingivitis

 

The characteristic signs and symptoms of gingivitis are

  • Red, swollen, tender gums that may bleed on brushing or

  • Gums that seem to have receded or pulled away from your teeth, giving the teeth an elongated appearance.

Gum disease leads to formation of pockets between the teeth and gums. Plaque and food debris can collect in these pockets. Gum disease can cause persistent bad breath or a bad taste in the mouth, even if the disease is not advanced.

 

How can I Prevent Gingivitis

 

Gingivitis is very much preventable--- if you maintain good oral hygiene. Tips to prevent gingivitis include

  • Daily brush and floss well to remove plaque from between teeth and below the gumline and control tartar buildup

  • Go for regular dental checkups. Preventive care can avert problems from occurring and control minor problems from becoming major ones. Cleaning by a dentist or dental hygienist is important for plaque that has hardened into tartar.

  • Eat a balanced diet. Your diet must contain calcium-rich foods such as milk and cheese as calcium makes teeth strong.

  • Avoid smoking and other forms of tobacco

 

Signs and Symptoms

 

How do I Know if I Have Gum Disease

 

Gum disease occurs most commonly in adults, but it can occur even in children. Gum disease (gingivitis) is easy to treat in this early stage as the bone and connective tissue that hold the teeth in place are not yet affected.

 

Consult your dentist if you have any of the following symptoms

  • Red, puffy or swollen, or tender gums

  • Bleeding from gums while brushing or flossing

  • Your teeth appear longer because your gums have receded

  • Gums seem to have separated, or pulled away, from the teeth, forming a pocket

  • Change in your bite (i.e. the way your teeth fit together on biting).

  • Pus between your teeth and gums

  • You have persistent bad breath or a bad taste in your mouth

 

What are the Stages of Gum Disease

 

Gingivitis or gum disease is inflammation of the gums. It can affect the bone that surrounds and supports your teeth if not treated appropriately. Gingivitis is caused by the plaque formed constantly in your mouth. If the plaque is not removed by daily brushing and flossing it can build up. The bacteria present in the plaque infect not only your gums and teeth, but the gum tissue and bone that support the teeth as well and can cause permanent damage to the teeth and jaw.

 

The three stages of gum disease are as follows

 

Gingivitis: This is the earliest stage of gum disease. It is caused by plaque deposited at the gumline. The bacteria present in the plaque produce toxins (poisons) which lead to irritation of the gum tissue and then gingivitis. As this is initial stage the gum disease (gingivitis) is easy to treat as the bone and connective tissue that hold the teeth in place are not yet affected.


Periodontitis: The bone and connective tissue that hold the teeth in place are affected in periodontitis. This leads to formation of pockets between the teeth and gums. Plaque and food debris can collect in these pockets. Further progression of periodontitis is possible through appropriate dental treatment and improved home care.
 

Advanced Periodontitis: This is the final stage of gum disease. The bone and connective tissue that hold the teeth in place are destroyed in advanced periodontitis. The teeth tend to shift or loosen and can affect your bite. At times even aggressive treatment can not save your teeth and they may need to be removed.

 
How is Gum Disease Treated

You should always go for regular dental checkups. Preventive care can avert problems from occurring and control minor problems from becoming major ones.

    * Gum disease in early stage can be reversed by daily brushing and flossing to remove plaque. This can prevent plaque buildup.
    * Cleaning by a dentist or dental hygienist is important for plaque that has hardened into tartar. Professional cleaning can clean or "scale" your teeth to remove the tartar above and below the gumline.
    * Your dentist may do a root planing procedure if your gum disease is serious. Root planing is done to smooth irregularities on the roots of the teeth. This prevents deposition of plaque. For more advanced condition further treatment in the dental office is needed.


Fighting Gum Disease: How to Keep Your Teeth

 
Early gingivitis causes red, swollen, tender gums that may bleed on brushing. Advanced gum disease can lead to tooth loss. So if you want to have teeth for your lifetime, you must take care of your gums.

Your mouth contains millions of bacteria, of which, some are harmless, where as others can attack the teeth and gums. Harmful bacteria are present in plaque. Plaque is the sticky substance that is constantly formed when bacteria present in the mouth get deposited along with saliva, food particles and other natural substances on the surface of the teeth. If it is not removed by daily brushing and flossing the plaque deposited on the teeth and under the gumline can irritate the gum tissue, causing gingivitis. If gingivitis is not appropriately treated it can lead to periodontitis and cause permanent damage to the teeth and jaw.

 
The good news is that-----gum disease is very much preventable by maintaining good oral hygiene with:

    * Daily brush and floss to remove plaque from between teeth and below the gumline and control tartar buildup
    * Regular dental checkups and cleanings as required and
    * Use of approved products to diagnose and treat gum disease, and even regenerate lost bone. Use of these products can improve the effectiveness of the professional dental care.


What is Gum Disease

Gum disease or periodontal disease denotes inflammation of the gums and the tissue surrounding and supporting the teeth. It is caused by formation of plaque on the teeth and under the gumline which causes bacterial growth and production of toxins (poisons). These factors lead to irritation of the gum tissue and if not treated at this stage can gradually destroy the tissue surrounding and supporting the teeth. Gingivitis and periodontitis are the two major stages of gum disease.

    * Gingivitis denotes inflammation of the gums.
    * Periodontal means "around the tooth." Periodontitis means inflammation of the bone and connective tissue that hold the teeth in place.

A dentist after examination can tell if you have gingivitis or periodontitis, based on what he or she sees and feels in your mouth, and the condition of your gumline. It is important to remember that all gingivitis do not progress to periodontitis.

 
Gingivitis: In people with early gingivitis, the gums are red, swollen and bleed often during tooth brushing. But the teeth are firmly planted in their sockets and there is no associated bone or other tissue damage. Bleeding does not necessarily indicate gingivitis. It just denotes that your mouth is unhealthy and needs attention. If it is left untreated, gingivitis advances to periodontitis.

Periodontitis: In periodonitis the bone and connective tissue that hold the teeth in place are affected. This leads to formation of pockets between the teeth and gums. Plaque and food debris can collect in these pockets. The bacteria in the plaque multiply, grow below the gumline and produce bacterial toxins. With disease progression, the pockets deepen and more gum tissue and bone are destroyed, and eventually tooth loss occurs. Further progression of periodontitis is possible through appropriate dental treatment and improved home care.

 
Signs and Symptoms

Gum disease and periodontal disease can progress painlessly at times. You may have hardly any evident signs, even in the late stages of the periodontal disease. On a visit to your dentist, you might come to know that you have chronic gum disease and are risk of losing your teeth. But this is not the case always.


You may have certain symptoms that may point to some form of the disease such as

    * Red, puffy or swollen, or tender gums
    * Bleeding from gums while brushing or flossing
    * persistent bad breath or bad taste in the mouth
    * teeth appear longer because your gums have receded
    * presence of deep pockets between teeth and gums
    * loose or shifting teeth, changes in your bite (i.e. the way your teeth fit together on biting).
    * Pus oozing from your teeth and gums

If you have any of these symptoms consult a dentist or a periodontist (a dentist who specializes in gum disease) who can recognize and determine if you have gum disease.

 
Diagnosis

Your dentist or a periodontist (a dentist who specializes in gum disease) can recognize and determine if you have gum disease. Your dentist will

    * Examine your gums for bleeding, swelling and firmness. Check your teeth for movement and sensitivity and evaluate your bite.
    * Take a full-mouth X-rays to check for damage to bone surrounding your teeth.
    * Do periodontal probing to determine the severity of your disease. A periodontal probe is a tiny ruler which is used to check for pockets around teeth. If you have deep pockets, the disease is likely to be more severe.

People with healthy gums, have pockets that measure less than 3 millimeters, there is no bone loss on X-rays, the gums fit snugly against the teeth and have pink tips. Pockets about 3 millimeters to 5 millimeters on periodontal probing indicate gum disease, and more than 5 millimeters indicate serious gum disease that includes receding gums and a greater degree of bone loss. After evaluation, your dentist or periodontist will recommend treatment options based on the severity and stage of gum disease.

 
Treatment

The aim of periodontal treatment is to

    * Control any infection that is present in the gums and the surrounding bone and connective tissue that hold the teeth in place, and
    * Halt the progression of disease.

 

Treatment options include


    * Home care: Such as healthy eating, proper brushing and flossing,
    * Non-surgical therapy: Treatment and medications (antibiotics) to control the growth of harmful bacteria and,
    * Surgery: For people with more advanced disease to restore supportive tissues.

Daily brushing and flossing-- help to remove plaque. Brushing removes the plaque from the surface of the teeth and flossing removes plaque from in between the teeth and under the gumline. Proper technique of brushing and flossing are equally important. Consult your dentist if you think that you may not be brushing or flossing the right way. Your dentists may recommend specialized toothbrushes. These brushes are motorized and have smaller heads, and are usually better for removing plaque than a standard toothbrush.

 

If you have some bone loss or receding gums on examination your dentist may recommend intensive deep-cleaning, non-surgical method called scaling and root planing (SRP), which is the standard treatment.

    * Scaling is used to remove the plaque and tartar from above and below the gumline.
    * Root planing is used to smooth irregularities on the roots of the teeth making it more difficult for plaque and germs to deposit that cause gum disease. The smooth, clean surface aids the gums to reattach to the teeth.
    * Doxycycline hyclate an approved drug, is often used in combination with SRP. SRP helps to remove the bacteria and doxycycline hyclate suppresses collagenase. This enzyme causes destruction of the teeth and gums.


Antibiotic Treatment


Antibiotic treatments are also often used alone or in combination with surgery and other therapies to control infection associated with periodontal disease. Oral or local antibiotics may be prescribed as required. Antibiotics that are approved as sustained-release doses to be applied into the periodontal pocket are doxycycline hyclate, chlorhexidine gluconate and minocycline.
 

Other Common treatment: Other measures for treating gum disease include;

 
Curettage: Diseased gum tissue in the infected pocket is scrapped. This promotes healing in the infected area.
 

Flap surgery: The gum is lifted to remove tartar. After this the gum is again sewn back in place so that it fits closely around the tooth. This removes the pocket and areas where bacteria multiply
 

Bone grafts: The bone destroyed by periodontitis is replaced. The grafted bone forms the platform for the regrowth of bone, which gives stability to teeth.

 
Soft tissue grafts: Tissue is grafted in areas where gum is thin or places where gum has receded. Tissue for graft is often taken from the roof of the mouth.


Medications: Oral medications are used to control germs that cause periodontitis. At times antibiotic gels, fibers or chips may be applied in the infected pocket. Your dentist may recommend chlorhexidine containing mouth rinse to help control plaque and gingivitis.

 

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  • satyendra09 Nov 2011
    excellent informations