Gingivitis – Gum Disease

Healthy gums should be pink and firm and keep your teeth securely in place. Your gums should not bleed when you touch or brush them. Gingivitis is not always painful, and you may be unaware you have it.

The initial symptoms of gum disease are:

• Red and swollen gums
• Bleeding gums after brushing or flossing your teeth

If gum disease develops into periodontitis (where the tissues that support teeth are affected), you may also have the following symptoms:

• A bad taste in your mouth
• Loose teeth that can make eating difficult
• Gum abscesses (collections of pus that develop under your gums or teeth)

Gum disease can be caused by a number of factors. However, poor oral hygiene is the most common cause.

Plaque

After eating and drinking sugary food and drinks, the bacteria in your mouth break the carbohydrates down into acid.
The acid combines with bacteria, saliva in your mouth and any small particles of food remaining after brushing to produce a sticky film called plaque.

Poor oral hygiene

Poor oral hygiene can cause plaque and tartar to build up on your teeth. Bacteria in plaque will irritate your gums, making them inflamed and sore. This is gum disease.
If gum disease is not treated and plaque and tartar continue to build up, you may develop periodontitis. This can lead to your teeth becoming loose and eventually falling out.

Who is at risk?

Everyone. But you are more at risk of developing gum disease and periodontitis if you are:
A smoker

• Diabetic – a long-term condition caused by too much glucose in the blood
• Weakened immune system – for example, due to conditions such as HIV and AIDS or certain treatments such as chemotherapy (powerful
• Cancer-killing medication)
• Certain medications

Periodontitis is a form of gum disease that develops if gingivitis is not treated. It affects the tissues that support teeth and holds them in place and can lead to teeth loosening or falling out.
If you have periodontitis, you will need a thorough dental examination. Your dentist may use a periodontal probe to examine your mouth.

The periodontal probe will be inserted beside your tooth, underneath the gum line. If you have healthy teeth, your gums should be attached to your teeth, and the probe should not be able
to slide very far below your gum line. You may have periodontitis if the probe is able to slide deeper under the gum line than normal.

In some cases, a number of X-rays may be needed to check the condition of your teeth and jaw bone.

The main prevention is maintaining good oral health. A good homecare routine involves:

• Brushing your teeth for 2-3 minutes twice a day (in the morning and at night).
• Using an electric toothbrush/manual and correct brushing technique – gums and teeth.
• If your gums bleed, it is very important to brush them as this is a sign that the gums are unhealthy, and the only way to stop them from bleeding is to maintain your homecare routine.
• Using toothpaste that contains fluoride (fluoride is a natural mineral that helps protect against tooth decay).
• Flossing or using interdental aids regularly (daily), as a toothbrush will not clean all surfaces of the tooth. Choose either morning or night when you can spend a longer period cleaning – brushing for 2-3mins then going around the mouth using interdental aids. This may take up to 10-15mins.
• No smoking.
• Regularly visiting your dentist (every 6 -12 months, depending on your dentist’s advice).
• Regular hygienist visits to help maintain motivation and daily homecare.

Scale and polish

Remove plaque and tartar (hardened plaque) that can build up on your teeth. This is a ‘professional clean’ usually carried out by a dental hygienist.

The dental hygienist will scrape away plaque and tartar from your teeth using a special instrument, then polish your teeth to remove marks or stains. If a lot of plaque or tartar has built up, you may need to have more than one scale and polish.

Root planning

In some cases of gum disease or periodontitis, root planning (debridement) may be required. This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth.

Before having the treatment, you may need to have an anaesthetic (painkilling medication) to numb the area. You may experience some pain and discomfort for up to 48 hours after having root planning.

Antibiotics

They may only be recommended in severe cases of gum disease.

Surgery

If you do not treat periodontitis, you may develop further complications, including:

• Recurrent gum abscesses (painful collections of pus).
• Increasing damage to the periodontal ligament (the tissue that connects the tooth to the socket).
• Increasing damage to the alveolar bone (the bone in the jaw that contains the sockets of the teeth).
• Receding gums.
• Loose teeth.
• Loss of teeth.