Signs of Gum Disease

Gum disease happens when the tissue that supports the teeth becomes inflamed and swollen. Knowing the signs of gum disease like bleeding gums and bad breath is crucial to avoid any serious complications. In this article we will explain everything you need to know about gum disease, what it is, signs and symptoms, and how to prevent it.

What is Gum Disease?

Gum disease is a serious condition where the soft tissue around the teeth becomes inflamed and swollen. This tissue, known as the gums or gingiva, helps keep the teeth in place and protects the underlying tissues and bone. Gum disease is due to a build up of plaque on the teeth that goes untreated and eventually irritates the gingiva or gums. When the gums are irritated they become diseased and inflamed, which can lead to bleeding, pain, bad breath and even tooth loss.

Types of Gum Disease

There are two main types of gum disease – gingivitis and periodontitis. Gingivitis is the mildest form of gum disease but, left untreated, may turn into the more serious condition of periodontitis.

• Gingivitis: Gingivitis is a mild type of gum disease that is usually an indication of the early stages of gum disease. Plaque has stayed on the teeth for too long and developed into tartar or calculus. This hard substance contains bacteria which irritates the gums and causes them to become red, swollen and bleed when brushing or flossing. At this stage of the gum disease there is no bone loss and it can be cured with dental treatment like a scale and clean.
• Periodontitis: This serious condition called periodontitis affects the gums and jawbone and is a result of gingivitis going untreated. The deep pockets that contain bacteria become deeper and more infected without treatment. When left infected and not addressed by a dentist, gums become inflamed, bleed, may recede and result in potential bone loss. At this stage of gum disease, there is no cure but it can be managed with treatments and surgery.

Signs and Symptoms of Gum Disease

The signs and symptoms of gum disease can vary depending on the severity of it. People with gum disease may experience anything from bleeding gums to tooth loss. In early gum disease, known as gingivitis, symptoms will be less pronounced. The more advanced the gum disease, as in periodontitis, the more serious the symptoms.

Early Gum Disease Symptoms

Gum disease in the early stages includes these symptoms:

• Swollen, puffy gums: Swollen gums are abnormally larger than usual and may be protruding. Swelling usually occurs between the teeth in the gums and is often associated with bleeding gums.
• Sore, tender gums: Gums may be tender when eating or teeth cleaning. Swollen and unhealthy gums can become uncomfortable which is a sign something is not right.
• Dark red gums: Healthy gums are light pink so when gums become dark red it is a sign something is wrong.
• Bleeding gums: Sometimes you might notice your gums bleeding after brushing or flossing. This may be a sign of early gum disease as healthy gums do not tend to bleed.
• Bad breath: When gum disease occurs, the gums pull away from the teeth which leaves pockets that fill with odour causing bacteria. This can lead to bad breath.

Advanced Gum Disease Symptoms

When gum disease is advanced, it still includes the early symptoms of red, swollen gums, gums that bleed when touched and bad breath. However, as the disease progresses, signs and symptoms become far more serious. These include:

• Gum recession: Gum recession is when the gums pull away from the teeth and expose the roots. It is a common symptom of advanced gum disease.
• Loose teeth: When gum disease advances, it can cause damage to the bone and tissues supporting the teeth. As the bone and tissues become lost, the teeth can become loose and eventually fall out.
• Sensitive teeth: When the tooth root is exposed it can lead to teeth becoming sensitive. The tooth root lacks the protective enamel which leads to pain and sensitivity when exposed to temperature or pressure.

Causes of Gum Disease

Gum disease occurs because of two main causes: plaque and tartar build up that is not treated, and poor oral hygiene. This combination results in gum disease which advances without proper treatment.

Plaque and Tartar Build up

Dental plaque is a normal, everyday accumulation of residue on your teeth that forms as a sticky film of bacteria. Without proper brushing or flossing, it turns into tartar. This hard plaque contains bacteria that has mineralised and settles on the teeth and gumline. Unlike plaque, tartar cannot be removed without dental expertise.

The chronic bacteria in the tartar causes the gums to become swollen, red and bleed. As gum disease progresses from gingivitis to periodontitis, the gum starts to detach from the teeth which exposes the tooth roots. Severe periodontitis can also cause bone decay and eventual tooth loss.

Poor Oral Hygiene

Poor oral hygiene, like lack of tooth brushing and flossing to remove plaque, can be a cause of gum disease. When plaque is not removed by regular oral hygiene, it develops into tartar, settles on the teeth and gums and becomes gum disease.

Risk Factors of Gum Disease

Certain people may be more prone to gum disease depending on their health and lifestyle. Risk factors that make gum disease more likely include:

Lifestyle

• Smoking: Smoking impairs the body’s ability to fight infection, reduces blood flow to the gums and affects the immune system which increases the likelihood of gum disease.
• Stress: Stress increases inflammation in the body and weakens the immune system which can contribute to the development of gum disease.
• Poor diet: A diet high in sugar can increase the likelihood of gum disease occurring as sugar contributes to plaque build up.
• Poor oral hygiene: Failing to clean and floss teeth and have regular dental appointments can contribute to gum disease forming because of the tartar build up.
• Pregnancy: Gums are more likely to become inflamed and bleed due to the hormonal changes in pregnancy. The increase in oestrogen and progesterone makes gums more susceptible to plaque build up which causes gum disease. This is known as pregnancy gingivitis.

Health

• Diabetes: People with diabetes are more susceptible to gum disease. Diabetes causes fatty deposits to form inside the blood vessels which reduces the ability for blood to flow as freely. This reduction in blood flow to the gums causes an increase in the likelihood of infection and consequently gum disease.
• Vitamin K deficiency: Vitamin k is essential for jaw bone health and helps fight off bad bacteria that harms teeth and gums. Someone with vitamin k deficiency will be more likely to develop gum disease because there is little resistance.
• Pernicious anaemia: People with pernicious anaemia are more likely to have gum disease symptoms because b12 deficiency impairs oral tissue health.
• Bruxism: Teeth grinding and clenching can increase the risk of gum disease. Constant pressure on the gums can cause them to become inflamed, damage supporting tissue and lead to gum disease.

When To See A Dentist for Gum Disease

If you are having bleeding gums on a regular basis, you should see a dentist immediately. Gums can bleed occasionally from brushing or flossing too hard but regular bleeding is a sign of gum disease. It is important to be diagnosed and have treatment to avoid gum disease progressing from mild gingivitis to severe periodontitis.

Depending on how advanced gum disease is, you may want to see either a dentist or a periodontist. A dentist will be able to diagnose what type of gum disease you have and suggest treatment. A periodontist is a specialist in more advanced gum disease like periodontitis.

Diagnosis and Treatment

Gum disease is diagnosed and treated either by a dentist or periodontist, depending on the severity. The process of diagnoses and treatment of gum disease is:

Diagnosis

To diagnose gum disease, a dental examination is necessary. The dentist will check for inflammation and measure the pockets around the teeth to make sure they are not too deep, which may be a sign of gum disease. Dental X-rays may be ordered to see if there is any bone loss associated with advanced gum disease. Sometimes the dentist might also order blood tests called CRP to determine if the c-reactive protein is present as periodontitis is associated with a higher level of CRP.

Treatment

Depending on the severity of the gum disease, there will be different levels of treatment. For mild gum disease, treatment may be less invasive like a scale and clean and improving oral hygiene. For advanced gum disease, treatment could extend to surgery. We explain how gum disease is treated here:

Mild gum disease treatment:

• Scale and clean: Dentist removes tartar with a handheld instrument called a scaler. This will remove the cause of the gum disease and give the gums a chance to heal.
• Root planing: This deep cleaning by the dentist removes the plaque and tartar below the gums and smooths the tooth roots.
• Improve oral hygiene: Regularly brush and floss teeth twice a day. Use an antibacterial mouthwash to help reduce bacteria, and have regular dental checkups.

Advanced gum disease treatment:

• Scale and root planing: This non surgical procedure is the first step for trying to treat advanced gum disease. While it is mostly successful for mild gum disease, its success for advanced gum disease will depend on the severity.
• Pocket reduction surgery: The dental surgeon separates the gums from the tooth to do a deeper clean of the gum tissue. It is then reattached into position. If there is bone loss, the dental surgeon may also reshape the underlying bone.
• Bone graft: If bone has been destroyed due to gum disease, a dental surgeon can perform a bone graft. This is to create a strong foundation for the teeth and avoid tooth loss.

Complications From Gum Disease

Gum disease left untreated can lead to several complications. Apart from bleeding gums and bad breath, gum disease can be a contributing factor in serious health issues. These include:

• Tooth loss: The tissue and bone that holds teeth in place becomes damaged from gum disease which can result in tooth loss.
• Respiratory disease: Bacteria from gum disease can spread through the bloodstream into the lungs, causing respiratory disease.
• Stroke and heart disease: Inflammation from gum disease can lead to stroke and heart disease. The inflammation damages the blood vessels which can build up plaque and form the clots that result in strokes and heart issues.

Prevention of Gum Disease

The two best ways to help prevent gum disease are good oral hygiene and regular dental visits.

Good oral care

• Brush teeth along the gum line twice a day.
• Use floss to remove food and bacteria from between teeth.
• Clean dentures every day.
• Eat a healthy diet, avoiding sugar as much as possible, particularly if prone to diabetes.
• Drink plenty of water.
• Quit smoking.

Regular dentist visits

• Regular dental checkups are essential for monitoring the health of your teeth and gums. Most dentists recommend a dental visit every six months for a routine checkup and clean.

Gum disease has a variety of signs that should not be ignored. If ignored and left untreated, it can become a serious health condition. With regular dental checkups and good oral hygiene, should gum disease occur, it will be easier to treat and have no lasting complications. Our article explains everything about gum disease, signs and symptoms and how to avoid it for optimum oral health. For further information, the experts in dental care at Hawthorn Road Family Dental are here to help.