gum disease: (Periodontitis)
to detect gum disease ?
recession between the teeth and redness indicate periodontitis.
... also ...
breath, bleeding gums, reddish gums, loose teeth.
This folks is periodontitis.
is a nasty one and in most cases people don't know they have it until
it is too late.
If you are
seeing gum recession, have very red gums that may even bleed after
light teeth brushing then you should have your gums examined by a periodontist
for the presence of periodontitis.
Or even your local dentist will detect gum disease.
is not curable in the sense that if your gums are already separated
partially from some teeth, treatment will not glue them back, but
it can be stopped in it's progression and the nasty effects of it
(teeth falling out) can be delayed considerably if treated soon and
gum disease symptoms:
What periodontitis does is the more it progresses the
more the gum and the tooth it surrounds grow apart, or in other terms
- the gum does not adhere to the tooth and hence does not support it
The deeper the gum does not adhere to a tooth - the less gum support
the tooth has which then leads to that tooth becoming lose and unstable,
but mainly allowing infection to get even deeper between the gum and
The deeper the gums are not adherent to the tooth, the easier it is for
the bacteria and infection to get to the actual jawbone around the roots
of the tooth - eventually causing the tooth to fall out.
This can also lead to visible gum recession and even spaces between
the bottom of teeth.
you see a space between your teeth that was not there before, the
gums may have receded or the teeth might have moved apart.
In dental speak this is called 'migrating'.
If two adjacent teeth which formerly contacted each other, and now
no longer touch as they previously did, the appearance of gum recession
or a 'space' is
related to this 'migration' or separation of the teeth.
If your gums are bleeding when you brush them, you definitely have
gum disease, even if the bleeding is not at the sight of the recession.
Patients who have gum recession have a tendency to avoid brushing
where the gums meet the teeth thinking that protects
This is incorrect.
Since many people do not brush where the gums meet the
teeth, they may not have any evidence of bleeding gums, even though
gum disease is present. This is why the absence of bleeding gums
does not mean there is no gum disease present, while the presence
of bleeding always means that gum disease is present.
Bad breath can be a sign of gum disease or it can be present if there
is no gum disease. Bad breath can be caused by certain foods, the
lack of proper cleaning of the teeth even with no gum disease, the
build-up of bacteria on the tongue or even from stomach problems.
However, if bad breath does not go away after brushing and flossing
properly, including brushing the tongue, you must consider that there
may be serious gum disease where the pus and bleeding from the disease
are contributing to the bad breath problem.
The normal gum colour is usually described as 'coral pink'.
If you see that your gums are red in colour, you should be suspicious
that gum disease is present. Reddened gums may not always bleed. However,
if you have red gums, especially shiny red gums, and even if they don't
bleed upon brushing them, you should see a periodontist. If you are
a 'mouth breather' this can contribute to the appearance of
red gums and then gum infection.
If you are aware of looseness of some teeth, this is a very clear sign
that advanced gum disease may be present. When the patient is aware
of looseness, that is usually a very bad sign since patients don't
perceive looseness until the teeth are very loose and sometimes hopeless.
Gum disease is caused by the bacteria that are normally in the mouth.
The types of bacteria may vary with some patients having more types
of bacteria that are associated with aggressive gum disease. The
bacteria then accumulate where the gums meet the teeth. The gums
normally form a 'ditch' or 'sulcus' that goes
completely around the tooth like a 'cuff on a shirt goes around
your wrist'. Once the bacteria cause the gums to become infected,
the gums detach from the teeth. When the gums are healthy, the normal
depth of the 'sulcus' is 1-3 millimetres. When the gums
detach from the teeth as a result of the gum disease, a diseased
called a 'pocket' and the 'pocket' has a depth
deeper than the 3 millimetres. of the 'sulcus'.
This deeper depth
of the 'pocket' then prevents the patient
from treating their own gum disease since a patient can not clean into
a 'pocket' and eliminate the excess bacteria when the pocket
depth is deeper than 3 millimetres. The untreatable (by the patient)
gum disease then spreads into the underlying bone which supports the
teeth. This causes loosening of the teeth. If the gum disease is not
treated early enough, the patient will lose her teeth.
Risk factors of
things that help gum disease (Periodontitis) to progress:
There are other considerations besides the gum factor that can cause
or help gum disease to advance faster
Smoking has been shown to increase the chances of getting gum disease
and also of having more aggressive types of gum disease.
Patients who have diabetes or who have diabetes in their family can
be predisposed to having gum disease or to having a more aggressive
type of gum disease. If a patient has poorly-controlled diabetes,
this may be associated with a more involved type of gum disease.
resistance to gum disease
There are genetic considerations which predispose patients toward a
more aggressive, severe type of periodontitis. Patients who have
a family history of tooth loss or parents wearing dentures, should
be more concerned about a genetic resistance consideration.
of bacteria that are present in a patient's mouth
It is not known why some patients naturally have bacteria present in
their mouths which are not associated with aggressive periodontitis
while other patients have the more aggressive type of bacteria.
has been shown that patients can transmit gum disease bacteria to
their spouses, and that when the spouses have gum disease, the other
spouse is more likely to have gum disease. If you are shown to have
a more serious type of gum disease, it is important to check the
gum health of your spouse.
How gum disease
Normal healthy gums are usually described as 'coral pink' in
colour and usually fit to a nice sharp point as they approach the point
where the teeth come together and contact. The healthy gums have a
'pebble grain' appearance which is called 'stippling'.
gums become diseased, they:
- change in colour from coral pink to a more reddish colour
- change in form from a nice sharp, tapered form into a rounded, swollen,
less tapered form.
- lose their appearance of stippling and become shiny as well as reddened.
The Periodontal Probe
The periodontal probe is basically a thin nail like instrument the dentist
will insert between the gum and a tooth and depending on how far the 'nail'
will slide in - the dentist can evaluate if one has gum disease.
If the nail
(the probe) slides in more than 4 mm - then this could indicate
disease periodontitis can be treated
The treatment of gum disease varies depending on the degree of involvement
with the disease.
There are three
ways of treating periodontitis:
1) non surgical planning - with a long thin drill like device
2) surgical removal of infected gum tissue
3) and then prevention = brush your teeth like mad
Non surgical Planning
of gum disease
non-surgical treatment is called root planning.
Root planning is where
the gum tissues are usually anaesthetized with a Novocain anaesthetic
and the dentist or hygienist will scrape the diseased tooth root
until it is clean and no longer contains bacterial waste products.
This is done by a long thin drill type of instrument which slides
between the tooth and surrounding gum, and the turning motion,
plus water and disinfectant squirted via this drill - clean out the
bacteria and scrape the area around the tooth and between the tooth
and the gum free of any material (infected tissue, pus, deep rooted
tartar etc) that may be present.
If this is done at the initial phases of gum disease, the disease
can be stopped in it's tracks, and be prevented from progressing.
If this is the case, the planning - drill scraping, should then be
repeated periodically - say twice a year - even 3 to 4 times a year
- or as often as suggested by your dentist.
Depending on how
sensitive one is, this treatment can sometimes be done without anaesthetic,
but if one is too sensible especially towards the outside of the
teeth roots, then small injections of anaesthetic may be injected
into the surrounding gum.
may sometimes be enhanced with antibiotics that are taken orally
or placed into the gum 'pockets'. Not all
cases of gum disease will have antibiotic enhancements as a part
of their root planning therapy. After root planning, the gum tissues
are usually tender or sore, but not usually painful. When the periodontist
determines the gum disease aggressiveness, the periodontist can determine
the modifications in the root planning treatments that best fit your
Gum surgery is done to eliminate disease pockets which still exist
after all healing has been achieved following root planning. There
are, however, a small number of cases which will not benefit from
non-surgical root planning and surgery will be recommended without
having root planning done. Surgery is most frequently done with a
Novocain local anaesthetic. A periodontal dressing may be placed
after the surgery in order to protect the tissues. There may be some
pain after periodontal surgery.
When surgery is done and diseased tissue is removed, the teeth may
have more root surface exposed. This amount of exposure represents
the amount of root surface which lost its gum and bone support from
the gum disease. The surgery does not causing unnecessary damage
will the benefits of gum treatment treatment last
The benefits of periodontal therapy are determined by the severity
of your case before you were treated. If you have severe problems
with many loose teeth, these teeth may not have much of a future.
You should not invest much in teeth with a poor future.
if your teeth still have good strength despite gum disease being
present, there is no reason why you should not get excellent long
term results if you properly take care of your mouth after your gum
What do I need to do in order to maintain
good health after gum
You must clean your teeth efficiently on a daily basis.
efficient brushing and flossing.
Patients who brush many times a day,
but not once efficiently are not cleaning their teeth properly.
How to clean your
Get a harder tooth brush, and don't be afraid to scrub the
teeth really hard, especially near where the teeth meet the gums,
use floss, and special mini inter-teeth brushes to get to the nooks
and crannies that a normal toothbrush just can't reach.
Brush your teeth after meals, or at least three times a day, and spend
at least 8 minutes brushing thoroughly each time.
This alone will do more wonders in gum disease prevention or stopping
it's progression than any magical dental technology invented.