Gum Disease and Infection

Table of Contents
Overview
What causes gum disease and infection?
Stages of gum disease
Symptoms of gum disease
How to treat gum infection?
Preventing gum disease
Related Articles

by John Baker

 

Overview

Gum disease or infection is very common among adults and children. Many people experience some form of gum disease. Unfortunately, over 50% of Americans have gingivitis, a form of gum infection. The earliest form of gum disease or periodontal disease is referred to as gingivitis. Gum disease is an inflammation and infection which deteriorates the tissues that support the teeth, including the gums, the periodontal ligaments, and the tooth sockets. Many people have some form or amount of gingivitis (earliest stage of gum disease). It commonly develops during puberty because of the hormonal changes.

Gingivitis is a result untreated built-up plaque deposits on our teeth. Plaque is the major cause for tooth decay and dental cavities. It is the sticky substance made up of bacteria, mucus, and left over food debris which develop on the surface of our teeth. If left untreated plaque can evolve into tartar which gets trapped at the base of the tooth. Tartar must be removed by a dentists. Plaque and tarter work together to irritate and inflame the gums; producing harmful toxins which infect and cause swelling of the gums.

People usually do not show symptoms of gum disease until they are in their 30s or 40s. Men are more likely to have gum disease than women are. Although teenagers rarely develop periodontitis (advanced stage of gum disease), they can often develop gingivitis.

Periodontal disease is a kind of disease that influences one or more of the following periodontal tissues:

  1. alveolar bone
  2. periodontal ligament
  3. cementum
  4. gingiva

While many different diseases affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the vast majority of periodontal diseases and have been divided into two categories; Gingivitis and Periodontitis

Types of Periodontal Disease

Risk Factors of Gum Infection

What causes gum disease and infection?

There are many components which put us at risk of gum disease:

  • Smoking -  Smoking is one of the most significant risk factors associated with the development of gum disease and infection. Smoking also lowers the effectiveness of certain treatments.
  • Infections and Diseases- Diseases like cancer or AIDS and their treatments can negatively affect the health of gums
  • Misaligned teeth -Rough edges of fillings, and ill-fitting mouth appliances like dentures can be difficult to clean and are prime areas for infection.
  • Poor oral or dental hygiene - Poor oral hygiene habits are the most common cause of gum disease and infection development.
  • Pregnancy or Hormonal Changes- The increase in hormones causes the gums to become increasingly sensitive.
  • Diabetes- Because diabetes affects the body's capability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease and cavities.
  • Genetic Susceptibility or Family History - If gum disease is common among your family, you can be more susceptible than others.
  • Medications-  Use of certain medications, including phenytoin, bismuth, and some birth control pills have been associated with gum infection.  There are hundreds of prescription and over the counter medications which reduce the flow of saliva, which has a protective effect on the mouth. Lack of saliva or dry mouth, make it difficult to keep the teeth and gums clean. Without sufficient saliva, the mouth is more vulnerable to infections like  gum disease.

Stages of gum disease

Gingivitis: Early Stages
Gingivitis is the mildest form of periodontal disease and is fairly treatable if caught immediately. It causes the gums to become red, swollen, and bleed easily. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred during the gingivitis stage. There is usually little or no discomfort at this stage during this stage, which can make it more difficult to notice. The most common cause of gingivitis is inadequate or improper oral hygiene.

ANUG (Acute necrotizing ulcerative gingivitis) - A more serious form of gingivitis is referred to as ANUG. A dentist can diagnose ANUG from the patient's signs and symptoms. As ANUG can trigger serious complications, it is important to see the dentist as quickly as possible. 
Untreated ANUG can lead to infection throughout the gums and bones surrounding the teeth. The gums between the teeth can become so damaged that teeth become loose and start falling out. The patient will have frequent episodes of bleeding gums and halitosis . 

Periodontitis

If gingivitis is left untreated it advances to a stage called periodontitis disease. Periodontitis is a much more serious form of gum disease and must be treated by a dentist. Bacteria in plaque cause toxins which  stimulate a chronic inflammatory response and the tissues and bone that support the teeth are broken down and eventually destroyed.

During periodontitis, the toxins produced by the bacteria in plaque as well as the body's good enzymes involved in fighting infections begin to break down the bone and connective tissue that secure the teeth. In turn,  the gums migrate away or recede from the teeth, forming pockets that can become infected. Receding gums can cause many gum related issues as well as an increased tooth sensitivity.

As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in placeand can become loose or have to be extracted. Gum disease is the leading cause of tooth loss in adults

There are many forms of periodontitis. Some of the more common forms include:

  • Chronic periodontitis -  Causes inflammation within the supporting tissues of the teeth, and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation or recession of the gums. It is mostly prevalent in adults, but can occur at any age as well.
  • Aggressive periodontitis - Occurs in patients who are otherwise clinically healthy. Common features include attachment loss , bone destruction and familial aggregation.
  • Periodontitis as a manifestation of systemic diseases - Usually people of a younger age experience this. Systemic conditions such as heart disease, or diabetes are associated with this form of periodontitis.
  • Necrotizing periodontal disease  - Infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most frequently observed in individuals with systemic conditions that effect the immune system.

Gum disease can progress painlessly, making it initially more difficult to discover. Although the symptoms of periodontal disease are often subtle, the condition is associated with several warning signs:

Some of the symptoms include

  • Plaque and tartar may be seen at the base of the teeth
  • Bright red or shiny gums
  • Inflammation of the gums
  • Persistent bad breath or bad taste in the mouth ( Halitosis)
  • Bleeding gums (usually before and after brushing or flossing)
  • Loose or migrating teeth
  • Sensitive or tender gums
  • Formation of deep pockets between the teeth and gums
  • Receding of the gums
  • Painful Chewing or longer appearing teeth
  • Mouth sores
  • Changes in the way teeth fit together while biting
  • Teeth falling out
  • Abscesses
  • Eating problems

Only a dentist or a trained periodontist can identify and determine the progression of gum disease or infection.

Oral Health and Gingivitis

Medication for Gum Infections

How to treat gum disease?

In order to reduce inflammation and potential infection of the gums a dentist will professionally clean your teeth using different tools and instruments to remove deposits located on the teeth.

The type and severity of treatment will vary, depending on the developmental stages of the gum disease. There are several techniques and strategies dentist use in the treatments of gum disease:

Scaling and Root Planing (Deep Cleaning)

  • Scaling and root planing is the process in which the dentist or dental hygienist removes plaque through a deep cleaning. Scaling involves scraping off the tartar from above and below the gum line. Root planing describes the removal of the rough areas of the tooth, that are conducive to germ development and eliminates harmful bacteria. In several cases the removal of plaque and tartar can be done through the use of a laser.

Medications

  • Accompanied with the scaling and root planing process are certain medication which work to relieve inflammation and bacteria in the gums. There are many medications used to this effect. Some of the more common ones are:
  • Prescription antimicrobial mouth rinse - A prescription mouth rinse containing an antimicrobial called chlorhexidine. It is mostly used to control bacteria when treating gingivitis and after gum surgery
  • Antibiotic gel - A gel that contains the antibiotic doxycycline, used to manage bacteria and reduce the size of periodontal pockets. Usually placed in the pockets after scaling and root planing.
  • Enzyme suppressant - A low dose of the medication doxycycline that helps manage destructive enzymes .  Used to prevent  the body’s enzyme response to break down the gum  tissue. Usually used with the scaling and root planing procedure.
  • Oral antibiotics -  Utilized for the short term treatment of an acute or persistent gum infection
  • Antiseptic chip - A tiny piece of gelatin filled with the medicine chlorhexidine, used to control bacteria and reduce the size of periodontal pockets. It is placed in the gum pockets where the medicine is gradually released over time.
  • Antibiotic microspheres -  Small, round particles that contain the antibiotic minocycline, used to manage bacteria and diminish the size of periodontal pockets. Placed into the pockets after scaling and root planing.

Surgical Treatments of Gum Disease

If gum disease persists or left untreated, your dentist or periodontist will suggest surgical options to help remove the infection. There are two types of surgeries recommended depending on the severity of the patient's condition.

  • Flap Surgery- If inflammation and deep pockets persist even after the deep cleanings and medication use. Flap surgery removes the tartar deposits in deep pockets and reduces the size of the pocket making it easier to keep clean. The actual surgery is quite common, in involves lifting back the gums and eliminating the tartar. The gums are then sutured back in place so that the tissue fits comfortably around the tooth again. After surgery the gums will heal and fit more tightly around the tooth
  • Bone or Tissue Grafts - Usually recommended in addition to flap surgery. It is a procedure to help the regeneration of bone or gum tissue which has been eliminated due to periodontitis. Bone grafting involves placing natural or synthetic bone in the area of the bone loss. It promotes the growth of bones in that area. Guided tissue grafting is a technique utilized with the bone grafting process, where a small piece of material is placed in between the bone and gum tissue, in order to prevent the gum tissue from developing into the area where the bone should be.

In certain situation your dentist might recommend a soft tissue graft. In which a synthetic material or tissue is taken from a different area of the mouth to cover exposed tooth roots.

Removing Gum Disease at the Source

Forms of Periodontitis

Preventing gum disease

1. Brushing twice a day with fluoride toothpaste

2. Using a toothbrush with soft polished bristles (less likely to irritate gums)

3. Schedule regular appointments with your dentist

4. Avoid smoking and other harmful substances

5. Flossing regularly

How to Avoid Gum Disease

In most cases,  gum disease can be prevented or reversed through good oral hygiene. Proper plaque control is vital to the health of your gums. It consists of professional cleanings twice a year and daily brushing and flossing. Brushing helps eliminate plaque from the surface of our teeth, while flossing removes the food remnants from in between teeth and the gum line.

1. Maintain a healthy diet

  • Proper nutrition helps your immune system fight off and avoid infection. Eating foods with antioxidant properties can help your body repair damaged tissue.

2. Stop Smoking

  • Tobacco use is a common contributor to the development of periodontitis. Smokers are seven times more likely to have gum disease than nonsmokers, and it can lower the chances of success of some treatments.

3. Teeth Grinding and Clenching

  • Puts excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are broken down. Teeth grinding can also lead to misalignment issues of the teeth and jaw.

4. Fluoride Treatments

  • Fluoride intake is very important in the maintaining of healthy teeth and gums. Fluoride helps strengthen tooth enamel and fight off gum disease. Fluoride treatments for children have dramatically helped to account for the decline in periodontal disease in adults.

 

Related Articles:

What to ask your dentist about gum disease?

If you feel you are experiencing any form of gum disease you should consult your dentist to:

1. Examine your gums to identify any signs of inflammation.
2. Ask about medical history to help discover any underlying conditions that are associated with the spread of gum disease.
3. Use a tiny ruler called a “probe” to measure any gum pockets. In a healthy mouth, the depth of these pockets are usually between 1 and 3 millimeters.
4. Take an x-ray for evidence of any bone loss.
5. Refer you to a periodontist.

How Does A Dentist Confirm Gum Disease?

The best way to discover if you have a form of gum disease is to schedule regular appointments with your dentist. During a dental exam, your dentist will check for:

1. Gum bleeding, inflammation, firmness, and pocket depth

2. Your jawbone, to help detect the deterioration of bone surrounding your teeth

3. Teeth migration, increased sensitivity and proper teeth alignment

 

Gum Disease (Gingivitis)

by John Baker

 

Gingivitis is another way of saying early gum disease. It is the mildest for of periodontal disease and can easily be treated. in most cases gingivitis is treated through proper oral hygiene at home. Unnlike with periodontitis (an advanced stage of gum disease) no other tissue damage occurs during gingivitis. The most common cause of gingiitis is an accumulation of plaque due to neglectful oral hygiene practicies. Gingivitis can cause  the gums to become red, swollen and bleed easily. 

There are several early warning signs of gum Disease.  They are as follows: Chronic bad breath, tender or painful swollen gums and minor bleeding after brushing or flossing. If left untreated, gum disease can cause the gum to separate from the teeth, which can create a pocket in which bacteria can spread.  It is necessary to treat Gingivitis in order to prevent more serious problems from occurring such as abscesses, bone loss or periodontitis.  There are a number of ways to treat Periodontitis.  Root planing involves cleaning and scraping below the gum line to smooth the roots.  This procedure acts to aid in the gums reattachment to the tooth structure.  Pregnancy also can lead to a case of gingivitis due to changes in hormones that leads to an increase in plaque production. 

A more severe for of gingivitis is referred to as ANUG (or acute necrotizing alceratice gingivitis). This form of gum disease must be treated by a dentist. If left untreated ANUG can result in serious infection throughout the gums and the surrounding teeth. The damage to the gums between the teeth can be so severe that teeth loosen and being falling out

 

 

 

How to Avoid Gum Infection

By

 

Gum infections can lead to major issues if not treated correctly. Unfortunately, gum infections are sometimes difficult to detect. If not cared for in the correct manner, your gums can become infected.

How does infection occur? Is brushing teeth enough to hinder infection or disease in the gums? Infection occurs when germs or bacteria are left in the mouth. These bacteria grow through the duration of time, and can result in disease in the gums. Bacteria can grow in the space between your gums and teeth, better known as the sulcus, and can multiply at a rapid rate. If the bacteria is not dealt with, infections in the mouth can occur and grow.

Unfortunately, over 50% of Americans have gingivitis, a form of gum infection. About 15% of American’s have a more serious form of gum disease, called periodontitis. Periodontitis impacts the sulcus, and weakens that attachment of your teeth and gums.

How does one prevent either infection? By visiting the dentist for a check up on a regular basis. We recommend a visit to the dentist once every six months in order to avoid disease, and treat oral complications head on. Signs of gum infection include swollen, tender, and bleeding gums. Some people endure pus coming from their gums, and some even experience bad breath.

Below are some effective methods to treat gum disease:

Root Planning: This is a deep cleaning treatment that thoroughly cleans gums and teeth.

Antibiotics: Antibiotics exist that effectively rid you of gum infection. Some come in injection form, and others in pills.

Surgery: If none of the above methods work effectively, your dentist may recommend that you endure surgery.

The best way to avoid gum infection is to take steps to prevent it from occurring. Be sure to brush, floss, and use mouthwash on a daily basis. Be sure that food particles, that ultimately grow to become bacteria, are not left in your mouth.

We recommend taking fluoride tablets to strengthen teeth, and use toothpaste that is approved by the dental association. It is also imperative to switch your toothbrush, and make sure you dry it prior to putting it away. Once oral hygiene becomes a habit, oral complications like gum disease are not even an issue. 

 

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