Dental Implants and Gum Disease

What is gum disease?

Periodontal disease (gum disease) is a chronic bacterial infection of the gums and bone supporting the teeth. It is a major cause of tooth loss in adults. However, because gum disease is usually painless, you may not even know you have it. Gum disease is caused by plaque bacteria which form a sticky film on the tooth surface. These plaque bacteria release toxins that can damage the gums. As the amount of plaque increases the saliva in your mouth can begin to mineralise the plaque to form tartar (calculus). These hard deposits on the roots of the teeth only serve to promote more plaque formation and further damage to the gums.

Types of Gum disease

There are two main types of gum disease- gingivitis and periodontitis. Gingivitis is very common and may affect up to 70% of the population. Periodontitis affects around 30% of adults over age of 30. Both these infections can be treated and controlled, but the earlier they are diagnosed and managed, generally the better the prognosis for your teeth.

A patient with generalised gingivitis. Note the red, swollen, inflammed gum tissues around the teeth. These gums bleed easily on brushing.

Diagnosis and treatment

Diagnosis and treatment of periodontitis in its early stages will significantly enhance the prognosis for the dentition. If you have not had a periodontal screening examination with your dentist in the last 12 months, make it a priority. Remember, most patients who present with periodontitis are completely unaware of a gum problem being present in their mouth because it rarely causes pain until it becomes very severe, by which time it may be too late to save your teeth.

What are the warning signs of gum disease?

Periodontal disease is typically painless and often the signs are subtle. Some of the symptoms may include:

• gums that bleed easily with brushing or flossing
• red, swollen or tender gums
• pus between gums and teeth
• gums that pull away from the teeth
• persistent bad breath
• loose or separating teeth
• a change in the way your teeth fit together when you bite

An increasing amount of research also suggests that there is evidence linking chronic periodontal disease to conditions such as coronary heart disease, diabetes and respiratory disease. Moreover, current research suggests that if you have periodontal disease during pregnancy you may be significantly more likely to have a baby born prematurely or with a low birth weight. Keeping your gums healthy will ensure a better chance of good general health.

A case of advanced Periodontitis. Very swollen gums, loose teeth, staining and heavy plaque and calculus deposits on all the teeth.

Heavy calculus (tartar) deposits on the inside aspect of the lower incisor teeth in a patient with periodontitis.

Patient with advanced periodontitis showing severe loss of bone and gum recession.

Risk Factors for Gum Disease

The main cause of periodontal disease is bacterial plaque. Oral bacteria form a sticky, colourless film on your teeth. These bacteria release various toxic by-products which irritate your gum tissues. While plaque bacteria are the main cause of periodontal disease there are other factors, such as those outlined below, that can also affect the health of your gums.

Smoking and Tobacco Use

The use of tobacco is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Smoking also increases the risk of periodontal disease and recent research has shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. Smoking also reduces the ability of your gums to heal properly following treatment, which may mean a less successful treatment outcome. Patients who smoke are also more prone to developing post operative infections following treatment. For these reasons all patients are encouraged to quit smoking as part of their periodontal therapy.

Genetics

Recent studies suggest that approximately 30% of the population may be genetically more susceptible to developing gum disease. Thus, some individuals are more prone to periodontal disease. Often the susceptibility to periodontal infection can be traced though families. Patients with a susceptibility to periodontal disease may require more intensive maintenance and more frequent recall for hygiene treatment.

Pregnancy & Puberty

At certain times such as puberty, menopause, menstruation and pregnancy your gum tissues may be more susceptible to irritation and infection. During these particular times your body experiences specific hormonal changes which can affect your gum tissues. Your gums may become more sensitive and at times react strongly to the hormonal fluctuations. Recent research also suggests that pregnant women with chronic gum disease are up to seven times more likely to deliver pre-term, low-birth-weight babies.

Grinding or Clenching your Teeth

Tooth grinding typically occurs at night while you are asleep and is also know as bruxism. Your jaw joint may click on opening or may be painful at times. If you wake up with frequent headaches and show wear on your teeth, you may be grinding your teeth. Tooth grinding may worsen your gum health if you have pre-existing periodontal disease.