Gum disease is an inflammation of the gums that can progress to affect the bone that surrounds and supports your teeth.
It is caused by the bacteria in plaque, a sticky, colorless film that constantly forms on your teeth. If not removed through daily brushing and flossing, plaque can build up and the bacteria infect not only your gums and teeth, but eventually the gum tissues and bones that support the teeth.
This can cause them to become loose, fall out or have to be removed by a dentist.
Different stages of gum disease
There are three stages of gum disease:
- Gingivitis: this is the earliest stage of gum disease, an inflammation of the gums caused by plaque buildup at the gumline. If daily brushing and flossing do not remove the plaque, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. You may notice some bleeding during brushing and flossing. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected.
- Periodontitis: at this stage, the supporting bone and fibers that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gumline, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.
- Advanced Periodontitis: in this final stage of gum disease, the fibers and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, if aggressive treatment can’t save them, teeth may need to be removed.
How do I know if I have gum disease?
Gum disease can occur at any age, but it is most common among adults. If detected in its early stages, gum disease can be reversed, so see your dentist if you notice any of the following symptoms:
- Gums that are red, puffy or swollen, or tender
- Gums that bleed during brushing or flossing
- Teeth that look longer because your gums have receded
- Gums that have separated, or pulled away, from your teeth, creating a pocket
- Changes in the way your teeth fit together when you bite
- Pus coming from between your teeth and gums
- Constant bad breath or a bad taste in your mouth
How is gum diseases treated?
- The early stages of gum disease can often be reversed with proper brushing and flossing. Good oral health will help keep plaque from building up.
- Professional cleaning by your dentist or hygienist is the only way to remove plaque that has built up and hardened into tartar. Your dentist or hygienist will clean or “scale” your teeth to remove the tartar above and below the gumline. If your condition is more severe, a root planing procedure may be performed. Root planing helps to smoothen irregularities on the roots of the teeth, making it more difficult for plaque to deposit there.
- By scheduling regular checkups, early stage gum disease can be treated before it leads to a much more serious condition. If your condition is more advanced, treatment in the dental office will be required.
Plaque
Plaque is a sticky, colorless film of bacteria and sugars that constantly forms on our teeth. It is the main cause of cavities and gum disease, and can harden into tartar if not removed daily.
How do I know if I have plaque?
Everyone develops plaque because bacteria are constantly forming in our mouths. These bacteria use ingredients found in our diet and saliva to grow. Plaque causes cavities when the acids from plaque attack teeth after eating. With repeated acid attacks, the tooth enamel can break down and a cavity may form. Plaque that is not removed can also irritate the gums around your teeth, leading to gingivitis (red, swollen, bleeding gums), periodontal disease and tooth loss.
How can I prevent plaque buildup?
It’s easy to prevent plaque buildup with proper care. Make sure to:
- Brush thoroughly at least twice a day to remove plaque from all surfaces of your teeth
- Floss daily to remove plaque from between your teeth and under your gumline, where your toothbrush may not reach
- Limit sugary or starchy foods, especially sticky snacks
- Schedule regular dental visits for professional cleanings and dental examinations
Tartar
Tartar, sometimes called calculus, is plaque that has hardened on your teeth. Tartar can also form at and underneath the gumline and can irritate gum tissues. Tartar gives plaque more surface area on which to grow and a much stickier surface to adhere, which can lead to more serious conditions, such as cavities and gum disease.
Not only can tartar threaten the health of your teeth and gums, it is also a cosmetic problem. Because tartar is more porous, it absorbs stains easily. So if you are a coffee or tea drinker, or if you smoke, it is especially important to prevent tartar buildup.
How do I know if I have tartar buildup?
Unlike plaque, which is a colorless film of bacteria, tartar is a mineral buildup that’s fairly easy to see if above the gumline. The most common sign of tartar is a yellow or brown color to teeth or gums. The only way for sure to detect tartar and to remove it is to see your dentist.
How can I prevent tartar buildup?
Proper brushing, especially with a tartar control toothpaste, and flossing are necessary to reduce plaque and tartar buildup.
Once tartar has formed, only your dentist or hygienist can remove it. The process for removing tartar is called scaling. During a scaling session, the dentist or hygienist uses special instruments to remove tartar from your teeth above and below the gumline.
Diabetes and periodontal diseases
Research shows that there is an increased prevalence of gum disease among those with diabetes, adding serious gum disease to the list of other complications associated with diabetes, such as heart disease, stroke and kidney disease.
Is there a two-way street?
Emerging research also suggests that the relationship between serious gum disease and diabetes is two-way. Not only are people with diabetes more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. Research suggests that people with diabetes are at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). People with diabetes are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums.
The Surgeon General’s Report on Oral Health states that good oral health is integral to general health. So be sure to brush and floss properly and see your dentist for regular checkups.
If I have diabetes, am I at risk for dental problems?
If your blood glucose levels are poorly controlled, you are more likely to develop serious gum disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control.
Other oral problems associated to diabetes include: thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness, ulcers, infections and cavities.
How can I help prevent dental problems associated with diabetes?
First and foremost, control your blood glucose level. Then, take good care of your teeth and gums, along with regular checkups every six months. To control thrush, a fungal infection, maintain good diabetic control, avoid smoking and, if you wear them, remove and clean your dentures daily. Good blood glucose control can also help prevent or relieve dry mouth caused by diabetes.
What can I expect at my checkup? Should I tell my dental professional about my diabetes?
People with diabetes have special needs and your dentist and hygienist are equipped to meet those needs. Keep your dentist and hygienist informed of any changes in your condition and any medication you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not in good control.
Heart disease and gum disease?
Overall the data indicates that chronic gum disease may contribute to the development of heart disease, the nation’s leading cause of death in both men and women.
How does this happen?
Gum disease is a bacterial infection that can affect conditions outside your mouth. In heart disease, one theory is that gum disease can cause bacteria to enter the bloodstream where they attach to the fatty deposits in the heart blood vessels. This condition can cause blood clots and may lead to heart attacks.
The Surgeon General’s Report on Oral Health states that good oral health is integral to general health. So be sure to brush and floss properly and see your dentist for regular checkups.
If I have heart disease, are there special requirements to maintain proper oral health?
To maintain the best oral health, you should:
- Establish and maintain a healthy mouth. This means brushing and flossing daily and visiting your dentist regularly.
- Make sure your dentist knows you have a heart problem.
- Carefully follow your physician’s and dentist’s instructions, and use prescription medications, such as antibiotics, as directed.
Am I at risk if dental procedures are performed?
If you have certain pre-existing heart conditions, you may be at risk for developing bacterial endocarditis – an infection of the heart’s inner lining or the valves. Anytime there is bleeding in the mouth, certain oral bacteria can enter the blood stream and may settle on abnormal heart valves or tissue weakened by an existing heart problem or heart condition. In these cases, the infection can damage or even destroy heart valves or tissues.
There are precautions you need to take if you have any of the following conditions:
- Artificial (prosthetic) heart valves
- A history of endocarditis
- Congenital heart or heart valve defects
- Heart valves damaged (scarred) by conditions such as rheumatic fever
- Mitral valve prolapse with a murmur
- Hypertrophic cardiomyopathy
Be sure to tell your dentist if you have a heart condition, and what, if any, medications you are taking for it. Your dentist will record important health information in your record and coordinate treatment with your physician.
Good oral hygiene
Good oral hygiene results in a mouth that looks and smells healthy. This means:
- Your teeth are clean and free of debris
- Gums are pink and do not hurt or bleed when you brush or floss
- Bad breath is not a constant problem
If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem.
Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.
How is good oral hygiene practiced?
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible for you to eat and speak properly. Good oral health is important to your overall well-being.
Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress. In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:
- Brushing thoroughly twice a day and flossing daily
- Eating a balanced diet and limiting snacks between meals
- Using dental products that contain fluoride, including toothpaste
- Rinsing with a fluoride mouthrinse if your dentist tells you to
- Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.