Gum disease (also known as periodontal disease) affects the supporting structures which hold our teeth in place. It is caused by the body’s reaction to plaque – the film of bacteria that forms on our teeth every day. Plaque can harden to form tartar over time. If this plaque is not thoroughly removed from the gumline everyday with a toothbrush and interdental brushes, inflammation can occur. 

The first stage of inflammation is called gingivitis. It is very common and is reversible if treated early. However if gingivitis is left neglected, it can develop into periodontitis which causes irreversible damage to the tissues that support the teeth.

Gradually this inflammation causes the gums to come away from the teeth. A channel (called a pocket) can form between the teeth and gums which traps further plaque and bacteria below the gumline. Over time, this causes damage to the bone that supports your teeth.

Periodontal disease can happen slowly over time or in certain individuals it can happen very quickly. If enough of the supporting structures are lost your teeth will become loose and eventually will need to be removed. They can also become infected and painful or even fall out.

There is often a family history of gum disease. However, smoking, poor oral hygiene, stress and uncontrolled diabetes can make gum disease worse and potentially exacerbate the damage to the tooth supporting tissues.

Gum disease is caused by plaque bacteria on the teeth. If you keep your teeth and gums clear of plaque then you should not be affected by gum disease. Therefore it is essential to brush your teeth two times daily for two minutes followed by cleaning in between your teeth with floss or inter-dental cleaning brushes or aids. Brushing your teeth with a manual or electric toothbrush only cleans 60% of the tooth surface area. Gum disease generally starts in between teeth where cleaning has not been adequate.

You should also see your dentist every 6 months for an examination. The dentist will assess your gums and if there is plaque or calculus detected, a scale and polish may be recommended. Patients who exhibit signs of gum disease or build up on their teeth will be encouraged for a deep cleaning. Some patients may only see the hygienist or dentist every six months for a scale whilst others may benefit from attending every three months.

Stopping smoking is essential for the successful treatment of gum disease.

Gum disease is often painless and symptoms vary vastly from person to person. Symptoms often do not become apparent until the disease has progressed to an extensive state. This is why it is so important to see a dentist regularly so that we can spot the first signs of gum disease and prevent damage from the onset.

Signs of gum disease can include:

• bleeding from the gums when brushing or even spontaneous bleeding
• red swollen gums
• bad breath (halitosis)
• loose teeth (mobility)
• receding gums
• painful recurrent gum infections
• bad taste
• drifting of teeth causing gap openings between teeth

Your dentist will initially carry out a few tests to determine the severity of the gum disease. This will include dental x-rays to assess the level of bone loss. Your medical history may be reviewed to detect for any risk factors.

The most important aspect of treating gum disease is achieving a good cleaning regimen. You have the best chance for successful treatment when you adopt a daily routine of good oral care, manage health conditions that may impact dental health and stop tobacco use.

The goal of periodontal treatment is to thoroughly clean the pockets around teeth and prevent damage to surrounding bone. Scaling removes tartar and bacteria from your tooth surfaces and beneath your gums. Tartar is a rough surface that allows the bacteria to hold on tightly. Tartar above the gumline can be removed during a Scale & Polish appointment. However, depending on the extent, tartar forming beneath your gums on the root surfaces of the teeth may require local anaesthetic to be removed thoroughly and painlessly. This is classed as a deep cleaning procedure (Root Surface Debridement). This treatment, alongside regular maintenance appointments, is usually sufficient to manage gum disease. Occasionally a referral to a periodontal specialist may be advised which may involve a surgical procedure.

People who smoke are more susceptible to gum disease and often do not respond as well to treatment as non-smokers do. Also poorly controlled diabetes is a risk factor for gum disease. Our aim is to give you advice that will help you modify any factors that are contributing to your gum disease. Occasionally we may ask you to liaise with your GP.