Our oral health is not just about our teeth. The health of our mouths has far reaching effects on the rest of the body. This is via the process of inflammation and transfer of bacteria.

Chronic inflammation in our mouths is associated with other inflammatory processes in our body, including cardiovascular disease, diabetes, dementia, pregnancy complications and respiratory problems.

Therefore, keeping our mouths healthy is about far more than a winning smile – it can help us live long and healthy lives. Read on to find out more.

What is Gum Disease?

Gum disease is the overall term used to describe both gingivitis and periodontitis. The suffix ‘itis’ means inflammation. Think of arthritis (inflammation of the joints), dermatitis (inflammation in the skin) or bronchitis (inflammation of the bronchi of the lungs). Therefore gingivitis is inflammation of the gingivae, which is the medical term for gums. The periodontium are the supporting structures of the teeth – namely the bone, and the fibres that attach the teeth to the bone. It is these structures that essentially hold the teeth in place. Periodontitis is inflammation of these structures.

Gingivitis is early gum disease, when the inflammation is contained with the gums. Left untreated, it can progress to periodontitis, which is where this inflammation spreads to the underlying structures and affects the attachment of the teeth.

So, what causes all this inflammation? Plaque. Plaque is the build up of bacteria which form a sticky layer on the teeth and gums, especially the join where the teeth and the gums meet. Some of this bacteria causes inflammation in the gums.

Inflamed gums

Signs and Symptoms of Gum Disease

Common symptoms of gingivitis include:

– gums that are tender

– gums that bleed when you brush or floss

– gums that look red

– gums that look puffy or swollen

– bad breath

Gum disease can cause bad breath

If left untreated, gingivitis can progress to affect the underlying supporting structures of the tooth (the periodontium). We call this stage of gum disease periodontitis. The periodontium includes the bone and the structures that attach the tooth to the bone. As this attachment is lost you can have:

– teeth that start to drift/move position

– recession of the gums

– teeth that become sensitive to hot/cold/sweet as the root surface of the tooth is exposed

– teeth that start to become mobile and may feel loose

– swellings/abscesses in the gums

– pus coming from the gums

– bad breath

The  problem with gum disease is that it can progress without you being aware of it. The underlying attachment of the teeth is below the levels of the gums. Attachment loss cannot be assessed without measurement from the dentist and/or x-rays. Therefore, regular dental examinations and screening for gum disease are key.

Calculus build-up between the teeth and under the gum-line

However, if you have not been to the dentist for a while and are worried about any of the above symptoms, don’t delay and book a dental examination. Gingivitis is easy to treat; periodontitis is harder. The earlier we can catch the signs of gum disease and start treatment, the better the outcomes.

Risk Factors

Factors that increase the risk of gum disease:

• Poor oral hygiene, meaning the plaque on the teeth is not thoroughly removed daily
• Poor diet – one high in sugars, which increase the rate at which plaque accumulates and/or low in nutritional foods
• Dry mouth –which means less saliva to wash away plaque
• Smoking, vaping, chewing tobacco and/or users of other nicotine products
• Diabetes
• Other immunological issues
• Hormonal changes, such as in pregnancy and menopause
• Genetics
• Stress levels

How gum disease is diagnosed

Screening for gum disease

At your dental examination the dentist will always carry out a screening for gum disease. We do this by walking a special probe with measurement markers around each tooth, measuring the depth of the ‘pocket’ between the tooth and the gum, while looking for bleeding, pus and noting any calculus (hardened plaque). We give each section of the mouth a score of between 0 and 4.

Where there is no bleeding, no calculus and a pocket between the tooth and gum of less than 3.5mm – this is score 0. If we get scores of 3 or 4 (pockets over 3.5mm and over 5.5mm respectively) we need to do a more thorough assessment.

As this screening is done at each examination, we can pick things up early. A small pocket of 4mm will be easier to treat than a deep pocket of 7mm for example.

Treatment Options

Scale and clean

The most effective means of treatment is in educating you to care for your teeth and gums at home. We can do scaling and cleaning here at the practice, but if this is not maintained at home, any treatment will not work. It’s what you do every day, day in day out, that makes the biggest different.

Other options for gum disease include non-surgical treatments such as professional tooth scaling and cleaning, and deep scaling to get down into those deeper pockets. Deep scaling will usually be carried out under local anaesthetic and is more involved than a straightforward scale and clean.

Scaling is when we remove the hardened build-up of plaque that forms on the teeth and root surfaces – known as calculus. This can form around the necks of the teeth, and also down under the gum on the root surfaces of the teeth. This needs to be removed and the tooth/root surface left smooth, to limit the accumulation of further plaque. When plaque is left in place and not removed by home care (brushing, flossing, interdental brushes), it calcifies on to the teeth and must be removed by a dental professional. This is why your home care is so important.

Interdental brushes

For more advanced periodontal disease, referral to a specialist – a periodontist – may be required for more in-depth treatment, which may also include surgical options.

Prevention

As always, prevention is better than cure! Prevention includes your home care. Thorough daily plaque removal is essential. This is done by brushing not just the teeth, but the gums as well. In addition, we must remove plaque from between the teeth with floss and interdental brushes. Your dentist can help ensure that you have the correct technique, as it can be tricky!

This is also why regular dental visits are important. Not only do we screen for gum disease, but we can also give you tailored oral hygiene advice. Advising the products and techniques that are good for you. In addition, regular professional teeth cleanings will remove calculus, making it easier for you to maintain at home.

Flossing demonstration

Connection Between Gum Disease and Overall Health

As mentioned, there are links between gum disease and systemic conditions.

Diabetes

This link can go both ways. Those with diabetes are more likely to have gum disease. But interestingly, those with gum disease have actually improved their diabetic control by having their gum disease treated

Heart disease

Those with gum disease are twice as likely to have heart disease.

Lung diseases

Untreated periodontal disease can result in bacteria from the mouth entering the lungs and causing respiratory disease such as pneumonia. The chronic inflammation from gum disease can also worsen lung diseases that also have chronic inflammation such as COPD and asthma.

Oral hygiene products

Alzheimer’s Disease

Again, studies have shown the link between bacteria in the mouth and these bacteria in the brain. You can read more here

Cancer

Research has found an increase risk in men with gum disease and kidney, pancreatic and blood cancers. In addition, other research found that in women, those with a history of periodontal disease were at 14% greater risk of developing any cancer.

Our overall sense of health and wellbeing can also be compromised if we have inflamed and bleeding gums and are worried about bad breath and loose teeth.

In Summary…

In summary, a healthy mouth is not just isolated to your mouth. The health of your mouth can affect the health of your whole body. It’s therefore important to ensure daily effective and thorough removal of plaque and regular dental visits to maintaining good oral hygiene and hence good health!

If you are overdue your dental examination, it’s not too late to book in! At your exam, we not only check your teeth, but will assess your gums. We have a strong focus on prevention and educating you to take care of your teeth and gums at home. If you are new to our practice, you can schedule a new patient comprehensive examination.

If you do have more advanced gum disease and need further assessment and treatment, we will get this organised for you. Treating gum disease early is the key to prevent tooth loss, and other health complications.