Gum Disease

Gum disease can be plaque and bacteria related or it may be non-bacteria related.

A. Bacteria-related gum disease

In this category, plaque bacteria are the main cause of gum disease:

Gingivitis

When bacteria dominate the gum tissue around your teeth and as a result the gum becomes inflamed, this is called gingivitis. This inflammation is a natural defence mechanism from your body. It should be considered a signal that your body is giving, alerting you that you are under attack from bacteria.

How do I know if I have gingivitis?

There are signs and symptoms that you should watch for when suspecting gingivitis. One or a combination of one of these signs and symptoms may indicate gingivitis:

  • Bleeding gums when brushing: It is usually difficult to understand where exactly the bleeding is coming from.
  • Bleeding gums when using dental floss: Assuming you do floss correctly (not rubbing the floss between teeth), if you see bleeding from your gums while flossing, gingivitis is the most likely reason.
  • Bleeding while using interdental brushes/toothpicks: When the gum is inflamed, cleaning between teeth with interdental brushes may cause bleeding if you have gingivitis.
  • Bad breath
  • Red and puffy gums (usually a purple/red band may show at the gum line around teeth)

While bacteria are the primary cause of gingivitis, there are other factors that can contribute to its development, such as:

  • Puberty
  • Menstrual cycle
  • Pregnancy
  • Medications (some medications)
  • Diabetes
  • Leukemia
  • Malnutrition and vitamin deficiencies

Gingivitis is usually reversible with proper treatment. However, if left untreated, it can progress to a more serious condition called ‘Periodontitis’.

Periodontitis

When gingivitis progresses and is not treated, the bacterial invasion leads to deeper inflammation in the gum. This leads to the supporting bone of the tooth getting affected. When this bacterial invasion dominates, the consequence is resorption and recession of the bone around the tooth.

Depending on the location and extent of the bacteria present deep at the gum line, the whole circumference of the bone may be affected or it can be localised to a smaller region around the tooth. As the bone recedes, the gum around the tooth follows suit.

The gum that is well attached to the root surface and lying over the bone, becomes detached from the tooth in the deep areas, this is when a periodontal pocket is formed. That is loose gum around the root of the tooth.

When the bone resorption (bone loss) around the tooth/root reaches a threshold, the tooth can gradually become mobile. The final consequence of periodontitis is severe bone loss and eventual loss of teeth.

Unfortunately, the disease process is usually painless. Therefore, periodontitis remains relatively silent for quite a long time until it may be too late.

The general signs and symptoms of periodontitis are the same as gingivitis. In addition there may be some other additional signs and symptoms that could be good indicators for periodontitis, these include:

  • Feeling weakness with one or a few teeth in the mouth
  • Constant and frequent food impaction between teeth
  • Mobility of teeth (not readily felt usually)
  • Hypersensitivity with cold and hot stimuli
  • Migration of teeth
  • Tenderness on teeth under pressure while chewing or biting
  • Receding gums

What factors make me susceptible to Periodontitis?

From literature, we now know that there are certain factors that may make some people more susceptible to periodontitis, these include but are not limited to:

Genetics / Family history of gum disease

  • If you have parents who lost their teeth at a young age, that may be an indication for genetic susceptibility
  • Smoking (current or history of smoking)
  • Current and ex-smokers harbour bacteria in their mouth more specific towards gum disease. The changes occur over time and even after you quit smoking it tends to keep that effect for a very long time. Also, current smokers tend to have a compromised immunity against periodontal pathogens. Hence, the initiation and progression of periodontitis occurs in an easier way compared to never-smokers.

Diabetes

There is good evidence in literature supporting a poorer immunity response from bacterial attack in diabetics. This is particularly more pronounced in uncontrolled diabetes. Even short periods of glucose fluctuation may have an impact on progression of gum disease.

Stress

Stress is one of the factors affecting your immune response. Individuals may harbour periodontal pathogens and chronic stress may lead to compromised subclinical poor immune responses against bacteria, leading to the initiation and progression of gum disease.

Plaque bacteria/poor oral hygiene

The ultimate cause of periodontitis is bacteria. Even in the absence of any other risk factors, chronic poor oral hygiene can lead to the development of periodontitis.

Vitamin D level

There is substantial evidence that show low levels of Vitamin D can be a contributing factor to the progression of periodontitis. Vitamin D has a strong role in immune response and its deficiency can compromise ones defence against bacteria.

Irregular attendance to dentist/hygienist

While good personal oral hygiene can eliminate most of the plaque bacteria from the surface of teeth, there is always a thin plaque bacteria accumulation around the gum line. These are the areas that are difficult to clean by individuals. Therefore, professional scaling and cleaning of teeth is required on a regular basis. Ideally, and for those with no history of periodontal disease, the interval should be 6 monthly. This interval is usually shorter when active periodontal disease is present and also after treatment in susceptible individuals.

Poor dental state or poor restoration/denture state

For example, the presence of multiple cavities on teeth can be a constant bacteria trap. This leads to bacteria growing constantly without being disturbed. Similarly, if dental fillings or a denture is made in a way that appropriate brushing is not possible, those sites will be at high risk of developing gum disease.

B. Non-bacteria related gum disease

In this category, bacteria have no role in occurrence of the gum disease. The presentation of gum disease may be different than gingivitis. The causes include:

  • Viral infections
  • Allergic reactions
  • Autoimmune disease with oral disease presentations
  • Fungal infections
  • Traumatic lesions (chemical, mechanical, thermal)
  • Foreign body reaction
  • Malignancies (cancer)
FAQS

Gum Disease

What is gum disease?
Gum disease, also known as periodontal disease, is an infection of the tissues that hold your teeth in place. It’s typically caused by poor brushing and flossing habits that allow plaque – a sticky film of bacteria – to build up on the teeth and harden.
What are the early signs of gum disease?
Early signs include red, swollen, or tender gums that bleed easily, especially when you brush or floss. You might also notice persistent bad breath or a bad taste in your mouth.
How is gum disease diagnosed?
A dentist or periodontist diagnoses gum disease during a dental exam. They will measure the depth of the pockets around your teeth, review your medical history, and take X-rays to check for bone loss.
Can gum disease be reversed?
In its early stages, gum disease can be reversed with good oral hygiene and professional cleaning. However, more advanced stages may require specialized treatment and maintenance to control the infection.
What treatments are available for gum disease?
Treatments range from non-surgical procedures like scaling and root planing (deep cleaning) to surgical treatments such as flap surgery, bone grafts, and tissue regeneration. The treatment plan depends on the severity of the disease.
How can I prevent gum disease?
Practising good oral hygiene is key. This includes brushing twice a day, flossing daily, using an antiseptic mouthwash, and visiting your dentist and Periodontist regularly for cleanings and check-ups.
Is gum disease hereditary?
While the primary cause of gum disease is bacterial plaque, genetics can play a role. People with a family history of gum disease may be more susceptible to developing it.
Can gum disease affect overall health?
Yes, gum disease has been linked to other health issues such as heart disease, diabetes, and respiratory disease. The inflammation caused by gum disease can potentially affect other parts of the body.
How often should I visit the dentist for gum disease check-ups?
It’s generally recommended to visit your dentist at least twice a year for routine check-ups and cleanings. However, if you have gum disease, your dentist may suggest more frequent visits to monitor and manage the condition.
What lifestyle changes can help improve gum health?
Quitting smoking, reducing sugar, maintaining a good, balanced diet rich in vitamins and minerals, and staying hydrated can all help improve gum health and prevent gum disease.

Level 5, 531 – 533
The Kingsway, Miranda NSW

(02) 9526 2688 Book an Appointment

Level 5, 531 – 533
The Kingsway, Miranda NSW

(02) 9526 2688 Book an Appointment