What Is Gum Diseases?
Periodontitis and gingivitis are the two different forms of gum disease, on the same spectrum. Gum disease is a very common disorder of our gingiva (“gums”).
Gingivitis is inflammation of gums, without any destruction of oral structures. Gingivitis occurs due to plaque build-up on the teeth. Plaque is also referred to as bacterial biofilms. The human mouth is filled with numerous amounts of different bacteria. Gum infections occur when there are excess bacteria in the mouth. These bacteria form layers called “films” that cover teeth and gums. The films elicit an inflammatory response by the body’s immune system, to try and restore normal bacterial balance. If gingivitis is not properly treated, it will progress to periodontitis.
Periodontitis is inflammation of the structures surrounding the teeth. Periodontitis is progressive if not treated, and can lead to degeneration of structures such as connective tissues (ligaments) and bone around the teeth.
In periodontitis, gums pull away from teeth, and the resulting space is then filled with bacteria. The immune system overreacts to heal the infection, and this causes damaged to the gums and tissues. Periodontitis may cause destruction and loss of bone that keeps teeth in place. There are different forms of periodontitis e.g. chronic, aggressive and necrotizing.
Studies show that oral health has a direct effect on systemic health, and may specifically affect the gastrointestinal system. Periodontitis increases the body's inflammation and can lead to atherosclerosis, as well as increased risk factors for myocardial infarctions or stroke.
Because of gum disease’s direct link to poor oral hygiene, it is more prevalent in lower socio-economic groups. Gum disease is the second commonest dental complaint worldwide and is seen more often in Asia, Mediterranean regions, and Africa.
Gum disease is diagnosed on clinical examination. In severe cases, X-rays may be done to assess how extensive the bone and tissue loss is.
What Are The Symptoms Of Gum Diseases?
- Sensitivity when eating hot or cold foods
- Bleeding gums when brushing or flossing
- Halitosis (bad breath)
- Tartar build-up on teeth
- Gums that pull away from teeth, making teeth more visible
- Gingiva may be red, swollen or inflamed
- Teeth that are loose in their sockets
What Are The Causes Of Gum Diseases?
- Poor oral hygiene is the biggest contributor to developing gingivitis.
- Hormones may play a role in women, especially in pregnancy and during puberty
- Heart disease or lung disease may present with periodontitis in childhood
- Conditions with lowered immunity such as diabetes may predispose to gum disease developing
- Poor nutrition can lead to gum disease
- Connective tissue disorders such as SLE or Ehler’s Danlos Syndrome may contribute to gum disease (especially periodontitis)
- Genetic conditions such as Down’s syndrome
What Are The Things One Should Do To Manage Gum Diseases?
- Practice good oral hygiene. Brushing twice a day with a fluoride- supplemented toothpaste
- Daily flossing is essential to remove excess plaque between the teeth, where brushing doesn't reach
- Regular 6monthly dental check-ups and professional cleaning to remove tartar
What Are The Things One Should Avoid To Manage Gum Diseases?
- Do not smoke. Second, to poor oral hygiene, smoking is the biggest contributor to gum disease.
- Do not leave any suspected gum disease unattended, periodontitis can have bad consequences, especially if the disease starts to spread into the mandible or maxilla.
What Are The Best Foods For Gum Diseases?
- Tea that has an anti-inflammatory effect such as rooibos or green tea.
- Foods high in fibre, such as vegetables and fruit have a natural brushing effect during chewing. The fibre may also help to stimulate blood flow to the gums. Furthermore, nutrients found in fresh fruits and vegetables, contribute to lowering inflammation and help to fight infection.
- Vitamin C. Scurvy is an oral disease caused by lack of fresh fruits and vegetables, specifically related to vitamin C. Although scurvy is not commonly seen anymore, vitamin C is still important in maintaining gum health. Foods rich in vitamin C include papayas, strawberries, oranges and bell peppers.
- Dairy products such as yoghurt and cheese may prevent tartar buildup by reducing the acidity in the mouth.
What Are The Worst Foods For Gum Diseases?
- Sugar and artificial sweeteners. Sugar is acidic, and also creates an environment for bacteria to thrive in.
- Unrefined carbohydrates like white bread and pastries.
- Foods that have a low pH (acidic foods). A low pH creates a favourable environment for bacteria. Coffee, alcohol and pickled foods are high in acid.
- Cold foods such as iced drinks or ice cubes, may worsen the pain and sensitivity related to gum disease. Receding and inflamed gums lead to exposed nerve endings, which can elicit a pain response to cold substances.
What Are The Medicines For Gum Diseases?
Gum diseases are due to infection and inflammation of the gingiva. The bottom line of treatment is to stop bacterial growth and to restore normal gum tissues.
In gingivitis and periodontitis restoration of healthy oral hygiene is the most important factor in management. Without it, the gums and surrounding structures will never heal.
For gingivitis, oral hygiene measures include the use of an antibiotic mouthwash.
Deep cleaning of teeth by a dentist or oral hygienist will be needed in periodontitis. Scaling and planning help to remove build of tartar and bacterial biofilms. Antibiotics such as doxycycline or azithromycin may be used to control the initial infection.
Severe periodontists may need extensive surgery to repair and prevent further damage to bones and connective tissue. Flap debridements, bone grafting, and tissue regeneration are part of surgical procedures performed.
What Are The Tips To Manage Gum Diseases?
Prevention is better than cure. Daily maintenance of good oral health will reduce the chances of gum disease by 80%.