Main symptoms and treatments of gum disease

Research shows that there are close to 700 species of bacteria naturally present in the mouth. These together with the teeth, gums and alveolar bone, form an ecosystem.  Under normal conditions these bacteria are generally harmless, however should the balance of the ecosystem be upset this will potentially give rise to the accumulation of bacteria in the form of biofilm or dental plaque.

Some of the main causes of this imbalance are poor oral hygiene, dietary, drugs and hormonal changes.

What is Gum Disease?

If biofilm or plaque is not removed it can reach levels that are detrimental to gingival health, resulting in gum disease. The first stage of gum disease is gingivitis, an inflammatory process confined to the soft gums tissue and because the teeth supporting tissues are not affected the process is reversible. Should this gingival infection go untreated it will lead to degeneration of the periodontal tissue, the tissues that form the tooth support and the underlying bone. This is known as Periodontitis and if this were to go untreated the damage may well be irreversible.

What are the symptoms of Gingivitis?

• Redness, inflammation and bleeding of the gums
• Changes in the consistency, texture and shape of the gum
• Bad breath

In addition to the above individuals would experience:

• Gum tissue recession
• Loosening of the teeth
• Formation of periodontal pockets
• Moderate to advanced loss of alveolar bone
• Tooth loss

What are the risk factors associated with Gum Disease?

Treatments for Gum Disease
The purpose of treatment is to stem the disease process by controlling the level and distribution of bacterial plaque and return the ecosystem to a balanced, healthy state. The main components of a treatment plan are:

• awareness as to the seriousness of the problem, impact on oral and general health
• instruction & motivation in good oral hygiene
• mechanical removal of all plaque, referred to as ‘scaling and root plaining’
• chemical treatment with the use of antiseptics and/or antibiotics

Restoring the function, appearance and the health of the mouth requires controlling the oral biofilm or bacterial plaque. Mechanical cleaning alone is generally insufficient and therefore dental professionals commonly recommend the use of an oral antiseptic for 4-6 weeks following treatment.

Chlorhexidine
The most important and widely used antiseptic is Chlorhexidine. It often referred to as the ‘Gold Standard’ due to its powerful and broad spectrum of antiseptic activity, controlled release (it is released gradually over 8-12 hrs) and the fact that there is no development of resistance. Chlorhexidine is most commonly prescribed in the form of a mouth rinse or gel for use twice daily.

Some important notes for user of chlorhexidine based products.....

Sodium lauryl sulphate (SLS) which is present in most toothpastes is known to partially inhibit the effectiveness of chlorhexidine and therefore it is recommended to either brush 30 minutes before rinsing or to use an SLS free toothpaste.

The most common side effect of chlorhexidine is a brown staining of the teeth. This discolouration is thought to stem from the interaction between the chorhexidine and tannins present in some foods, notably tea, coffee and red wine. However this staining is only to the surface of the tooth and can be easily removed by a dental professional.

Recommended Daily Oral Care

• Brush your teeth after each meal and before going to bed
• Use a soft toothbrush to eliminate plaque/biofilm without causing damage to the gums
• Use an SLS free toothpaste daily
• Use alcohol-free chlorhexidine mouthwash as directed by your dental professional
• Use interdental brushes and/or floss to thoroughly clean the interproximal spaces
• Use a tongue cleaner to remove plaque and debris from the surface of the tongue