Managing and Preventing Gum Disease
Gingivitis is one of the most common phrases used in dentistry. You’ve doubtlessly gotten the feeling that it’s a bad thing, and that one of the main reasons why you should brush and floss regularly is to prevent it. But is gingivitis just a synonym for gum disease, or is it a worse form? And is it something that interacts with other diseases? One of a dentist’s most important responsibilities is teaching their patients how to look after themselves and how to recognize when they need help, so this month’s newsletter is devoted to the basic aspects of gum disease and what options a patient has for treating it at various stages.
Gingivitis and Periodontitis Defined
Gingivitis simply means inflammation of the gums, which are also known as gingival tissue. It is actually the less serious form of gum disease. Although the gums can become swollen due to an acute injury, gingivitis is usually meant to describe the inflammation that results from harmful oral bacteria clinging to the teeth. Oral bacteria secrete acid as a waste product of cellular respiration. A film of saliva and bacteria called plaque is constantly forming on the teeth, and acidic products become trapped in it. The acid not only causes decay in the adjacent tooth enamel, but also irritates the nearby gums.
Gums don’t cling to teeth at exactly the place they extend to. There is actually a bit of a pocket in between them and the enamel, which your hygienist probes during regular cleanings. When plaque doesn’t get removed, it hardens into tartar above and below the gum line. Tartar continues to irritate the gums, which is why a person might notice them bleeding when they brush their teeth or find that they feel more sensitive. As a gum pocket infection progresses, it will become periodontitis, also known as periodontal disease, which is the worse version of gum disease. At this point, the acid is damaging the structure of the jaw bone and causing the deep gum tissue to recede away from the tooth roots. If it goes on, the tooth could become loose enough to fall out.
Risks of Gum Disease
People are much more likely to develop gum disease when they aren’t brushing away plaque or flossing out food debris regularly. However, gums can also become inflamed more easily when their walls have been weakened due to chemical changes in the body. Pregnant women commonly experience gingivitis due to hormones that are making their cells more permeable, and people with diabetes experience damage to vascular systems throughout their bodies. Anything that suppresses the immune system is also going to make it harder for the body to fight off a gum infection, making gum disease symptoms more likely to develop. Smoking also damages gum tissue and puts a person at greater risk for infection. There is also a possibility that the patient is brushing their teeth too hard or flossing too deeply.
Options for Treatment
Gum Disease isn’t usually difficult to manage while it’s still in the gingivitis stage. A professional cleaning can safely break up tartar without risking harm to the enamel and pull plaque from beneath the gum line. Brushing more efficiently (with a soft-bristled brush) can stop gums from bleeding, and you can also combat oral bacteria by using mouthwash and chewing sugar-free gum after meals.
Ending periodontal infections will require more serious intervention. A common first step is scaling and planning, wherein a dentist applies local anesthetic to the mouth. They then clean deep within the gum pocket and shave the tooth root in order to smooth it out and deprive oral bacteria of a hiding place. They may also place slow-releasing anti-bacterial gel packets in the gum pockets. Some dentists use lasers to remove diseased tissue.
In severe cases, oral surgery may be recommended. This could include the use of sutures to pull receded gum tissue back into place. Oral surgeons may also recommend gum grafts or bone grafts to replace damaged tissue, particularly if a patient has lost a tooth and doesn’t have enough jaw bone tissue for an implant. The patient would also be prescribed stronger antibacterial mouthwash. Serious cases of gum disease may not be completely reversible, so we hope a patient would seek help long before reaching that point. Patients should also quickly seek help for anything that is causing physical damage to their gums and may want to consider orthodontics or veneers to make their teeth easier to clean.