Gum disease or periodontal disease is a common condition where the tissues supporting the teeth like gingiva, cementum, periodontal ligament and the alveolar bones are affected.

Gum disease ranges from simple gum inflammation to severe disease that results in major damage to the soft tissue and bone that support the the teeth; causing you to lose your teeth.

Gum disease (Periodontal disease) is broadly classified into two groups; gingivitis and periodontitis

Gingivitis

Our mouth is full of bacteria; the bacteria along with mucus and other particles forms a sticky plaque (bacterial biofilm) on teeth. The longer that plaque on the teeth, the bacteria causes inflammation of the gums that is called Gingivitis. In gingivitis the gum becomes red, swollen and can easily bleed.

Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing, flossing and regular dental cleaning by dentist or dental hygienist.

Periodontitis

Periodontitis is inflammation around the teeth. When gingivitis not treated it can advance to periodontitis. It is characterized by gingival inflammation accompanied by loss of supportive connective tissues including alveolar bones.

Risk Factors

• Smoking : Smoking is the most significant risk factor of gum disease. Smoking also lowers the chances of successful treatment
• Diabetes: People of diabetes are higher risk of developing gum disease
• Hormonal change (Pregnancy gingivitis): Hormonal shifts during pregnancy causes gingival overgrowth and inflammation. The pregnancy related gingivitis may not be associated with dental plaque and usually doesn’t involve the periodontal space
• Vitamin C deficiency: Gingival disease caused by Vitamin C deficiency is called Scurvy. The gingival component of Scurvy is sometime difficult to distinguish from bacterial gingivitis. However Scurvy is associated with other systemic symptoms like petechial rashes, ecchymosis, coiled hair and hyperkeratosis
• Medications: Certain medications may cause gingival overgrowth which makes it difficult to keep gum and teeth clean. Common drugs are – antiepileptic (phenytoin), antihypertensives (Calcium Channel blockers – amlodipine, diltiazem, verapamil, nifedipine) and anti neoplastic (Cyclosporine)
• Systemic disease: Systemic disease like HIV, Leukemia or some genetic disorder like Down syndrome puts at high risk for developing periodontal disease

Symptoms

• Bad breath that doesn’t go away easily
• Red or swollen gums
• Tender gums which bleed easily even with brushing and flossing
• Painful chewing
• Sensitive and loose teeth
• Receding gums
• Pus may be seen coming from the infected pockets

Diagnosis

You should see your dentist if you have any of the above mentioned symptoms. The doctor will take a detailed history to identify the risk factors or underlying conditions causing the disease. He will examine your mouth to look for any signs of inflammation and also check for the infected pockets. You will also be asked to have an X-ray to see for any bone loss. You will be referred to a periodontist if you have periodontitis.

Treatment

The main goal of treatment is to control infection. Treatment varies depending upon the extent of gum disease.

• You can reverse gingivitis (the simple form of gum disease) if you brush twice daily and floss your teeth as well as have a dentist or dental hygienist clean your teeth regularly.
• Treatment of periodontitis includes debridement, scaling and root planing of subgingival biofilm and calculus by a dental specialist (Periodontist)
• Systemic antibiotics, such as amoxicillin or metronidazole , may be prescribed for severe and generalized cases.
• Rinsing your mouth with an antimicrobial/antiseptic mouthrinse or dentifrice (eg toothpaste, powder or gel) twice daily will also help in plaque control.
• Diabetes control
• Quit smoking
• Vitamin C supplement in a case of scurvy

Prevention

To prevent gum disease, you have to do the following:

• Brush your teeth twice a day (with fluoride containing toothpaste)
• Floss your teeth regularly to remove plaque from between teeth
• Don’t smoke
• If you eat sweets, brush your teeth right after eating. Otherwise, make sure you rinse your mouth with water.
• Visit the dentist regularly for check – up and professional cleaning