Do you notice some blood in the sink while brushing your teeth? That bleeding may be one of the first indicators of gum disease. The term suggests an inflammation of your gum line, which later spreads to the bone that supports and surrounds your teeth. Gum disease can cause a lot of discomfort but the condition often sneaks up on you without prior notice. This is the reason why gum disease, despite being a commonly occurring health issue, is usually overlooked.
Prevalence of the Problem
A whopping 80 percent of the national population of India, especially children, suffers from oral health problems, including gum diseases. According to experts, poor oral health is a public health concern in the country. The issue is exacerbated by the lack of dentists, and lots of Indians do not submit to regular oral health examinations. So gum diseases go undetected until they progress to advanced stages. Efforts to reduce gum disease and other oral health conditions are required immediately.
Research suggests that children, especially, are at a higher risk of oral health problems throughout India. Eastern India reports the highest prevalence at 89 percent, followed by 88 percent in western India. South and North India record prevalence of 64 and 85 percent respectively. Several cities record high prevalence with Mumbai and Kolkata recording 90 and 93 percent prevalence of oral health problems respectively.
Studies reveal various factors behind this, such as poor oral hygiene trends among young individuals. Over 70 percent of kids fail to brush twice daily and 60 percent have not visited a dental doctor in the past year. Parents also show low awareness when it comes to oral hygiene, which partly explains the higher number of Indian children missing out on regular dental check-ups.
These statistics indicate why gum disease is such a rampant problem in the country and why timely treatment can be an effective deterrent. Failure to spot the condition early can have major consequences, as it is one of the key reasons behind tooth loss in adults. However, a dental doctor can detect the signs quickly and help you combat this insidious intruder.
Types of Gum Disease
A visit to a dental doctor will reveal that you are suffering from one of three stages of gum disease. From least to most severe, these include gingivitis, periodontitis, and advanced periodontitis. If left untreated, these conditions increase your risk of things, such as heart disease, pneumonia, diabetes, osteoporosis, and even, cancer. Early detection is the safest bet.
This is an inflammation of the gums or gingiva that usually develops due to the accumulation of bacteria or plaque on the teeth. This is a mild, non-destructive version of gum disease that progresses below the gum line and into the bone, if left untreated. Then it takes on a more serious form called periodontitis that results in the loss of teeth.
Good oral hygiene is necessary to deal with the problem. But the issue is exacerbated by the fact that most patients do not realize they suffer from gingivitis in the first place. But it is harmful to neglect the condition for too long.
Categories of Gingivitis
Gingival diseases can be primarily divided into two categories:
- Dental plaque-induced gingival disease due to malnutrition, medication, plaque, or systemic factors
- Non-plaque induced gingival lesions from certain virus, fungus, or bacterium, genetic factors, wounds, reactions to foreign bodies (dentures), systemic conditions (certain illnesses and allergic reactions)
Causes of Gingivitis
The prevalent cause of this type of gum disease is the accumulation of bacterial plaque around and between the teeth. The body automatically triggers an immune response, which destroys the gingival or gum tissue. Further complications include the loss of teeth.
Dental plaque protect the mouth from the colonization of hazardous microorganisms, but they also lead to tooth decay and gum infections. Improper removal of plaque results in its hardening into yellow-colored tartar or calculus at the base of the teeth, over the gums. Dental doctors should professionally remove calculus.
Tartar and plaque irritate the gums, leading to gum inflammation near the base of the teeth and increasing the chances of gum bleeding.
- Hormonal Changes: Gingiva become more sensitive during pregnancy, puberty, the menstrual cycle, and menopause, increasing the risk of inflammation.
- Diseases: HIV, cancer, and diabetes are associated with greater gingivitis risk.
- Drugs: Medication affects oral health, especially during reduced saliva flow. Anti-angina medication and anticonvulsants like Dilantin can also lead to abnormal growth of gum tissue.
- Age: The greater the age, the greater the risk of gingivitis.
- Dietary Habits: Gum disease is often associated with the deficiency of vitamin-C.
- Family History: You are likely to develop gingivitis if your parent or parents had it.
- Smoking: Smokers develop gingivitis more commonly than non-smokers.
Symptoms of Gingivitis
The signs of gingivitis are not always evident, especially in mild cases, since there is no noticeable discomfort.
Common signs of the condition include:
- Tender, painful gums
- Purple or bright red gums
- Bad breath or halitosis
- Receding gums
- Swollen or inflamed gums
- Bleeding gums while flossing or brushing
- Soft gums
Dental doctors provide detailed instructions to prevent this type of gum disease. But gingivitis spreads and affects tissues, bones, and teeth without timely treatment, leading to complications such as:
- Recurrent gingivitis
- Trench mouth
- Infection or abscess in the jaw bone or gingiva
2 – Periodontitis
This type of gum disease damages the bone and soft tissue supporting the tooth. Without timely treatment, the alveolar bone surrounding the teeth gets progressively lost, and increases the risk of heart attack, stroke, and other health conditions.
The most common cause is bacterial plaque, a colorless sticky membrane that forms over the surface of the teeth. It hardens over time to become calculus or tartar.
Symptoms of Periodontitis
Periodontitis shows different signs and symptoms, including:
- Frequent swelling or inflammation of gums
- Purple or bright red gums
- Painful gums
- Longer-appearing teeth due to receding gums
- Pus between gums and teeth
- Bad breath or halitosis
- Loose teeth
- Metallic taste in mouth
- Bleeding while flossing or brushing
- Gaps between teeth
Diagnosis of Gum Diseases
Dental doctors look for symptoms like tartar or plaque in the oral cavity. They also search for periodontitis symptoms. This usually involves periodontal probing or X-rays that measure pocket depths around the teeth.
Treatment of Gum Diseases
With prompt and early diagnosis, gum diseases can be reversed or prevented from further destroying tissue and bone. Dental doctors are equipped to treat gum diseases in the following ways:
1 – Treatment of Gingivitis
Dental doctors can remove plaque and tartar through scaling. The procedure may be uncomfortable, especially when the tartar build-up becomes extensive or if your gums are sensitive. If necessary, the oral hygienist will also show how to brush and floss properly and explain the need for oral care.
They may recommend follow-up appointments with regular cleanings. Dental problems like badly fitted bridges or crowns, crooked teeth, make it difficult to properly remove tartar and plaque, resulting in gum irritation. These medical professionals can also fix the damaged teeth.
2 – Treatment of Periodontitis
Treatment involves cleaning out bacteria from tooth pockets and preventing extensive oral damage. Dental doctors suggest brushing regularly with soft brushes and fluoride toothpaste to prevent periodontitis. Even if your gums and teeth are healthy, proper oral hygiene is a must to avoid infection.
Brush your teeth twice in one day and floss once every day. If the gap between your teeth is large, dental doctors may recommend an interdental brush. Smaller teeth gap requires soft-picks. Dental doctors suggest the use of an electric toothbrush to arthritic patients or those with dexterity issues.
After treatment, periodontitis problems may recur without good oral hygiene.
Scaling and Cleaning
Dental doctors perform scaling and debridement for cleaning below the gumline. This is done using hand tools or ultrasonic devices that break up the calculus or plaque. They perform root planing to smoothen the rough areas on teeth roots. Depending on the amount of calculus or plaque present, it could take one or two visits. Dental doctors recommend cleaning twice in one year, and even more often depending on the rate of plaque accumulation.
Dental doctors recommend the use of medicated mouthwashes and other treatments.
- Prescription Antimicrobial Mouth Rinse: Chlorhexidine or similar medical mouth rinse is prescribed by dental doctors for controlling bacteria during the treatment of gum disease. Patients are advised to use it like a regular mouthwash.
- Antiseptic Chip: This small chlorhexidine-filled piece of gelatin is advised by doctors for controlling bacteria and reducing the size of periodontal pockets. Dental doctors place this in pockets after root planing, where the medication gradually gets resealed.
- Antibiotic Microspheres: Dental doctors place these tiny particles containing the antibiotic minocycline in pockets after root planing and scaling to control bacteria and reduce periodontal pocket size.
- Enzyme Suppressant: Dental doctors use this medication to limit destructive enzymes using small doses of doxycycline. Various enzymes break down the gum tissue but this medication delays the body’s enzyme response. Dentists administer the medication orally as a pill and use it for root planing and scaling.
- Oral Antibiotics: Prescribed orally in tablet or capsule form, oral antibiotics are used short-term for the treatment of locally persistent or acute periodontal infection.
3 – Treatment of Advanced Periodontitis
In cases of advanced periodontitis, non-surgical treatments and good oral hygiene are not always effective. Surgical intervention is necessary. Dental doctors perform the following surgical treatments:
- Flap Surgery: Dental doctors perform flap surgery for removing calculus from deep pockets or reducing the pocket size to clean it easily. They lift back the gums and remove the tartar, suturing the gums back in position so they fit closely to the tooth. Post-surgery, the gums heal and fit tightly around the tooth once more. In a few cases, the teeth look longer than before.
- Bone and Tissue Grafts: Dental doctors recommend this procedure for regenerating damaged gum or bone tissue. They replace the lost bone with natural or synthetic bone to promote bone growth. Dentists use special proteins or growth factors to help the bone regrow naturally.
Some dental doctors perform GTR or guided tissue regeneration to direct growth of new gum and bone tissue at sites where one or both are lacking. This regenerates tissue and fixes problems stemming from periodontitis.
Dental doctors may also recommend a soft tissue graft where tissue is taken from other parts of the mouth or synthetic materials are used to cover exposed tooth roots.
Gum disease affects many people at some point in their lives. Good oral hygiene is the best way to prevent the problem in the first place. But in case you’re suffering from bleeding gums, schedule a trip to the dental doctor immediately. Timely treatment is the key to recovery.