What Is Gum Disease ?
Periodontal (gum) disease is a chronic infection of the supporting bone and tissues that hold your teeth in place. This disease can occur at any age. It affects one tooth or several teeth. The three stages of periodontal disease – from mild to severe – are gingivitis, periodontitis and advanced periodontitis. If left untreated, gum disease can lead to sore, bleeding gums, and even permanent tooth loss.

What Causes Gum Disease ?
Our mouths are filled with bacteria. These bacteria and other particles constantly form – a sticky, colourless “plaque” on the teeth. Practising good oral hygiene daily such as thorough brushing and regular flossing can help get rid of plaque. Any plaque that has not been removed can build up and harden to become tartar. Simple scaling and polishing performed by a dentist can remove stubborn tartar.

Several factors can increase the risk of periodontal disease:
  • Smoking
  • Diabetes
  • Certain medications such as steroids, anti-epilepsy drugs, cancer therapy drugs, calcium channel blockers
  • Poor oral hygiene
  • Bridges that no longer fit properly and defective fillings
  • genetic susceptibility

What Are the Symptoms of Gum Disease ?
Common signs and symptoms of gum disease include:
  • Bleeding gums when brushing and flossing of teeth
  • Red, swollen or tender gums
  • Pus discharge or swelling of gums
  • Gum recession
  • Persistent bad breath
  • Loose or shaky permanent teeth
  • Discomfort or a dull ache in gums and teeth causing painful chewing

It is also possible to have gum disease without any noticeable signs and symptoms.

How Is Gum Disease Diagnosed ?
During a dental visit, the dentist or dental hygienist will:
  • Examine your gums for any signs of inflammation.
  • Use a specialised ruler called a “probe” to check for any pockets around the teeth. Don’t worry, this test is painless!
  • Ask about your medical history or any underlying symptoms to identify conditions or risk factors that may contribute to gum disease.
  • Take an X-Ray to check for any bone loss, if necessary.
  • Refer you to a periodontist, a specialist in gum disease, if required, to provide you with treatment options that a general dentist does not offer.

How Is Gum Disease Treated ?
The number and types of treatment will vary, depending on the extent of the periodontal disease. It is also essential to maintain good oral hygiene. Dentists will strongly advise changing certain unhealthy habits such as quitting smoking to improve the treatment outcome.
Non-surgical periodontal treatment
At its earliest stages, you can reverse the early signs of gum disease quickly. The dentist will perform scaling and polishing to remove plaque and tartar from above and below the gum line and root surfaces. Special instruments such as ultrasonic scalers, hand scalers and other tools are used for root planing to remove tough tartar and bacterial deposits on the roots of the teeth, usually under local anaesthesia. Replacement of defective fillings or dental bridges is necessary to reduce the collection of plaque on the teeth. The dentist will suggest personalised oral hygiene instructions to achieve optimal dental health.
Surgical Periodontal Treatment (Gum Surgery)
Open Flap Debridement (OFD)
If the gum inflammation persists, the pockets between the teeth and gums might become deeper. Tartar starts growing in these gum pockets, which can be difficult to reach. The periodontist may recommend flap surgery, also known as the Open Flap Debridement (OFD). Flap surgery is a periodontal procedure that reduces gum pockets and treats periodontitis. During the surgery, the gums are raised and moved aside from the teeth under local anaesthesia. The periodontist will thoroughly clean the roots and remove the stubborn tartar in the gum pockets. The pockets are then closed with stitches, so the gum tissue once again fits around the teeth. The healing process begins.
Bone Grafting
Tissue Grafting

How Can I Prevent Gum Disease ?
Effective removal of plaque can help prevent gum disease. These are some preventive steps:
  • Brush your teeth at least twice a day with a soft toothbrush and fluoride toothpaste. Don’t forget to brush your tongue!
  • Replace your toothbrush once every three months because germs accumulate and bristles lose efficiency.
  • Regular flossing cleans out food particles and plaque between your teeth, where a toothbrush can’t easily reach.
  • Visit your dentist at least twice a year for routine check-ups and professional cleaning.
  • Do not smoke.
  • Eat nutritious meals.
Remember, a beautiful smile starts with healthy gums!

Periodontal (gum) disease and systemic diseases
Research and studies are on-going to establish the link between oral infections and inflammation seen in gum disease and overall health.
Uncontrolled high blood glucose (blood sugar) levels increase your risk of developing gum disease.
The saliva in your mouth protects against dryness and bacteria build-up. For a diabetic patient, the saliva production is reduced, thus less protection. Diabetes can also increase the amount of glucose in your saliva, leading to more bacterial growth and plaque build-up. If not properly managed, these issues can eventually lead to gum disease. In conclusion, diabetes care and dental care go hand in hand.

Even if you do not have diabetes, studies have shown inflammation caused by gum disease increases your risk for diabetes.
Heart disease
Heart disease refers to a broad set of conditions including heart attack and stroke caused by the narrowing or blockage of important blood vessels. Gum disease may increase the risk of heart disease because inflammation in the gums and bacteria may eventually lead to narrowing of important arteries.
Alzheimer’s disease
New study suggests that periodontal disease caused by Fusobacterium nucleatum and left untreated or poorly treated could exacerbate symptoms of Alzheimer’s disease. Conversely, treating periodontal disease effectively in those who have early-stage Alzheimer’s could potentially slow Alzheimer’s progression.
Pregnancy hormones can cause oral health problems like gum disease. Gums may also be extremely tender, and brushing and flossing may be uncomfortable.

Studies have shown that women with premature births more often have some degree of gum disease compared to their peers with full-term pregnancies.

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