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Gum Disease: Causes, Symptoms and Treatment

Your gums play an important role in oral health. Without proper care and cleansing, gum diseases can develop and cause tooth and even bone loss in the mouth. Warning signs such as redness and swelling of the gums indicate you have some form of gum disease. However the symptoms are not noticeable initially which can make it hard to catch a gum disease. By the time people notice the symptoms, gingivitis has progressed to periodontitis. This is why regular dental visits are very important to maintain the health of your teeth and the gums. 

Gum Disease

Gum disease has various stages. It often starts with Gingivitis which is a mild form of the gum disease. It causes irritation, redness, swelling (inflammation), of your gums as well as sensitivity and pain. It occurs when a film of plaque or bacteria and tartar build up on the teeth. Periodontitis is a more advanced stage of gum disease and a serious infection of the gums. It is mainly caused by poor oral hygiene. If you have symptoms of gum disease, you must not waste any time and book an appointment with your dentist to confirm the diagnosis. If symptoms of gum disease are caught early and treated early and proper oral hygiene is maintained, the damage can be stopped. Let us take a look at gum diseases, its causes and symptoms in detail. 

What is gingivitis?

Gingivitis is a mild form of gum disease in which the patient experiences inflammation of the gums, usually caused by a film of plaque, or bacteria on the teeth. Gingivitis is usually a non-destructive type of gum disease but if left untreated, it can become a more serious infection known as periodontitis and cause tooth loss in adults. 

Signs of gingivitis include red and puffy gums that bleed easily when the person brushes and flosses. However, when gingivitis is mild, there aren’t any noticeable symptoms, and thus patients may not even know they have it. Regular dental visits can help diagnose and clear up gingivitis and prevent it from getting worse.  

What is periodontitis 

Periodontitis is a serious infection of the gums which damages the soft tissues. It’s caused by the films of bacteria that have been allowed to accumulate on your teeth and gums. As periodontitis progresses, it can damage your teeth and destroy the bone that supports your teeth. It can also cause teeth to loosen (due to losing bone support) and even lead to tooth loss. Brushing after meals and flossing daily and regularly can greatly enhance the effectiveness of the treatment for periodontitis. 

Periodontitis starts with inflammation in the gums known as gingivitis and gets worse over time. In the early stages of periodontitis, your gums recede, bone pulls away from your teeth and small pockets form between gums and teeth. These small spaces between teeth and gums collect debris and harbor harmful bacteria and gradually develop infection. The body’s immune system tries to fight the infection, as the plague spreads. On the other hand, the bone and connective tissue that hold teeth in place and your gum tissue starts to recede as the disease progresses. 

What causes gingivitis and periodontitis?

Your gums actually attach around the neck of your teeth at a lower point than the gum edges that we see. This forms a natural space between the surface of the tooth and the surrounding gum tissue called a sulcus. Food and dental plaque can accumulate in this space and cause damage such as gum inflammation, or gingivitis. 

Are you wondering what plaque is exactly? Plaque is a sticky film of bacteria that constantly forms on your teeth. It contains millions of bacteria which produce acids after you eat or drink which can destroy tooth enamel and cause gingivitis. When plaque extends below the gum line, you can develop an infection. If left untreated, gingivitis can cause the gums to recede and ultimately separate from the teeth and the jaw bone causing periodontal pockets. The presence of periodontal pockets implies that your gum disease has progressed to periodontitis (gum disease), a serious oral infection. The tooth may become loose and unstable. It can also lead to changes in the bite and pain while chewing or biting. 

What are the symptoms of gingivitis and periodontitis?

Untreated gum disease can cause teeth to become loose or fall out. It can even progress into life threatening health conditions. However, many people aren’t aware that they have gum disease. This is because most often there are very mild symptoms or no symptoms which is why there is quite a possibility that symptoms can go unnoticed. The following can be symptoms of gum disease:

  • gums that are inflamed, red, tender or swollen
  • Receding gums or gums that have pulled away from the teeth
  • gums that easily bleed when you brush or floss your teeth
  • loose teeth or loss of teeth 
  • Painful chewing 
  • New spaces developing between your teeth 
  • A change in how your teeth fit together resulting in a poor bite 
  • Sensitive teeth
  • Bad breath that just won’t go away even after you brush your teeth
  • Pus between teeth and gums leading to pus discharge in the mouth 

Risk factors for gingivitis and periodontitis

Although the main cause of periodontal (gum) disease is plaque, there are several other risk factors for gingivitis and periodontitis. All of them are mentioned below. 

  • smoking or chewing tobacco
  • Diabetes that is not controlled properly 
  • Use of certain medications such as birth control pills, steroids, calcium channel blockers, anticonvulsants, and chemotherapy
  • dental appliances that fit poorly
  • broken fillings
  • crooked teeth (as it gets difficult to clean between your teeth)
  • pregnancy
  • compromised immunity such as with HIV/AIDS
  • genetic factors

How is gum disease diagnosed?

During a dental exam, the dentist will examine your gums with a small ruler and try to find any signs of inflammation. He will also measure any pockets around your teeth. In a healthy mouth, the depth is 1 to 3 millimeters. But as periodontal disease progresses, these pockets usually get deeper and start to bleed as the tissues are more inflamed. Your dentist may also order X-rays to check for decay between teeth and bone loss caused by gum disease. 

Talk to your dentist openly about your symptoms. If you have experienced any gum bleeding recently do tell him about the same. During the dental exam, your dentist will also check for teeth movement and sensitivity. If gingivitis or periodontitis is present, he may give you medicines to control bacterial growth or you may be referred to a periodontist who specializes in the treatment of gum diseases.

How is gum disease treated?

Your dentist can help you detect and treat the gum disease before it gets serious. Below are the types of treatment available if you are diagnosed with a gum disease. 

  • Deep cleaning – Unlike a regular cleaning, deep cleaning gums involves a careful, in-depth cleaning of the gums. This type of cleaning is done below the gum line where the root of the tooth is embedded in your jawbone and is known as scaling. In scaling, the dentist will use special instruments such as a hand held dental scaler to manually scrape off tartar and plaque both above and below your gum line. Deep cleaning of the gums often involves something called root planing to smooth rough spots on the roots of your teeth that promote gum disease by trapping bacteria. 
  • Medications – Your dentist may prescribe both topical or oral antibiotics that can help reduce or entirely eliminate disease causing bacteria. Such medications can treat persistent areas of gum inflammation and control bleeding of the gums. Also, they help fight the bacterial infection causing gingivitis. 
  • Surgery – Severe forms of gum diseases may need a surgical treatment. Flap surgery is a commonly performed procedure for patients with moderate to severe gum disease. During the flap surgery, the gums are lifted back and the built up plaque and tartar is removed. Other surgical treatments for gum diseases include bone grafts, soft tissue grafts, guided tissue regeneration and bone surgery. 
  • Practice good oral hygiene at home – One of the easy ways to treat gingivitis at home is to practice good oral hygiene and keep gums clean. In addition to daily brushing and flossing, use a germicidal mouthwash to increase the cleanliness of the mouth. However, it is only effective when gingivitis is at an early stage. 

One should note that smoking is not just an important cause of severe gum disease but treatment for gum disease may not work as well if you smoke. You should cut back on smoking, if you smoke, as it can make it harder to fight off a gum infection. 

How can gum disease be prevented?

Gum disease can lead to unfortunate tooth loss and tooth decay. You should not ignore your gums at any cost! Below are some tips to prevent gum disease. 

  1. Brush your teeth after every meal to remove sugar and particles of food that remain in your mouth after eating. Or else plaque and bacteria start feeding on it. 
  2. Floss at least once a day to clean between your teeth. Flossing can help remove the plaque and food that’s beyond your toothbrush’s reach. 
  3. See your dentist on a regular basis. They can detect early gum disease symptoms. 
  4. Smoking is strongly associated with oral decay and gum diseases. And thus you should quit smoking to prevent any gum disease. 
  5. Always use fluoride toothpaste to protect your teeth and gums from decay and reduce gingivitis 
  6. Use a therapeutic mouthwash that reaches virtually 100% of your mouth. It can help reduce plaque and prevent gingivitis.
  7. Most importantly, eat a balanced diet for achieving and maintaining good gums health.
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