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Gum diseasePublished by BUPA's health information team, healthinfo@bupa.com, August 2007. This factsheet is for people who have gum disease, or who would like information about it. Gum disease is very common and affects people of all ages. It's the most common cause of tooth loss in adults. It can be treated by your dentist or hygienist and, in the early stages of gum disease, the effects can be reversed.
What is gum disease?Plaque is a mixture of food, bacteria and bacterial waste products that build up on your teeth after eating. When plaque is left on your teeth, it irritates your gums (gingivae). This is the early stage of gum disease known as gingivitis. If gingivitis is not treated, the gums begin to pull away from your teeth, leaving a little pocket around the tooth. This pocket traps plaque that can't be reached with brushing. Plaque that is not removed hardens to tartar (calculus). Plaque and tartar build up causes further irritation. The irritation caused by plaque and tartar gradually starts to affect the bone structures around your teeth. As time goes on, the pockets get deeper and more difficult to clean, and the gum and bone move back from the roots, so that some of the root may be visible. This can make your teeth wobbly. This stage is called chronic (long-term) periodontitis. After years, the teeth may fall out, or they may need to be taken out by a dentist. SymptomsYou may not know if you have gum disease. Often it's not painful and some people with gum disease have no symptoms. Usually the first sign of gum disease is bleeding from the gums when you brush your teeth. Your gums may also be red and swollen and you may have bad breath and an unpleasant or metallic taste in your mouth. If gum disease has been left untreated, your teeth can become wobbly and you may get gum abscesses (pus collecting under the gum). CausesGum disease happens when plaque builds up because the teeth are not cleaned properly. This is more likely to happen if you find it difficult to clean your teeth well, for example if you wear braces, have dentures or have irregularities in your teeth that you can't reach with a toothbrush.
There are other factors that can make you more likely to get gum disease. These include:
In all of these cases though, the cause of the gum disease is the build up of plaque. TreatmentTreatment needs to be given by a dentist or hygienist. The type of treatment depends on how severe the gum disease has become. If you have gingivitis, your dentist or hygienist will clean your teeth thoroughly using a scaler and an electric toothbrush with gritty toothpaste. He or she may also recommend an antiseptic mouthwash, such as chlorhexidine (eg Corsodyl), that helps prevent plaque forming. He or she will also teach you how to brush and floss your teeth properly. If gum disease has progressed to periodontitis, you may need more extensive scaling to remove plaque and tartar from the pockets that have formed. This can take several appointments with the dentist or hygienist. You may need to have your gums numbed with an injection of local anaesthetic before the scaling, and you may feel a little discomfort afterwards. Your dentist or hygienist will monitor the size of the pockets during the following months to make sure the treatment has been successful and the periodontal disease is not getting any worse. If your gum disease is more serious, the pockets may be too deep for a dentist or hygienist to clean simply by scaling. You may then need gum surgery, which can be carried out by your dentist. Your dentist may refer you to a periodontist, a dentist who specialises in treating periodontitis. He or she will carry out more extensive and deeper scaling, along with other treatment adjustments. For any of the treatments to be successful you need to put time and effort into cleaning your gums and teeth. You will have to follow your dentist's advice and make sure you remove plaque every day. If you smoke, it's likely that treatment will be less effective. PreventionPreventing gum disease involves controlling the amount of plaque and tartar that builds up on your teeth. Regular visits to your dentist or hygienist, brushing and flossing your teeth regularly and stopping smoking will help to do this. Your dentist or hygienist can show you the correct way to brush, floss and use interdental brushes. Dental floss or interdental brushes are used to remove plaque and particles of food from between the teeth and under the gum line. These are areas that a toothbrush can't reach. Even thorough brushing and flossing can't remove every trace of plaque. Most people have irregularities in their teeth where plaque can build up out of reach and harden into tartar. This can only be removed by a dentist or hygienist using special tools in a process called scaling. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr Brian Franks BDS (U. Lond) LDS RCS (Eng) MFGDP (UK) FPFA ACIArb, clinical director (dentistry) BUPA Wellness, and by other BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: August 2007. Expected review date: August 2009.
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