Bacteria are all around in nature including more than 700 different bacterial species living in the mouth. This multitude of species live in harmony with one another and keep each other in check so that no one specie may over dominate the other. However, when plaque is not frequently removed by tooth brushing, the oral environment becomes favoured by certain microbes and their toxins lead to gum inflammation and cause periodontal disease. Gingivitis and periodontitis are two types of periodontal diseases that are caused by inflammation from disease-producing bacteria.
Gingivitis is inflammation around the gums that is caused by a build-up of plaque. The gums will appear swollen, red, bleed when you brush or floss, feel tender and you may experience bad breath. If plaque is not effectively removed, it hardens and form tartar or calculus. Calculus, at a microscopic level, has a porous, rough structure that allows continual plaque accumulation and harbour disease-causing bacteria. These deposits are difficult to remove with normal toothbrushing and inflammation will remain unresolved.
Gingivitis not only affect individuals with poor brushing habits but the following conditions a well:
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If you are smoking
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Obesity
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Diabetes
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A weak immune system
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Dry mouth caused by some medications or medical conditions
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Poorly fitting dentures
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Wearing orthodontic retainers
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Hormonal changes during menstruation, pregnancy, or menopause
Luckily there is treatment for gingivitis. Plaque and tartar can be professionally removed to restore the gums to a healthy state. It is important to follow the home care advice from your dental health care professional that will provide instructions and advice about oral health care at home.
When gingivitis is left untreated, the unresolved inflammation may spread from the gums into the bone, surrounding the teeth. This can permanently damage and destroy teeth and bone. Your teeth might appear longer due to the gum tissue receding downwards as the roots become exposed. In severe cases, teeth start to move or tilt as there is no proper bone or ligament to support these teeth. The disease is irreversible, but further progression can be stopped and teeth can be saved if treated early enough.
A dental professional can take the initial steps and bring gingivitis and periodontitis under control. Treatment includes a comprehensive periodontal assessment and a diagnosis before periodontal therapy will start. The amount of visits are determined according to the severity of the disease. During these visits, plaque and tartar will be removed with special periodontal instruments. Some of these areas are too deep and difficult for your toothbrush or floss to remove. Each patient is educated about oral self-care at home according to their individual needs.
After treatment, a follow up appointment is made several weeks later to examine how the gum tissue has healed. Further treatment might be required in areas that do not heal so well. If healing is going well, you will be on a maintenance program and your dentist or oral health therapist will schedule a three or six monthly recall visit. It is important to note that the progression of periodontitis is much faster in smokers. The tissue does not heal that well and progression may continue rapidly. Gum disease might only be noticed or picked up by your dental professional, therefore, it is important to see your dentist or oral health therapist to help diagnose these conditions.
Resources:
American Academy of Periodontology. (n.d.). Types of gum disease. perio.org/consumer/types-gum-disease.html
Gehrig, J. S., Shin, D. E., & Willmann, D. E. (2019). Foundations of periodontics for the dental hygienist (5th ed.). Jones & Bartlett Learning.
Mayo Clinic Staff. (2017). Periodontitis: Overview. mayoclinic.org/diseases-conditions/periodontitis/home/ovc-20315537
Periodontal (gum) disease: Causes, symptoms, and treatments. (2013). nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm