Doris Obinna
As people chew food and meat, some of them get trapped in the space between the teeth and gum. Without regular brushing and flossing to remove the trapped items, bacteria build up as plaque on the surface of the teeth.
When plaque advances, it hardens and becomes tartar. The gums may get infected when the plaque extends below the gum line. Once this happens, the gums become red, swollen and can bleed easily.
Red, swollen and bleeding gum is a sign of gum disease. If you notice bleeding while brushing or flossing or when eating certain food, you should schedule a meeting with your dental professional for evaluation.
Studies have shown that in addition to tooth loss, gum disease may contribute to the progression of other diseases, including heart disease and diabetes. It is, therefore, important that you begin treating periodontal disease as soon as possible.
Gum disease can be gingivitis, a common and mild form or periodontal disease that causes irritation, redness and swelling (inflammation) of your gum. Because gingivitis can be mild, you may not be aware that you have the condition. But it’s important to take gingivitis seriously and treat it promptly.
Gingivitis can cause much more serious gum disease, including periodontitis and eventual tooth loss.
Periodontal is an inflammatory disease that affects the tissues that surround and support the teeth. It is a major cause of tooth loss in adults. The disease is usually painless, yet, if left untreated could lead to major tissue damage or even tooth and bone loss.
According to experts, periodontal diseases could be mild, such as in gingivitis, an inflammation of the gum caused by bacterial infection. This leads to plaque and tartar buildup to more advanced and chronic forms, resulting in major damage to the soft tissue and even tooth loss.
“Chronic periodontitis, the most advanced form of the disease, progresses relatively slowly in most people and is typically more evident in adulthood. Early detection is key to controlling and treating periodontal disease before it becomes worse,” a dentist told Daily Sun.
Explaining this, a dentist, Dr. Olatunji Ambali, said “most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.”
He said people usually don’t show signs of gum diseases “until they are in their 30s or 40s,” adding: “Men are more likely to have gum diseases than women. Although, teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease.”
Also, Dr. Wayne Aldredge, President of the American Academy of Periodontology (AAP), said, “gum disease is typically caused when prolonged exposure to bacteria in dental plaque causes an inflammatory reaction. Flossing is an effective and useful way to remove the plaque, especially in between the teeth or under the gum line-places where a toothbrush cannot reach.”
According to him, if gingivitis is left untreated, it could “progress into more severe periodontal disease, a leading cause of tooth loss that may also increase the risk of developing other systemic disease, such as heart disease and diabetes.”
The Centers for Disease Control and Prevention (CDC) said nearly 50 per cent of American adults, age 30 and older, have some form of periodontal disease.
He said: “If you have bleeding gums, loose teeth, or bad breath, you may have gum disease. However, some people are more susceptible to periodontal disease than others, like those who smoke, people with diabetes or those with a family history of gum disease.
“Therefore, it’s essential that in addition to diligent oral hygiene, which includes flossing, patients should receive an annual comprehensive periodontal evaluation each year. Those diagnosed with or at risk for periodontal disease should seek the care of a periodontist, a dental expert specially trained to treat the gums.”
However, experts say flossing is an integral part of a comprehensive oral health routine. Periodontists agree that keeping the spaces between your teeth clean is paramount in ensuring healthy teeth and gums.
Earlier this year, the U.S. Departments of Agriculture and Health and Human Services removed flossing from the federal 2015-2020 Dietary Guidelines, citing the gap in quality research, experts continues to recommend daily flossing as part of a complete oral health regime. Along with brushing twice a day and receiving an annual comprehensive periodontal evaluation, flossing is crucial to preventing teeth disease.
Prevalence and causes
According to Nigeria Journal of Basic and Clinical Sciences, the prevalence of gingivitis and periodontitis was 75.4 per cent and 15.4 per cent respectively. The prevalence of periodontitis was higher among older participants, those of lower educational attainment and longer driving experience, and those that indulged in only once-daily teeth cleaning, tobacco users, and regular alcohol and kolanut consumers.
The most common cause of gingivitis, according to experts, is poor oral hygiene. This encourages the formation of plaque, an invisible, sticky film composed mainly of bacteria.
Plaque forms on the teeth when starches and sugars in food interact with bacteria normally found in the mouth.
Aldredge said: “Brushing your teeth at least twice a day and flossing each day removes plaque. Plaque requires daily removal because it re-forms quickly, usually within 24 hours.
“Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar can also develop resulting from the mineral content in your saliva. Tartar makes plaque more difficult to remove and creates a protective shield for bacteria. You usually can’t get rid of tartar by brushing and flossing; you need a professional dental cleaning to remove it.
“The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth. In time, your gum becomes swollen and bleed easily. Tooth decay (dental caries) also may result.”
Signs and symptoms
Healthy gum is firm and pale pink. If your gums are puffy, dusky red and bleed easily, you may have gingivitis. Because gingivitis is seldom painful, you can have it without even knowing. However, the followings are connected: soft, puffy gums, receding gums, occasionally, tender gums.
Aldredge said the problem of gums can be very irritating and can be shown in the form of: bleeding gums, piorea (pus and liquid white liquid secretions out of the infected area), gingivitis, but paradontist that is inflammatory disease that affects the periodontium, which is the tissue that surround and support the tooth.
“Pediodontitis involves progressive alveolus bone loss around the teeth and if untreated can cause tooth decay and followed by tooth loss,” he said.
Other signs that you may have gum disease include:
Swollen, sore or bleeding gums: Gums that are bleeding or aching may be the result of gum disease. Healthy gums generally won’t bleed when you brush and floss. Without regular brushing and flossing, the dental plaque created from bacteria will continue to build up and eventually begin to irritate the gums, making them red, swollen or sensitive, and susceptible to bleeding.
Smoking restricts the normal blood flow to the gum, masking the early warning signs of gum disease.
Dr. Aniruddh Narvekar, Clinical Assistant Professor and Diplomat of the American Board of Periodontology and Dental Implant Surgery in UIC Department of Periodontics said, “bleeding gums, while brushing and flossing, are a common sign of gum disease. However, smoking restricts the blood flow to the gums and smokers may not experience this early warning sign.”
Gum recession: Have you heard the term, ‘long in the tooth?’ This phrase originated with horses, whose teeth continue to grow and be worn down as they age.
For humans, the teeth won’t continue to grow or begin to look longer as they grow older. However, with advancing gum disease, the teeth can appear to be longer because the gums that surround them are receding. Gum recession is the loss of gum tissue from around the tooth, exposing the root. Receding gums become a health concern when the roots of the teeth become exposed, leaving the teeth at risk of decay, infection and loss. The exposure of root surfaces and receding gum line causes not only aesthetic concerns, but also potentially serious tooth sensitivity issues.
Sometimes, gum recession is related to the way you brush your teeth. “We are starting to see more patients brushing too hard or using hard-bristle toothbrushes that cause gum recession,” says Dr. Kevin Wanxin Luan, Clinical Assistant Professor and Board Certified Periodontist and Dental Implant Surgeon in UIC Department of Periodontics.
“We advise our patients to use either a soft bristle toothbrush or an electric powered toothbrush with pressure sensors and then demonstrate proper and effective brushing techniques to minimise the harmful effects of gum recession and its related symptoms,” Luan said.
Tooth sensitivity: Do you experience uncomfortable sensations in your teeth when you consume hot or cold drinks, crunch on ice, or expose them to the cold air? Dentinal hypersensitivity, commonly referred to as tooth sensitivity, can be caused by exposed teeth roots and thin tooth enamel (the hard covering that protects teeth). And in some cases, gum recession or pocketing can lead to unusually sensitive teeth. The gums cover the tooth roots, which have no enamel to protect them. When those roots are exposed it can be quite uncomfortable and even painful because the dentine has tiny tunnels that transmit the information directly to the nerves inside your teeth.
“If the sensitivity becomes progressively worse, consult your dentist; it may be due to gum disease,” Luan advised.
Persistent bad breath: All of us have had bad breath at one time or another and it is usually easy to get rid with breath mints, mouth wash or brushing. However, having bad breath all the time may be a sign of poor oral health due to excessive bacteria, tooth decay or even gum disease.
Persistent bad breath is usually caused by the smelly gases released by the bacteria that coat your teeth, gums and tongue. As with the other warning signs, a dental consultation and treatment can help with persistently smelly breath and its causes.
Test and diagnosis
Dentists usually diagnose gingivitis based on symptoms and an examination of your teeth, gums, mouth and tongue. Your dentist will look for plaque and tartar buildup on your teeth and check your gums for redness, puffiness and easy bleeding.
If it’s not clear what has caused your gingivitis, your dentist may recommend that you get a medical evaluation to check for underlying health conditions.
“Prompt treatment usually reverses symptoms of gingivitis and prevents its progression to more serious gum disease and tooth loss. Effective treatment requires professional care followed by stepped up oral hygiene at home,” according to experts.
Professional gingivitis care includes:
• An initial evaluation and thorough dental cleaning to remove all traces of plaque and tartar.
• Instruction on effective home brushing and flossing techniques
• Regular professional checkups and cleaning.
• Possibly fixing crowns or fillings (dental restorations) that make good hygiene difficult.
An expert advised: “Your initial professional cleaning will include use of dental instruments to remove all traces of plaque and tartar, a procedure known as scaling. Scaling may be uncomfortable, especially if your gums are already sensitive or you have extensive plaque and tartar buildup.
“Misaligned teeth or poorly fitting crowns, bridges or other dental restorations may irritate your gums and make it harder to remove plaque during daily home care. If problems with your teeth or dental restorations contribute to your gingivitis, your dentist may recommend fixing these problems.
“Gingivitis usually clears up after a thorough professional cleaning as long as you continue good oral hygiene at home. Your dentist will help you plan an effective at-home programme.”
Prevention and home remedies
The best way to prevent gingivitis is to have a programme of good dental hygiene, one that you begin early and practice consistently throughout life. Good oral health habits, such as brushing at least twice a day, getting regular dental checkups, can help prevent gingivitis.
Again, routine oral care, which includes brushing after every meal and before bedtime, and flossing at least once a day, is the best way to prevent gum disease. However, a recent survey estimates that only 13.5 per cent of Americans and about 10 per cent of Nigerians floss each day. It is vital that you keep up with your daily oral care, and see a dental professional for a thorough check-up twice a year. If gum disease is diagnosed, a consultation with a periodontist may be beneficial.
Complications
Untreated gingivitis can progress to gum disease that spreads to underlying tissue and bone (periodontitis), a much more serious condition that can lead to tooth loss.
Periodontitis and poor oral health in general may also affect your overall health. It’s not completely understood and researchers haven’t established whether periodontal disease actually causes any of these conditions but having periodontitis may be associated with heart attack, stroke, lung disease and premature birth or having a baby with low birth weight, in women.
Most dentists recommend regular checkups to identify gingivitis, cavities (caries) and other dental conditions before they cause troubling symptoms and lead to more serious problems. If you notice any signs and symptoms of gingivitis, schedule an appointment with your dentist. The sooner you seek care, the better your chances of reversing damage from gingivitis and preventing its progression to periodontitis.