The Signs of Gum Disease - Harrow Dental Practice Blog

Spotting the early warning signs of gum disease is a key factor in ensuring that your dental health space in tiptop condition. Gum disease can progress painlessly on the whole and is often not until the disease has spread to the more advanced stages you will actually notice at home.

Our latest blog post answer some of the most common questions asked about gum disease and looks at how you can prevent it in the 1st place.

What are the causes of gum disease?

Gingivitis or Pyria, commonly known as gum disease is an inflammation of the soft tissue area (gum) which surrounds your teeth.

Throughout the day a thin layer called biofilm forms over your teeth, this is known as plaque. This is a sticky and natural layer made up primarily of bacteria. As these bacteria in plaque feed on the sugar, you ingest they excrete acid and it is this acid which causes tooth decay.

When you clean your teeth you will be removing this biofilm layer but if the film is not removed adequately enough then it can begin to harden, particularly in between teeth where it’s difficult to clean. As it hardens it turns into a thick cream coloured layer called tartar.

This tartar can then irritate the gums whilst also giving the bacteria a really good place to read and hide.

This inflammation of the gums, caused by the buildup of tartar then turns into gum disease.

How to catch gum disease?

Gum disease isn’t something you can catch as it is not an infectious disease. However, there are other diseases which are infectious which can lower your resistance and mean you are more inclined to develop gum disease.

Gum disease is caused by poor oral hygiene, not by catching it from anyone else. There are however certain other risk factors which can increase the likelihood of catching gum disease including various medical conditions and of course, smoking.

It’s also possible to be more susceptible to gum disease if you are wearing orthodontic braces, it is therefore really important that you keep your teeth and orthodontic appliance clean whilst having teeth straightening treatments.

What are the symptoms of gum disease?

Gum disease has a series of symptoms depending on its severity, but classically:

Gums become red, puffy and inflamed. Typically they will look red and swollen.
Bleeding can occur, initially only on vigorous brushing or when using an interdental floss or stick.
Gums can then begin to bleed spontaneously as the gingivitis progresses.

What is periodontal disease?

If gum disease is left untreated it can then turn into the more serious periodontal disease. This is where the layer surrounding the root of your tooth becomes inflamed and infected. Gingivitis is an inflammation of the gum, the part of the mouth you can see, periodontitis is an inflammation underneath the gum around the bone, the part of the mouth you can’t see.

Periodontal disease, because it affects the support around the tooth and root if left unchecked can ultimately lead to tooth loss, so it should be treated as a serious condition.

What are the symptoms of periodontal disease?

If you have periodontal disease then you will almost certainly have all of the signs and symptoms of gum disease, in addition, you may also have:

Gums which are pulling away from your teeth making your teeth look longer.
Loose or wobbly teeth.
Puss coming up between your gums and teeth.
Continuous bad breath.
Pain in your teeth caused by the pressure of the infection.

What is black gum disease?

It’s important to bear in mind that gum colour varies enormously between individuals, gums can appear anything from dark black to light pink and both are perfectly normal.

Un-natural back gums can be caused by:

Smoking. Smokers black gums are known as melanosis, this is because there are cells in your gums called melanocytes, nicotine can stimulate these cells to produce more melanin than normal and this gives the dark black appearance on the gums.
Some medications. Some treatments for chlamydia or acne can result in a side-effect of discolouration of the gums. There are often alternatives so speak to your medical practitioner if you feel this is the cause.
Old silver fillings. Amalgam (Silver) fillings are extremely dark by nature, looking very black and grey. As you age you may find that the outside of your teeth where you have a filling wears down and becomes thinner, as this happens the amalgam filling can show through. If the amalgam is closed your gum it can give a grey/black appearance to the gum.
SEVERE gum disease. In some instances of severe gum disease the soft tissue can actually die. This necrosis, sometimes called trench mouth then gives the black appearance. It is often accompanied by extreme bad breath, mouth ulcers, and bleeding gums.
Hyperpigmentation caused by Addison’s disease. This is a condition which affects the adrenal glands, its symptoms include tiredness, lack of appetite, weak muscles and thirst. The condition has a side-effect that hyperpigmentation occurs in parts of the body and the gums can appear darkened or black.

How can gingivitis be reversed?

very early onset gingivitis can easily be reversed at home by maintaining a good oral health plan and ensuring you brush your teeth twice a day for 2 min using the fluoride-containing toothpaste. However, if you have noticeable symptoms of gum disease then it may have already progressed to a more serious stage which requires intervention by your dental hygienist.

A dental hygienist is able to clean underneath the gum line, known as the cleaning or deep scaling. This can remove any detritus or plaque which has formed underneath the gum and caused the gum disease.

Your hygienist may recommend an intense course of professional cleaning in order to thoroughly clean the teeth, they will then give you advice on how you can do this at home yourself to prevent the condition coming back and the plaque building up again.

How can periodontitis be reversed?

Because periodontitis is an infection deeper underneath the gum it requires a higher level of skill to treat.

Non-surgical intervention.

There are a range of nonsurgical techniques including scaling, root planing, and antibiotics. scaling can be done using instruments or with a laser or ultrasonic device. The root planing removes the bacteria around the route and encourages the soft tissue to reattach itself to the root and tooth. Antibiotics can then treat any infection.

Surgical intervention.

If the periodontitis is more severe or nonsurgical interventions have not worked then treatment by a specialist periodontist may be required, typical techniques involve:

Pocket reduction – this is where the soft tissue around the infected area is gently lifted away, the underlying bone and root can then be extensively cleaned. The gum can then be stitched back into place.
Soft tissue grafting – if there has been extensive loss of soft tissue (gums) a craft can be taken, often from the roof of your mouth, and used to replace the soft tissue around your teeth.
Bone grafting – if the periodontitis has infected so much bone the bone has been lost then grafting from either your own bone or synthetic bone can be used to rebuild the area around your teeth.

Summary

Brushing and flossing really is the key to good oral hygiene, protecting your teeth and gums, soft tissues and bone. Regular dental health checks can also ensure that gingivitis isn’t progressing unnoticed.

Author: Dr Saleh Aria

Dr Aria qualified in Stockholm, Sweden and has been practicing in the UK since 1999. He has extensive experience in all aspects of Dentistry and post-graduate education in most areas. He has a very special interest in Dental Implants, Invisalign, Six Month Smiles, Cosmetic Dentistry, Smile Makeovers, complicated restorative cases, management of stress related Dental problems (tooth-wear, headaches) and difficult cosmetic cases. View all posts by Dr Saleh Aria