Gum disease, also called periodontal (meaning “around the tooth”) disease, is an infection of the supporting tissues and bones around the teeth, which is usually caused by bacteria from plaque build-up. Gingivitis, normally the milder form of gum disease, may progress to periodontitis if left untreated for long.
Types of Gum Disease
- Gingivitis is the inflammation of the gums (the tissues surrounding the teeth) due to mild infection.
Acute necrotizing ulcerative gingivitis (ANUG) or necrotizing ulcerative gingivitis (NUG) is an extremely severe and invasive form of gingivitis.
- Periodontitis is a more severe form of infection which involves not only the gums but also the tissues and bones supporting the teeth below the gums. Periodontitis may be of different types :
1. Chronic periodontitis.
2. Aggressive periodontitis.
3. Necrotizing periodontal diseases, such as necrotizing ulcerative periodontitis (NUP).
4. Periodontitis as a result of systemic diseases.
What Causes Gum Disease?
Build-up of plaque (which consists of saliva, acid, food debris, and bacteria normally present in the mouth) on the teeth causes bacteria to produce toxins that cause inflammation and destruction of gum tissues. If it is not attended to, over time it breaks down not only the gum tissues but also the bone and connective tissue underneath which supports the teeth. As a result, pockets are formed around the teeth which harbor more bacteria. As further destruction occurs around the teeth, they become loose in their sockets and may finally fall off.
Risk Factors of Gum Disease
- Smoking and chewing tobacco are significant risk factors not only for development of gum disease but also in hindering effective treatment.
- Hormonal changes occurring in women during puberty, menopause, menstruation and pregnancy make the gums more prone to developing gum disease.
- Medication that reduce saliva in the mouth.
- Birth control pills.
- A diet low in nutrients.
- Diseases, such as AIDS and cancer, and related therapy.
- Poor oral hygiene.
- High level of stress.
- Bruxism (frequent clenching of the teeth).
- Genetic susceptibility and family history of gum disease.
Symptoms of Gum Disease
Sometimes there may not be any obvious symptoms even in the presence of gum disease but usually one or more of the following symptoms are present, such as :
- Red, swollen, tender gums.
- Gum bleeding during or after brushing.
- Chronic bad breath (halitosis).
- Bad taste in the mouth.
- Sensitive teeth.
- Loose teeth.
- Pain on chewing.
- Receding gums (teeth may appear longer than normal).
- Pocket formation between teeth and gums.
- Pus discharge from the gums.
- Changes in teeth alignment on biting down.
Treatment of Gum Disease
Treatment will depend upon the type and extent of gum disease. The aim of treatment is to stop gum disease from progressing, reducing pain, swelling and infection, and attempting to reattach healthy gums to teeth.
The following measures may be necessary.
- Plaque removal by a deep-cleaning method called scaling and root planing.
- Chlorhexidine gluconate mouth rinse to control bacteria.
- Antibiotics to control and treat infection.
- Surgical dental procedures may become necessary when inflammation and deep pockets persist despite deep cleaning and medication. A common procedure is flap surgery. Bone and tissue grafts may be needed in addition to flap surgery when there is extensive destruction of gum tissues and bone.
Gum Disease and Related Health Problems
- Whether gum disease can cause health problems beyond the mouth is still a matter of debate although potential links have been found between them.
- More research is needed before it can be proved conclusively that gum disease causes problems such as stroke and heart disease, although the risk does seem to be higher, particularly in immuno-compromised people.
- Some studies have shown that pregnant women with gum disease are more likely to deliver preterm, low birth weight babies, but whether this is caused by gum disease or other factors is yet to be determined.
- Diabetes is considered a risk factor for developing gum disease and it is possible that gum disease may worsen diabetes by making blood sugar control difficult.