Periodontal Disease (Gum Disease)

Also known as gum disease or periodontitis, periodontal disease is a bacterial infection.

This bacterial infection attacks the soft tissue and bone that support your teeth, resulting in the destruction of your gums and bone, and eventually the loss of your tooth.

A dentist can examine your gums and determine whether you have been impacted by gum disease. Gingivitis and periodontitis are the two most common types of gum disease.

Different treatment options are available depending on the stage of deterioration.

What Is Gum Disease?

Plaque serves as the primary cause of gum disease. Other risk factors, such as existing illnesses, medications, and lifestyle choices, can also trigger gum disease.

Plaque, a sticky biofilm coating your teeth, forms due to the combination of bacteria in your mouth with food debris and mucus. The reaction between sugars, starches in food and drinks, and bacteria results in the creation of plaque.

Over time, if plaque is not removed, it releases toxins and acid that are detrimental to your tooth enamel, the outer shell protecting your teeth. Despite its strength, tooth enamel is susceptible to erosion and damage from this acid. Gradually, these acid attacks may lead to tooth decay.

Unremoved plaque also hardens and, within days, transforms into tartar or calculus, accumulating at the gum line. When tartar build-up is not addressed, it poses the risk of irritating the gums, potentially causing swollen or red gums. This condition, known as gingivitis, represents the first stage of gum disease.

Gingivitis

Gingivitis is caused predominately from poor oral hygiene practices. This means not brushing and flossing regularly or utilising poor brushing techniques. This enables plaque to form on the teeth and if not removed continues to build up.

Unlike plaque, tartar proves challenging to remove, and only a professional cleaning can effectively eliminate it. Its hard texture provides a shield for bacteria to thrive, particularly along the gum line, leading to irritation and potential inflammation of the gums.

This poses a threat to your teeth and gums. Persistent neglect of oral hygiene allows tartar to remain and continue building up. Over time, you may observe bleeding gums, increased sensitivity of the gums and teeth, and the potential development of dental decay (caries). Additional signs may include bad breath, deep red or inflamed gums, and receding gums.

Continued neglect of the gums increases the risk of advanced gum disease, known as periodontitis, and raises the possibility of tooth loss.

What Causes Gum Disease?

There are many reasons why you may develop periodontal disease. These include:

plaque and tartar
poor oral hygiene habits
medications
illnesses that impact the condition of your gums
family history of gum disease

Gingivitis

This represents the first stage of gum disease. Your gums may show signs of redness, swelling, tenderness, and may also bleed.

The early stages of gingivitis occur when plaque build-up causes inflammation and irritation of the gums.

Periodontitis

If gingivitis is not treated, it can progress to periodontitis. In periodontitis, the inner layer of the gum and bone begins to pull away from the teeth, forming pockets that may become infected.

This infection has the potential to break down the bone and connective tissue, leading to loose teeth. If not addressed, this condition could ultimately result in the loss of the affected tooth.

Periodontitis

If left untreated, gingivitis can progress to the development of periodontitis, an advanced form of gum disease that severely impacts the gums.

The inner lining of the gum tissue, along with the bone, begins to pull away from the teeth, creating a gap that becomes an ideal space for bacteria to collect and further fester, potentially developing into an infection.

Over time, the immune response aimed at fighting bacteria and addressing the resulting infection contributes to the disintegration of gum tissue and even loss of bone. As more gum tissue is destroyed and bone is eroded, teeth may begin to loosen.

The signs and symptoms of periodontitis mirror those of gingivitis. Additionally, you may observe:

Gum recession, where the gums pull away from the teeth, causing teeth to appear longer and gums to appear irregularly shaped or visibly damaged.
Difficulties chewing, accompanied by pain or irritation.
Visible infection, characterized by pus between teeth and gums.
Gums that bleed easily.

Gum disease does not need to effect all teeth. It is common that some people have only a few teeth with advanced gum disease while the other teeth are in satisfactory condition.

Reasons for Gum Disease

There are many reasons why you may develop gum disease. These include:

genetic disposition for poor gum health
poor diet and lifestyle choices - such as smoking and drinking alcohol, drug use
poor oral hygiene practices
stress and being prone to teeth clenching can add pressure on gums and expedite the onset of gum disease
medical conditions (e.g. diabetes) and certain medications
hormonal changes - e.g. pregnancy
dental devices that are ill-fitting, difficult to clean and maintain and which compromise oral hygiene.

Reducing plaque and tartar

Prevention

The good news is that preventing gum disease and even reversing early gum disease is achievable. The key lies in maintaining a robust oral hygiene program, which involves:

Brushing your teeth with fluoride toothpaste—brush twice daily and floss at least once a day. This practice enhances the removal of food particles and bacteria, increasing your chances of eliminating plaque.
Regularly seeing your dentist for a 6-12 monthly checkup and scale and cleaning. Routine dental visits can pinpoint early stages of gum disease, allowing for timely intervention.
Making sound lifestyle choices, such as maintaining a balanced diet and reducing the intake of sugary and starch-based foods and drinks.

If you fall into a higher risk category—such as experiencing dry mouth, taking specific medications, having compromised oral health, or suffering from certain illnesses—you may need to schedule more frequent visits with your dentist.

Gum disease may progress without pain and with only a few symptoms. But you may have some warning signs that there is a problem.

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