Glendowie Dental Centre

What is Gum or Periodontal Disease?

The key to avoid periodontal disease is to have regular hygiene maintenance

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the gum tissues surrounding the teeth. These are the gums, the bone and connective tissue holding our teeth in place.  In its early stage, called gingivitis, the gums become swollen, red, and may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Bad breath may also occur.

Periodontal disease is generally due to bacteria in the mouth infecting the tissue around the teeth. Risk factors include plaque and tartar, diabetes, smoking, genetic component, certain medications and HIV/AIDS.  

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the gum tissues surrounding the teeth. These are the gums, the bone and connective tissue holding our teeth in place.  In its early stage, called gingivitis, the gums become swollen, red, and may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Bad breath may also occur.

Periodontal disease is generally due to bacteria in the mouth infecting the tissue around the teeth. Risk factors include plaque and tartar, diabetes, smoking, genetic component, certain medications and HIV/AIDS.  

The main cause of periodontal disease is poor oral hygiene.  Poor oral hygiene causes accumulation of plaque and tartar either above or beneath the gum tissue. Plaque is a sticky colourless film which is consistently forms on our teeth due to an accumulation of food debris at the gum margin.  Plaque can be removed by brushing and flossing, but if that does not happen properly every day, the plaque thickens and starts inflaming the gums. It is then eventually hardens into a rough, porous deposit called calculus or tartar. The bacteria that live in the plaque release toxins (poisons) irritating the gums and start destroying the connecting tissue and bone supporting the teeth. Unless treated the infected teeth can become loose and eventually lost. 

The main cause of periodontal disease is poor oral hygiene.  Poor oral hygiene causes accumulation of plaque and tartar either above or beneath the gum tissue. Plaque is a sticky colourless film which is consistently forms on our teeth due to an accumulation of food debris at the gum margin.  Plaque can be removed by brushing and flossing, but if that does not happen properly every day, the plaque thickens and starts inflaming the gums. It is then eventually hardens into a rough, porous deposit called calculus or tartar. The bacteria that live in the plaque release toxins (poisons) irritating the gums and start destroying the connecting tissue and bone supporting the teeth. Unless treated the infected teeth can become loose and eventually lost. 

Another main factor of periodontal disease is smoking.  Smoking reduce the gum tissue inflammation and altered gingival crevicular fluid inflammatory cytokine profiles (GCF), immune cell function and altered proteolylic regulation.  These cause gradual loss of periodontal tissue and loss of surround bone around the teeth.  Smoking also lowers the chances of successful hygiene treatment.

Another main factor of periodontal disease is smoking.  Smoking reduce the gum tissue inflammation and altered gingival crevicular fluid inflammatory cytokine profiles (GCF), immune cell function and altered proteolylic regulation.  These cause gradual loss of periodontal tissue and loss of surround bone around the teeth.  Smoking also lowers the chances of successful hygiene treatment.

Diabetes appears to exacerbate the onset, progression, and severity of periodontitis.  In well managed diabetes there seems to be a small effect of diabetes on the risk for periodontal disease. However, the risk increases exponentially as glycaemic control worsens. Overall, the increased risk of periodontitis in diabetics is estimated to be between two and three times higher.  So far, the mechanisms underlying the link are not fully understood, but it is known to involve aspects of inflammation, immune functioning, neutrophil activity, and cytokine biology.

Diabetes appears to exacerbate the onset, progression, and severity of periodontitis.  In well managed diabetes there seems to be a small effect of diabetes on the risk for periodontal disease. However, the risk increases exponentially as glycaemic control worsens. Overall, the increased risk of periodontitis in diabetics is estimated to be between two and three times higher.  So far, the mechanisms underlying the link are not fully understood, but it is known to involve aspects of inflammation, immune functioning, neutrophil activity, and cytokine biology.

What is Periodontal Treatment?

  • The dentist will inspect the gum tissue around the teeth both visually and with a periodontal probe and sometimes even with help of x-rays to diagnose the periodontal disease.
  • In mild to moderate cases of periodontal disease, initial treatment usually involves careful cleaning of the teeth and root surfaces and instruction in oral hygiene by our hygienist. More advanced cases may require surgical treatment by a gum specialist (periodontist) to aid cleaning of the root surfaces in deep pockets and recontour the gum tissues into the gum tissues into a shape that is easier to clean.
  • Moreover, treatment involves good oral hygiene and regular visit to see the dentist and dental hygienist to maintain the periodontal disease.  Oral hygiene involves brushing at least twice a day, morning and night and flossing at least once a day at night.  Antibiotic sometimes can be use in conjunction with treatment of periodontal disease.

Risks associated with Periodontal Disease

Periodontal disease is strongly increasing the risk of stroke, high blood pressure, heart attack, atherosclerosis and alzheimer. People with instability of high sugar level in their body or uncontrolled diabetes have higher degrees of periodontal disease.

Following are the published papers for linkage of various disease to the periodontal disease:

https://www.ncbi.nlm.nih.gov/pubmed/32219849
https://www.ncbi.nlm.nih.gov/pubmed/32127090
https://www.ncbi.nlm.nih.gov/pubmed/32218402
https://www.ncbi.nlm.nih.gov/pubmed/28232969
https://www.ncbi.nlm.nih.gov/pubmed/31818283

Signs and symptoms

  • Redness or bleeding of gums while brushing teeth and using dental floss or biting into hard food (e.g. apples).
  • Gum swelling.
  • Spitting out blood after brushing teeth.
  • Halitosis, or bad breath, and a persistent metallic taste in the mouth.
  • Gingival recession, resulting in apparent lengthening of teeth.
  • Sensitive teeth during brushing, eating or hot and cold drink.
  • Deep pockets between the teeth and the periodontal gum tissue.
  • Pain may occurs at the late stage due to bacterial infection.
  • Facial swelling.
  • Pus may form around the infected tooth/teeth.
  • Loose teeth in the later stages.