Five Ways to Prevent Gum Disease

What is Gum Disease?

Gum disease is a term commonly used to describe periodontal disease. Periodontal diseases are a group of inflammatory diseases that affect structures which support and protect our teeth: the gingival tissues (gums), jaw bone and periodontal ligament. Without treatment, some cases of periodontal disease will lead to loosening of the teeth and tooth loss. In fact, gum disease is the primary cause of tooth loss in adults over the age of 35! Recent studies show that almost 40% of Australians aged 55 and over have experienced moderate to severe gum disease.

Gum disease is divided into two main stages: gingivitis and periodontitis.

Gingivitis is the mildest form of gum disease that causes redness, irritation and inflammation of the gingival tissue (gum). Importantly, gingivitis is preventable and can be reversed without any damage to the tooth supporting structures (jaw bone and ligament). However, left untreated gingivitis progresses to periodontitis.

Periodontitis is advanced gum disease characterised by gingival inflammation with destruction of alveolar bone and periodontal ligament fibres which connect the tooth root to bone. Unlike gingivitis, periodontitis causes irreversible damage to the tooth supporting tissues. With progressive alveolar bone loss tooth mobility and loss may result.

What Causes Gum Disease?

Periodontal diseases occur due to the accumulation of dental plaque on teeth and in the gingival sulcus. Frankly, a complete lack of oral hygiene and/or ineffective oral hygiene are responsible for plaque accumulation and gum disease. When plaque is left undisturbed dental biofilms form and release bacterial toxins into the adjacent gums triggering an inflammatory response. These inflammatory mediators lead to destruction of the periodontium (bone, periodontal ligament, gums).

Risk Factors for Gum Disease

There are multiple risk factors which are known to increase the risk and prevalence of gum disease. The most common of these include:

  • Tobacco smoking
  • Age
  • Medical conditions such as diabetes, osteoporosis, obesity and HIV infection.
  • Local risks factors like defective dental fillings, tartar/calculus deposits, tooth shape and alignment.

Tobacco smoking has been identified as the single most significant, modifiable risk factor for periodontal disease. Smoking has been associated with greater severity and more rapid rate of periodontitis with deeper periodontal pockets and more alveolar bone loss.

Signs and Symptoms

Gingivitis and periodontitis are typically silent diseases meaning symptoms, particularly pain, often do no present until advanced stages. The most common signs and symptoms of gum disease include:

  • Gums that bleed easily with tooth brushing, flossing and eating certain foods.
  • Red, swollen and tender gums.
  • Mobile or loose teeth.
  • Persistent bad breath.
  • Receding gums.

It is important to note that smokers, whom experience increased prevalence and severity of periodontitis, typically DO NOT experience red, swollen and bleeding gums. This is due to the vasoconstriction of blood vessels in gingival tissues as a result of the heat generated during cigarette smoking.

What Treatment is Required for Gum Disease?

Management of gum disease depends on the stage and severity of disease as well as individual patient factors. Treatment varies from routine scaling and cleaning to specialist periodontist referral for treatment with follow-up appointments. In all cases the success of treatment revolves around patient education and improving oral hygiene techniques to prevent recurrence.

In cases where medical conditions or local factors (e.g. overhanging fillings) are contributing to the disease process managing these factors is essential to successful treatment and stabilising gum health.

Smoking cessation is critical in patients who smoke. Multiple studies demonstrate that smoking has a detrimental effect on the tissue response to periodontal treatment with these patients exhibiting significantly less reduction in probing depths compared to non-smokers.

Antibiotics are not routinely used in treatment of gum disease.

Can Gum Disease Affect my General Health?

Certainly! You only need to type into Google search ‘periodontal disease and’ to see the effect gum disease may be having on your overall health.

There is overwhelming evidence that link significant periodontal disease with increased risk and greater severity of certain medical conditions. Periodontitis have been strongly linked to an elevated risk coronary artery disease, stroke, diabetes mellitus, respiratory disease and low-birth weight babies.

 Top Five Tips to Prevent Gum Disease:

  1. Practice good oral hygiene – This means brushing your teeth well twice a day and flossing daily. Be sure to be extra diligent around those bleeding areas!
  2. Use a mouth rinse as directed by your dental professional after brushing, especially if your gums are bleeding. Mouth rinse DOES NOT replace tooth brushing!
  3. Check your gums for any bleeding sites after brushing. Be sure to spend extra time cleaning these areas as bleeding indicates gingival inflammation!
  4. Have you teeth checked and cleaned regularly by your dentist or hygienist. Early identification of early signs of gum disease which can be reversed before permanent destruction of underlying jawbone and gum recession occurs.
  5. Smoking cessation – smoking is detrimental to periodontal health and decreases the successfulness of treatment.

Be sure to ask your dentist about your periodontal health status at your next appointment!

For more information on gum disease click here.

For smoking cessation advice, counselling and resources click here.