Gum Disease

There are many different types of gum disease or more correctly, periodontal diseases; all are caused by dental plaque and can usually be prevented. Dental plaque consists of bacteria and bacterial by-products. It forms on everybody’s teeth and accumulates in places that are hard to reach, such as between the teeth, next to a rough restoration or under a bridge.

Individuals may have widely differing genetic susceptibilities to gum disease, and susceptibility may also be altered by systemic disease (such as diabetes) or lifestyle factors (e.g. smoking).

If plaque is allowed to accumulate undisturbed it undergoes a change in character and begins to produce toxins that irritate the gums. Everybody’s resistance to these toxins and irritants is different; some people can accumulate vast quantities of plaque, yet have very little trouble with their gums. Others will show early signs of gum disease when only tiny amounts of plaque are present. For example, pregnant women are very sensitive to plaque, smokers are more likely to have gum problems, and there may even be a correlation between gum disease and stress. No matter how sensitive the individual is to plaque, a dramatic improvement in any form of gum disease will result from very careful and thorough cleaning. Often this may simply involve visits with our hygienist and instruction in the use of cleaning aids, such as interdental brushes and dental floss. It is not at all uncommon to see a very rapid improvement in gum health in just one or two weeks following an improvement in these habits.

The first sign of gum disease is often bleeding gums - “gingivitis”. If this is not dealt with it can develop into “periodontitis” where the attachment of the tooth to the gum and bone is weakened. “Pockets” form; these are regions where although the gum is closely apposed to the tooth it is not actually connected to it anymore. Plaque can then lodge in the pockets, causing the disease to progress quickly, as simple cleaning will not clear the plaque. If the pockets deepen, teeth may become loose and abscesses may form.

We often see new patients who have first become aware of their gum problem when a tooth becomes mobile or they experience pain from an acute abscess. The precise treatment of a gum problem depends very much on location, severity and the type of infection.

What does treatment involve:

The most important first stage of any treatment is cleaning, that is removal of all the plaque around the neck of the teeth. This is sometimes enough to eliminate the gum disease, however where pockets have formed you need help from a member of the dental team to remove plaque and tartar (mineralised plaque) from the depths of the pocket.

Such treatment involves root planning, which is removal of tartar, and cleaning of the tooth surface below the gum line. This is usually carried out by our hygienists, but where pockets are deep, or the tooth furcation is involved, treatment may be carried out by our Periodontists, who may employ gum surgery where applicable. Where large amounts of bone have been destroyed by gum disease, regenerative techniques can sometimes be used to rebuild the supporting bone, cover root surfaces with new tissue where the gum has receeeded, or reattach failing gums to teeth affected by deep pockets.