Gum disease - Gingivitis and Periodontitis
What is gum disease?
Gum disease is an oral health condition where the gums become swollen and red due to a build-up of plaque on the teeth. If you’re concerned about gum disease, read on to learn more about the symptoms, causes and treatment, and how you can prevent it.
What causes gum disease?
Gum disease is caused by a build-up of plaque.
Plaque is a soft, sticky substance containing bacteria, which consume sugar in our diet and release acid and other harmful substances. Regular brushing and flossing removes plaque from the teeth – when it is left on the teeth, it can cause decay and irritate the gums.
When left for a long time, plaque can harden into a substance called tartar. Unlike plaque, this can’t usually be removed with brushing and flossing – instead it has to be removed with special instruments by a dentist or dental hygienist.
Gingivitis vs periodontitis - what is the difference?
Mild gum disease is called gingivitis – this isn’t usually serious and can be treated by having plaque removed. Left untreated, however, gum disease can progress to periodontitis. This can cause pain, difficulty eating, abscesses and eventually tooth loss. Both gingivitis and periodontitis are caused by a build-up of plaque and tartar. Irritation initially occurs as a result of the harmful substances released by the bacteria in the plaque. However, damage to the teeth and gums can also be done “accidentally” by the immune system in the process of attacking these bacteria.
The main difference between gingivitis and periodontitis is that gingivitis is milder and easier to treat. Gingivitis is something you should be able to reverse by visiting your dentist to get the plaque and tartar cleaned from your teeth. Periodontitis, meanwhile, is much more severe and tends to require in-depth treatment from your dentist.
Symptoms of gum disease
- Swollen and red gums
- Bleeding when you brush or floss your teeth
- Bad breath
- A bad taste in your mouth
- Pockets of pus between your teeth and gums
- Difficulty eating
- Loosened teeth
How is gum disease treated?
Gingivitis can be treated by having the plaque and tartar removed from your teeth – this is a procedure referred to as a “scale and polish” that’s usually done by a dental hygienist. Because gingivitis causes swelling and bleeding, you might find the process a bit uncomfortable, and your gums may be tender afterwards.
In addition to this kind of cleaning, your dentist may also advise that you use an antiseptic mouthwash – usually one containing chlorhexidine. This will help to kill the bacteria in your mouth and prevent further irritation and inflammation.
Finally, your dentist will give you advice on how to take care of your teeth and gums to prevent gingivitis in the future.
Periodontitis is more complex to treat than gingivitis and can get progressively worse over time.
Treatment usually involves cleaning out “periodontal pockets” – these are gaps between the teeth and gums that fill with plaque and tartar, and become infected and inflamed. Your dentist or dental hygienist will do a deep clean of these pockets, normally after administering local anaesthetic to numb any pain.
This process is done to enable the gum to reattach to the tooth, however these pockets don’t usually heal completely. This means you’ll need to maintain a high standard of oral hygiene and have regular check-ups to prevent plaque build-ups.
Who is at high risk of gum disease?
Anyone can be vulnerable to gum disease if they don’t take good care of their teeth (i.e. by brushing and flossing), however some groups are more high-risk, including:
- People with a weakened immune system
- People with diabetes
- Pregnant women
- Older people
Diagnosing gum disease
If you think you have gum disease, you should see your dentist. The NHS recommends booking an urgent appointment if:
- You have very swollen and painful gums
- Your teeth feel loose or are falling out
- You have ulcers or red patches in your mouth
- You have a lump on your lip or in your mouth
It will be easy for your dentist to diagnose gum disease, whether it’s mild (gingivitis) or severe (periodontitis). They’ll confirm by checking your teeth and gums, and by taking X-rays of your teeth and jaw bone.
Preventing gum disease
The best way to prevent gum disease is to remove plaque from your teeth regularly. The basics of good oral health are as follows:
- Brush your teeth at least twice a day
- Use toothpaste with fluoride
- Spit after brushing, but don’t rinse your mouth with water
- Use floss and/or interdental brushes to clean between your teeth
- Replace your toothbrush or toothbrush head at least every three months
- Quit smoking
Mouthwash can be helpful in certain situations (e.g. if you have gingivitis) but you shouldn’t use it just after brushing your teeth.
Other than the tips listed above, make sure you visit your dentist and dental hygienist for regular check-ups as advised. This is especially important if you’ve had gum disease in the past, or if you’re pregnant or have type 2 diabetes.