Gum disease affects the surface layers or the deep tissues in the mouth. Although more complicated forms of gum disease do exist, they are very rare. If you would like more specific information about these, please email or telephone our clinic.
Gum disease that affects surface tissues is known as gingivitis. This is inflammation of the gum immediately surrounding the teeth. It is caused by dental plaque which has been left to accumulate for a period in excess of two weeks. The gums become swollen, red in colour and bleed easily (eg. upon tooth brushing). In addition, the gums can be sore, and an unpleasant taste/odour can develop.
The treatment for gingivitis is aimed at removing the dental plaque and keeping it away. The dental hygienist carefully removes all soft and hard plaque deposits. The patient is instructed in keeping the plaque away (toothbrush brushing efficiency, the use of mouthwashes, flossing etc) and the condition readily resolves over a period of two weeks.
Some forms of gingivitis are of sudden onset whilst others have been present for longer periods (months, even years). In addition, gingivitis can develop due to certain medical conditions (eg. pregnancy). Another common form of gingivitis is that due to the taking of certain prescription drugs (eg. common drugs used in the control of Hypertension). All patients benefit from a full medical history to exclude any of the above.
If gingivitis is left unchecked then it can progress. Progressive or deepening gum disease is known as periodontal disease. It is not possible to accurately predict who is susceptible to periodontal disease and who is not, although genetic inheritance does appear to play a major role.
Periodontal disease is characterised by all the features of gingivitis but in addition and most importantly, the gum and bone surrounding the teeth is gradually lost. Obviously, if one loses enough bone surrounding a tooth then the tooth will become loose and eventually fall out. That is the extreme scenario and most examples of bone loss are less severe. The bony voids (called ‘pockets’) are replaced by hard and firmly attached dental plaque.
Treatment involves full diagnosis & assessment which includes taking numerous measurements of the degree of bone loss, both clinically and by the use of x-rays. After that, a protocol of treatment is drawn up which usually involves deep cleaning, a process known as root planing. This process aims to eliminate all hard plaque that has accumulated in the pockets. Sometimes, in addition to root planing, self-resorbing slow release antibacterial devices are placed into the pockets to help eliminate resistant bacteria. The patient is then instructed in the maintenance of a plaque-free mouth. The condition is reviewed and reassessed at regular intervals to ensure that healing is uneventful. The lost bone cannot be recovered but its loss can be prevented. Achieving stable bone levels is the primary aim of treatment.