Gum Disease

What is Periodontal (Gum) Disease?

There are two main forms of gum disease: gingivitis and periodontitis.

What is gingivitis?

Gingivitis means ‘inflammation of the gums.’ This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning. Gingivitis is a temporary condition which can be treated and prevented. It does not cause any permanent damage.

What is periodontitis?

Periodontitis is an infection, which causes the destruction of the tissues which hold the teeth in place (gum, bone and ligament) and can lead to tooth loss.

How do you know if you have Periodontal Disease?

Some of the signs and symptoms of periodontal disease include:

Persistent bad breath or a bad taste in your mouth
Gums that bleed when brushing or flossing
Red, swollen and/ or tender gums
Teeth that appear longer because your gums have receded
Gum boils or abscesses
Teeth that seem loose
Spaces unexpectedly developing between your teeth

Periodontal disease is generally a painless condition; therefore you may be unaware of its presence in your mouth. We can examine you for this condition.

What causes Periodontal Disease?

Periodontal disease is caused by a build up of bacterial dental plaque. This is a soft, colourless film of bacteria, which forms on the tooth surface daily. Toxic substances from the bacteria enter the gums and cause a reaction (inflammation).

Dental plaque can be controlled by good oral hygiene (tooth brushing and cleaning in-between the teeth). If plaque is not removed it may become a hard material – calculus (tartar).

Risk Factors

If you do not brush and floss regularly you are more likely to get periodontal disease no matter what your age or general state of health. However there are other factors that may place you at an increased risk of developing periodontitis.

Local risk factors (mainly associated with dental plaque build up):

  • Poor personal oral hygiene and/ or irregular visits to your dentist/ dental hygienist
  • Roughness on teeth where bacteria grow
  • Uneven position of teeth
  • Breathing through your mouth instead of your nose

Systemic risk factors

  • An individual persons immune response (the bodies ability to fight infection – in this case plaque bacteria) may leave one person at greater risk of disease than another person.
  • Previous history of periodontal disease
  • Increasing age – Periodontitis becomes more common with increasing age.
  • Genetic/ inherited or a family history of periodontal disease.
  • Smoking cigarettes reduces blood flow to the gums thereby increasing the severity of periodontal disease.
  • Stress.
  • Diabetes or a history of diabetes in the family.
  • Blood diseases – acute leukaemia, AIDS.
  • Hormonal changes – already existing gum disease can be worsened by hormonal changes, due to pregnancy or oral contraceptives (‘the pill’).

More FAQs

How will smoking affect my gums and teeth?

The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums don't heal. Smoking causes people to have more plaque and the gum disease to get worse more quickly than in non-smokers. Gum disease is a major cause of tooth loss in adults.

What happens if gum disease is not treated?

Unfortunately, gum disease does not usually cause pain as it gets worse so you do not notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. This results in the teeth becoming loose and falling out/ needing extracted.

What do I do if I think I have gum disease?

You should make an appointment with us for a thorough examination of your teeth and gums. We will check if your gums are healthy and we will take X-rays to check that you have not lost more bone from around your teeth than is appropriate for someone your age.

What is the treatment for gum disease?

This is called root planing. It uses the same equipment as a normal ‘Scale and Polish’ but takes longer. It is performed under Local Anaesthetic to keep things comfortable for you. Your dentist/ dental hygienist will clean your teeth to remove plaque and calculus (tartar). The roots of the teeth are cleaned with hand instruments to leave them clean and smooth – this is called root planning.

Deep Cleaning is normally carried out over 2-4 visits.

Successful treatment of your periodontal disease is dependent on YOUR oral home care – effective brushing and cleaning in-between your teeth.

If the destruction of the bone supporting the tooth is too severe, tooth extraction may be the required treatment.

Periodontal surgery with a Periodontal Specialist may be required in certain cases.

What else may be needed?

Regular follow-up and care is essential in the long term management of the periodontal condition. Regular ‘scale and polish’ visits will be recommended.

Once I have had periodontitis, can I get it again?

There is no cure for periodontal disease in that if you are genetically susceptible to it you will always be genetically susceptible to it. The aim is to manage it so that the loss of bone around the teeth happens as slowly as possible. The aim is to prevent loss of teeth.

Other Things To Consider

  • Patients that have active gum disease are not suitable candidates for dental implants.
  • Patients that have lost too much bone due to gum disease will not be able to have dental implants.
  • It is common for patients who are going for surgery such as othopaedic surgery (e.g. hip/ knee replacement) or heart surgery to attend the dentist at the request of their surgeon. These patients will not be deemed fit for surgery until their gum disease is under control. It is common for patients to have to postpone surgery until their gum disease has been treated.

I have heard gum disease is linked with other health conditions – is this true?

Yes. There are new findings which support something that dental professionals have suspected for a long time: infections in the mouth can be linked with problems in other parts of the body.

What problems could my dental health cause?

Problems which may be caused or made worse by poor dental health include:

  • Heart disease.
  • Strokes.
  • Diabetes.
  • Giving birth to a premature or low-birth-weight baby.
  • Respiratory (lung) disease.

Quite how these links work is the subject of much research.

However, recent large-scale studies have shown that the medical costs for patients with diabetes, cardiovascular disease or strokes, and for pregnant women, can be significantly less if their gum disease is treated thoroughly. This is just another reason to make sure you always look after the health of your teeth and gums at home and visit the dental team regularly.

How can the health of my mouth affect my heart?

People with gum disease are almost twice as likely to have coronary artery (heart) disease than people without gum disease. When people have gum disease, it is thought that bacteria from the mouth can get into their bloodstream. The bacteria produce protein. This can then affect the heart by causing the platelets in the blood to stick together in the blood vessels of the heart. This can make clots more likely to form. Blood clots can reduce normal blood flow, so that the heart does not get all the nutrients and oxygen it needs.

If the blood flow is badly affected this could lead to a heart attack.

What is the link between gum disease and strokes?

Several studies have looked at the connection between mouth infections and strokes. They have found that people who have had a stroke are more likely to have gum disease than people who have not had one.

How could diabetes affect my dental health?

People with diabetes are more likely to have gum disease than people without it. This is probably because diabetics are more likely to get infections in general. People who do not know they have diabetes, or whose diabetes is not under control, are especially at risk.

If you do have diabetes it is important that any gum disease is diagnosed, because it can increase your blood sugar. This would put you at risk of diabetic complications.

Also, if you are diabetic, you may find that you heal more slowly. If you have a problem with your gums, or have problems after visits to your dentist, discuss this with your dental team before you have any treatment.

New research has also shown that you are more likely to develop diabetes if you have gum disease.

If you have diabetes, you have an increased risk of losing teeth.

Could gum disease affect my unborn baby?

Pregnant women who have gum disease may be over three times more likely to have a baby that is premature and so has a low birth weight. There is a one-in-four chance that a pregnant woman with gum disease will give birth before 35 weeks.

It is thought that gum disease may raise the levels of the chemicals that bring on labour. Research also suggests that women whose gum disease gets worse during pregnancy have an even higher risk of having a premature baby.

Having gum disease treated properly during pregnancy can reduce the risk of a premature birth.

How could bacteria in the mouth affect my lungs?

Bacterial chest infections are thought to be caused by breathing in fine droplets from the throat and mouth into the lungs. This can cause infections, such as pneumonia, or could make an existing condition worse.

People with gum disease have more bacteria in their mouths and may therefore be more likely to get chest infections. This particularly affects frail, elderly people who may die from pneumonia caused by breathing in bacteria from their mouth. Good oral hygiene for this group of people is therefore particularly important.

Does gum disease run in families?

Although there is some evidence that gum disease runs in families, the main cause is the plaque that forms on the surface of your teeth. To prevent gum disease, you need to make sure you remove all the plaque from your teeth every day by brushing, and by cleaning in between your teeth.

Can exercise help to prevent gum disease?

A recent study has shown that people who stay fit and healthy are 40 percent less likely to develop tooth-threatening gum infections that could lead to gum disease. It also found that not exercising, not keeping to a normal body weight and unhealthy eating habits made a person much more likely to get advanced gum disease.

If you are serious about your health - and your teeth - you will need to exercise, eat a healthy, balanced diet and keep to a normal body weight.

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