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What is gum disease?
What is Gum Disease?
Gum disease is your body’s inflammatory response to the build-up of plaque (a sticky film of bacteria) around your teeth and gums. It has two main forms – gingivitis and periodontitis.
Gingivitis is the non-destructive inflammation of the gums. The gums become swollen, red and tender, with a tendency to bleed when you brush. If we catch it early, gingivitis can be reversed and no destruction to the supporting structures of the tooth will occur. However, if the early signs are ignored, it can escalate (often without warning) into the far more serious periodontitis.
Periodontitis causes damage that is irreversible. It leads to the destruction of the structures supporting the teeth. It is characterised by the detachment of the gum from the teeth and the formation of deep gum ‘pockets’. As it is allowed to progress, periodontitis will lead to the loss of bone around your teeth. At best, treatment can manage the disease and arrest further degradation. At worst, your teeth will become painful to chew on, loosen and could fall out completely.
Once diagnosed, the condition remains with you for life and will need constant monitoring and control.
Healthy gums with a pink colour and no sign of bleeding or swelling. These teeth have not incurred any loss of gum or bone attachment. The teeth are firm with no mobility.
Periodontitis has resulted in the recession of gum around multiple teeth. The loss of bone and gum support around the teeth has led to drifting away from their original position. Large gaps are appearing between teeth.
Here we see the gums appearing extremely swollen and the progressive loss of bone around the teeth has resulted in significant displacement and drifting of the teeth. Teeth are beginning to develop painful abscesses and have become considerably loose.
If allowed to progress, periodontitis will lead to tooth loss. Teeth may become so loose that they no longer function, or the repeated development of abscesses, due to excessive bone loss, may prove unrestorable.
Risk factors for gum disease
Anything that adversely affects your body’s immune response to bacteria will increase your susceptibility to gum disease, and its severity and progression will be determined by the effectiveness of that response.
Well recognised risk factors for gum disease include smoking and poorly controlled diabetes.
There is evidence of a genetic component to gum disease. It can run in the family.
The adverse effects of stress on health are well known. It may also play a role in the progression of gum disease.
Conversely, a major factor in reducing your risk is to scrupulously follow a recommended oral health routine at home: we, as patients, can exert a powerful force against gum disease by inhibiting the build-up of plaque in the first place.
Probing your gums will inform us of the extent and severity of your gum disease
Patients with gum disease will require lifelong monitoring with regular probing to keep an eye on the stability of their gum disease
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The treatment of gum disease
How do we treat gum disease?
As mentioned above, there are multiple factors that contribute to the development and progression of gum disease. Controlling these risk factors is, therefore, of paramount importance. Reduction (ideally quitting) in smoking/vaping, control of diabetes, and excellent home oral hygiene measures are essential. Without this, the treatment by a periodontist will be of limited efficacy.
Dr Khan will start off with assessing the extent of your gum disease through detailed examination, including probing measurements and radiographs. Once a diagnosis is made, a tailor made treatment plan to suit your unique needs can be made.
Gingivitis is usually treated by the hygienist, alongside your diligent following of the home oral hygiene routine Dr Khan will recommend.
The more severe periodontitis requires specialist periodontal treatment and, in more extreme cases, surgery. This can involve deep cleaning those gum pockets that are inaccessible to the hygienist, and may require us to lift the gum clear, clean the roots of the teeth and then replace and tighten your gum. This will give your body a chance to heal the area, and make it easier for you to keep your teeth and gums clean at home.
Gum disease cannot be cured. Once stabilised, gum disease will require regular supportive maintenance in order to prevent further bone loss.