Understanding Gum Disease

Introduction

Gum disease is caused by the germs (bacteria) which live in your mouth. The bacteria stick to your teeth, irritate the gums and make them bleed. Gum disease can eventually destroy the gum and bone which support your teeth. If untreated, periodontal disease can lead to loosening and loss of teeth. The two most common forms of gum disease treated in our practice are Gingivitis and Periodontitis.

What is Gingivitis?

Within our mouths, there are hundreds of thousands of bacteria and microscopic organisms living together, creating a “biofilm” or plaque. This sticky substance covers our teeth, gums, lips, cheeks, and tongue. Even people who brush and clean their mouths thoroughly still have biofilms in their mouths, as they are a natural part of the environment.

When oral hygiene is lacking, biofilm builds up substantially, and this thick plaque triggers the body’s inflammatory response, leading to bleeding gums and gum irritation, also known as gingivitis. The good news is that gingivitis is a reversible condition with proper oral hygiene and care.

What is Periodontitis?

Periodontitis is a more advanced stage of gum disease, caused by bacterial toxins that damage the supportive structures around the teeth. This results in irreversible damage to the bone and tissue supporting the teeth, which can lead to premature tooth loss.

Signs and symptoms of periodontitis, include:

• Receding gums
• Changes in bite (the way your teeth fit together when you bite or chew)
• Bad breath
• Loose teeth and/or tooth loss
• Red, swollen and bleeding gums
• Painful chewing

Gingivitis is often a precursor to periodontitis. If proper care and treatment are sought at the gingivitis stage, damage to the gums and bone can often be prevented.

How Did I Get This?

Some of the following factors play a significant role, including:

• Poor oral hygiene (leading to plaque buildup)
• Smoking or tobacco use
• Genetic predisposition
• Uncontrolled diabetes
• Chronic stress
• Poor nutrition (low in vitamins and minerals)
• Medications (that reduce saliva or affect oral health)
• Hormonal changes (e.g., pregnancy, menopause)
• Certain illnesses (e.g., heart disease, rheumatoid arthritis)

What Can I Do to Help My Gums?

• Brush twice a day with fluoride toothpaste for 2 minutes.
• Brush your gum margins to prevent plaque buildup.
• Use interdental brushes to clean between your teeth daily.
• Quit smoking to improve gum health.
• Maintain good oral hygiene to prevent bleeding and inflammation.

Can It Be Cured?

• Gingivitis can be reversed with proper oral hygiene and regular dental visits.
• Periodontitis cannot be cured, but it can be managed with professional help. The damage caused by periodontitis (such as bone loss) is irreversible, but with ongoing professional care and excellent at-home oral hygiene, the condition can be stabilized, and further bone and tooth loss can potentially be prevented.

Will I Lose All My Teeth?

If left untreated, periodontitis can lead to the loss of the bone and supporting structures around the affected teeth. This could result in tooth mobility, sensitivity, and difficulty chewing. If the condition progresses, it could ultimately lead to tooth loss.

What Treatment Can I Expect?

The goal of treatment is to bring the condition under control, stabilize it, and monitor it closely to prevent further deterioration of your periodontal (gum and bone) health. This will help you retain your natural teeth and any dental prostheses (such as dentures, crowns, and implants).

Treatment is generally divided into stages, with Non-Surgical Periodontal Therapy (NSPT) being the first line of treatment. The protocol is supported by the European Federation of Periodontology (EFP) and the British Society of Periodontology (BSP).

Treatment Phases:

Step 1: Hygiene Phase Therapy

• Objective: Improve oral hygiene and lay the foundation for successful treatment outcomes.
• Focus: Self-care at home, oral hygiene instructions, and clinical examination (e.g., gum pocket depth, bleeding scores, X-rays).
• Duration: This phase may involve multiple visits depending on disease severity and patient progress.

Step 2: Non-Surgical Periodontal Therapy (Deep Cleaning)

• Objective: Remove tartar (calculus), plaque, and bacterial toxins from the root surfaces.
• Procedure: Performed with or without local anesthesia, using mechanical and/or hand instruments.
• Duration: Treatment may take 1–4 appointments, depending on disease severity.

Step 3: Supportive Care Therapy

• Objective: Monitor healing and ensure plaque control at home. Check for improvements such as reduced inflammation and bleeding.
• Duration: The stage concludes with a reassessment, where we will measure improvements and assess your ability to care for your oral hygiene.

Step 4: Retreatment and/or Referral

• In cases of advanced or non-responding conditions, further non-surgical treatment may be necessary, or you may be referred to a specialist.

Step 5: Maintenance Phase

• If gum disease is stable, you will move to a maintenance phase, with regular visits (every 2–4 months) for monitoring, cleaning, and continued oral hygiene support.
• If disease recurs, treatment may need to be repeated.

Risks, Benefits, and Alternatives

Expected Complications

• Numbness lasting a few hours.
• Possible discomfort, swelling, and bruising.
• Increased sensitivity to hot, cold, or sweet stimuli.
• Requirement for future maintenance care.

Common Risks and Complications

• Trauma to other parts of the mouth (teeth, gums, cheeks, tongue).
• Increased tooth sensitivity.
• Risk of abscess or gum infection.
• Gum recession and root exposure (leading to “black triangles” between teeth).

Rare Risks and Complications

• Trauma to tissues beneath the tooth, such as bone or nerves.
• Allergic reactions to materials used during treatment.

Note: Gum treatment is not always 100% successful. In some cases, teeth may require further treatment or extraction.

Benefits of Periodontal Treatment

• Prevents further destruction to the tissues supporting your teeth.
• Reduces harmful bacteria to a level manageable by your immune system.
• Helps prevent tooth movement and spacing issues.
• Keeps disease progression under control.

Alternative Treatment Options:

1. Referral to a specialist.
2. Regular hygienist visits (plaque removal, but does not fully resolve periodontal disease).
3. Tooth extraction (in cases of severe disease).
4. Refusing treatment, which may lead to further gum and tooth loss.

Note: There is increasing evidence that untreated gum disease may be linked to higher risks of heart disease, stroke, diabetes, respiratory issues, artificial joint failure, prosthesis failure, and complications during pregnancy.

Long-Term Care

After treatment, you will need to see us regularly for monitoring (usually every 3 months) to ensure proper oral hygiene and maintain gum health. Regular visits and excellent home care are key to preventing recurrence of periodontal disease.

Get in Touch

Schedule a consultation with our expert team today for a personalised treatment plan to stop gum disease in its tracks. Visit us now or call on 01494 528153 to book an appointment. Your smile’s health is worth it!

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