How can I tell if I have gum disease?

Healthy gums are pale pink and firm. If yours are red and swollen, you may have gum disease or gingivitis. One of the most common signs is blood on the toothbrush after brushing and often there is bad breath (halitosis) as well. You may notice that your gums bleed when flossing.

What’s the cause?

The accumulation of a surface film of dental plaque (a sticky layer of bacteria) starts the inflammatory process. Inflammation develops and penetrates the soft gum tissues and cause your immune system to respond. This response may cause damage to the tissues supporting the tooth.

If left untreated this gradually progresses, resulting in the destruction of the tooth attachment and the bone around your teeth (periodontitis). This causes the affected teeth to become loose and in some cases move position.

The depth of the space between the neck of the tooth (where the tooth meets the gum) and the base of the gum crevice, along with presence of bleeding indicates if you have a gum problem or not. These spaces are known as ‘pockets’. Healthy gums have small pocket measurements (0-3mm), but in gum disease these pockets can be very deep( 5-10mm or more) and means that special gum treatment is needed. The measurements taken by your dentist or hygienist indicate how severe any existing gum problems are.

Who is affected?

Periodontitis and gingivitis can affect anyone at any age. The milder form, gingivitis, is more common. Gingivitis causes bleeding gums but if left untreated may progress to periodonititis.

What can be done about this?

Gingivitis can be treated by visiting a dentist or hygienist who will clean your teeth professionally and advise you on how to improve your tooth cleaning at home. You may be unaware that there is a problem, as gingivitis can be painless during the early stages of the disease.

Basic periodontal treatment involves cleaning out the deposits of plaque and hardened plaque (tartar) from above and below the gums. The treatment is usually done by cleaning the affected areas, sometimes after making them numb with anaesthetic. In most cases the gum problems resolve after this type of treatment when accompanied by an effective oral hygiene routine at home.

Gum problems are also made worse by smoking and your dental professional may encourage you to stop.

When is basic treatment not enough?

Sometimes basic treatment is not successful at getting the gum disease under control. This is because the pockets in severe periodontitis are so deep that it is not possible to fully clean the root surfaces of the teeth without actually looking at them. Your dentist may recommend gum surgery. This treatment involves pushing the gums away from the teeth so that the roots can be seen. It is only by doing this that the dentist can be sure that the roots are clean.

Gum disease and gum surgery

Two types of gum surgery are available:

Surgery to clean the roots of the teeth – root surface debridement.
Surgery to replace the lost bone and soft tissues as well as clean the roots of the teeth.

Who may need gum surgery?

Patients who have stubborn deep periodontal pockets and gum disease.
Patients who have short teeth which need crowns. The teeth can be made longer with surgery so that crowns can be fitted.
Patients who have a high lip line, show a lot of gum and need their smile improved.

Preventing gum disease

Visiting your dentist or hygienist for advice on brushing and flossing techniques and the use of special brushes, together with regular cleaning and dental appointments will help to keep your gums healthy. Maintaining good oral hygiene helps to prevent gum conditions from worsening.