What is gum disease?
Gums or gingiva are soft tissues that surround the teeth and seal them around. They are bound to the teeth and the underlying bone providing protection to the root of the teeth. There are three types of gums called the marginal gums, attached gums, and the inter-dental gums. Healthy gums are of pink color, have smoothed and curved appearance, and are firm to touch.
Gum disease occurs when there is a bacterial infection that is generally caused due to poor dental care. Gum disease can also occur due to systemic and external influences and is progressive in nature. Gum disease is characterized by inflammation of the gums which is known as gingivitis. Gum disease progresses from gingivitis to periodontitis, and advanced periodontitis which leads to tooth loss.
How does gum disease develop?
In gum disease, a dental bio-film called plaque develops when a mass of bacteria grows on the surface of the tooth. Initially, this dental bio-film is colorless; however, over a period of time this develops into tartar and turns yellow or brown.
This tartar gets deposited in between teeth, on the surface of the teeth and behind the teeth. Around 12 weeks after the development of this plaque (also known as bacterial plaque), it becomes motile and gets accumulated in the sub-gingival areas. This leads to gingivitis or inflammation of the gums. As the bacterial plaque matures, it leads to periodontal diseases like periodontitis.
Risk factors for gum disease and periodontal disease
Even though the level of inflammation of the gums and the progression of gum disease depends upon the type of bacteria, and the response of the patient’s immune system and others are major factors for gum disease.
Risk factors for gum disease
- Vitamin c deficiency
- Hormonal imbalances in women
- Certain genetic/medical conditions
- Use of some medications that reduce production of saliva
- Smoking and chewing tobacco
- Alcohol consumption
- Poor oral hygiene
- Substance abuse
People who smoke are especially at risk of periodontal disease as they have deposits of tar accumulated in between their teeth. Proper dental care with dental cleaners along with smoking cessation is recommended for them.
What are the symptoms of gum disease?
- Bad breath
- Inflammation of gums (gums that are swollen and red)
- Tenderness of the gums
- Gum bleeding
- Sensitivity of teeth
- Pain while chewing food
- Receding gum line
- Loose teeth
You should consult a dental clinic near you immediately after you notice any of these symptoms in order to avoid tooth loss. Gum diseases are diagnosed by a dental specialist and treatment is given in a dental hospital.
Stages of gum disease
Most people with gum disease have a less severe form called gingivitis. A few of them have a much more serious type of gum disease known as periodontitis. Improper dental hygiene helps bacteria in the mouth to form plaque on the teeth surface. These bacteria cause gums to inflame and then resulting in red, swollen or bleeding gums.
Inflammation in gingivitis is not painful to many people and it can be reversed and healed if caught early and with proper oral hygiene. Gingivitis can worsen if left untreated and ultimately leads to tooth loss. An early and immediate dental and medical attention is required for the following symptoms even there is no severe discomfort:
- Changes in the way teeth fit together on biting
- Formation of deep pockets between teeth and gums
- Gums that bleed during and after tooth brushing
- Loose or shifting teeth
- Continuous bad breath or bad taste in the mouth
- Receding gums
- Red, swollen, or tender gums
Gingivitis progresses into periodontitis where both gums and bone that hold the teeth in place can be severely weakened. Bacteria on the teeth release toxins which harm the gums and make them infected. Both infection and inflammation degrade the gums and bone in the jaw further more. This episode gives exceptionally swollen, painful gums that bleed and if left untreated, periodontitis leads to permanent tooth loss. The common symptoms of gum diseases are sore, swollen, and bleeding gums.
Gums and Mouth ulcers
Sometimes, mouth ulcers lead to painful gums. These painful ulcers develop inside the mouth anywhere including on the gums with red edges. Mouth ulcers start as one at a time or multiple throughout the mouth.
Researchers don’t know the concrete causative agent causing mouth ulcers, mostly it is bacterial or viral related. People suffering from autoimmune diseases are also likely to have gum problems caused by ulcers. These ulcers come back time and again.
Hormonal effects on gums
Gum problems are seen during puberty, menstruation, pregnancy, and menopause in some women. An increased blood flow to the gums makes them red, swollen and sensitive during puberty. In menstrual gingivitis, the gums become red, swollen and are likely to bleed just before each menstrual period and subside once the period begins.
Pregnant women encounter pregnancy gingivitis which typically is seen during second and third trimester causing gums to sore and bleed.
In contrast, gums become extremely dry, sore and then bleed in some women going through menopause.
Gum disease treatment
Treatment for gum disease and periodontal disease involves removal of the bacteria that forms plaque and tartar. This is done by root planing, scaling and the use of dental cleaners. Once the plaque and tartar is removed, the patient is put on anti-microbial medication. This medication is either administered locally or orally.
The patient is asked to visit the dental clinic twice a year or as per the recommendation of the dental doctor for follow up. While dental cleaners are available over the counter to be used as advised, root planing and scaling is done only at a dental clinic.
Prevention of gum and periodontal disease
Gums play a major role not only in dental health, but in overall wellbeing of an individual. The focus about dental health should be mostly towards preventing cavities in teeth. It is also very important to pay attention to gums as well.
Swollen, red and bleeding gums are a sign of gum disease in many instances. Gum problems are caused due to many reasons but there are steps to minimize gum damage and discomfort.
To keep teeth clean, there is always a high temptation to vigorously brush teeth. Unfortunately, gums are made of delicate tissue and brushing the wrong way could damage gums.
Always find a brush with soft nylon bristles as medium or hard bristles may damage the enamel on teeth as well cause red and swollen gums.
Brushing teeth gently in up and down direction, circular motions is advised rather than back and forth motion to prevent damaging gums and thereby making them sore or bleed which eventually leads to upward movement of the gum exposing the tooth root.
Flossing every day helps remove plaque from places where your toothbrush can’t reach. This bait of flossing should be so gentle that it isn’t hurting the gums or bleeding gums. It’s better to floss carefully by sliding up and down following the tooth curve rather than forcing floss between teeth.
Other tips to prevent gum disease include:
- Use of antibacterial, fluoride toothpaste
- Brush twice a day
- Using anti-plaque, and antibacterial mouthwash
- Quit smoking and usage of alcohol
- Controlling diabetes
- Get adequate nutrition
- Use dental cleaners (as recommended by a dental specialist)
- Periodically visit a dental clinic near you