Gum disease is very common, affecting people of all ages. It is the most common cause of tooth loss in adults. Gum disease can be treated by your dentist or hygienist and if treated in the early stages its effects can be reversed.
Plaque, a mixture of food, bacteria and bacterial waste products, builds up on your teeth within minutes or hours after eating. When plaque is left on your teeth, it irritates the gums (gingivae). This early stage of gum disease is called gingivitis.
If gingivitis is not treated, the gums begin to pull away from your teeth, leaving a little pocket around the tooth. This pocket traps plaque that can't be reached with toothbrushing. Plaque that is not removed hardens to tartar (calculus). Plaque and tartar build up, causing further irritation.
The irritation caused by plaque and tartar gradually starts to affect the bone structures around your teeth. As time goes on, the pockets get deeper and more difficult to clean, and the gum and bone recede, so that some of the root may be visible. This can make your teeth wobbly. This stage is called chronic (long-term) periodontitis. After years, the teeth may fall out, or they may need to be taken out by a dentist.
Gum disease happens when plaque builds up because the teeth are not cleaned properly. This is more likely to happen if you find it difficult to clean your teeth properly, for example if you wear braces, have dentures or have irregularities in your teeth that you can't reach with a toothbrush.
There are other factors that can make you more likely to get gum disease. These include:
In all of these cases though, the cause of the gum disease is the build up of plaque.
You may not know if you have gum disease. Often it is not painful and some people with gum disease have no symptoms.
Usually the first sign of gum disease is bleeding from the gums when you brush your teeth. Your gums may also be red and swollen and you may have bad breath and an unpleasant or metallic taste in your mouth.
If gum disease has been left untreated, your teeth can become wobbly and you may get gum abscesses (pus collecting under the gum).
Preventing gum disease involves controlling the amount of plaque and tartar that builds up on your teeth. Regular visits to your dentist or hygienist, brushing and flossing your teeth regularly and stopping smoking will help to do this.
Your dentist or hygienist can show you the correct way to brush, floss and use inter-dental brushes. Dental floss or inter-dental brushes are used to remove plaque and particles of food from between the teeth and under the gumline. These are areas that a toothbrush cannot reach. Even thorough brushing and flossing cannot remove every trace of plaque. Most people have irregularities in their teeth where plaque can build up out of reach and harden into tartar. This can only be removed by a dentist or hygienist using special scraping tools in a process called scaling.
Treatment needs to be given by a dentist or hygienist. The type of treatment depends on how severe the gum disease has become.
If you have gingivitis, your dentist or hygienist will clean your teeth thoroughly using a scaler and an electric toothbrush with gritty toothpaste. He or she may also recommend an antiseptic mouthwash such as chlorhexidine (eg Corsodyl) that helps prevent plaque forming. He or she will also teach you how to brush and floss your teeth properly.
If gum disease has progressed to periodontitis, you may need more extensive scaling to remove plaque and tartar from the pockets that have formed. This can take several appointments with the dentist or hygienist. You may need to have your gums numbed with an injection of local anaesthetic before the scaling, and you may feel a little discomfort afterwards.5 Your dentist or hygienist will monitor the size of the pockets during the following months to make sure the treatment has been successful and the periodontal disease is not getting any worse.
If your gum disease is more serious, the pockets may be too deep for a dentist or hygienist to clean simply by scaling. You may then need gum surgery, which can be carried out by your dentist. Alternatively you may be referred to a periodontist, a dentist who specialises in treating periodontitis. He or she will push the gums away from the teeth to get access to the roots and clean them.
For any of the treatments to be successful you need to put time and effort into cleaning your gums and teeth. You will have to follow what your dentist has taught you to make sure you remove plaque every day. If you smoke, it is likely that treatment will be less effective.
Visiting the dentist and hygienistDentists and hygienists play an important role in preventing problems such as tooth decay, gum disease and erosion. At check-ups, they will be able to detect any problems early, and provide advice and treatment.
Your dentist will give you advice about how often you should have a check-up. For adults, this will vary from every three months to every two years.
Children, and adults who are at high risk of developing dental disease, need to see a dentist more often. You may be at high risk if you smoke, have a diet high in sugar, or have had lots of dental treatment in the past.
Even thorough brushing and flossing cannot remove every trace of plaque. Most people have irregularities in their teeth where plaque can accumulate out of reach and harden into tartar. This can only be removed by a dentist or hygienist using a special scaling instrument. Polishing, using a rotating brush and abrasive paste, removes stains from teeth
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