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A Detailed Look at Gum Disease

A man with gum disease

Are you a person who worries about your teeth and gums a lot?

Well, if you are, then it’s safe to say that gum disease is probably on your mind a fair bit.

A study by the Australian Research Centre for Population Oral Health showed that your age and demographics have a lot to do with the likelihood of you developing gum disease.

Now, we know this sounds like bad news, but as always, the darkness is balanced by the light.

The truth is that gum disease is preventable.

Yes, you heard that right.

But how is that possible I hear you say? Four words… brush and floss regularly!

Okay, there is a little bit more to consider and we’ll cover it all with professional advice and helpful tips below.

What is Gum Disease?

Your gums are a part of the foundation that holds your teeth in your body.

Underneath your gums, you’ve got bone.

Now your teeth, gums and bone are attached to one another via the periodontal ligament. That’s what holds your teeth to your jawbone.

Gingiva is the dental term that dentists call your gums.

If you have plaque in your mouth, it will slowly solidify and harden, causing the plaque to stick to your teeth.

Once this occurs, it is now called calculus (you might know it as tartar).

Calculus around your teeth
When it forms as calculus, it sends toxins through to your gums, and it will start to break down the ligament holding the gum to your tooth.

At this stage, it’s called gingivitis.

If left untreated, this calculus will build up over time causing toxin levels to rise. Once it reaches this stage, your bone that is attached to your tooth is affected.

As it starts to break down your periodontal ligament, where the bone is attached to the tooth, it is called gum disease, or in scientific terms Periodontitis.

Difference Between Gingivitis and Gum Disease

Gingivitis only affects where the gum is attached to the tooth.

Gum disease or periodontitis (as it’s formally known) is when it affects the bone as well as your gums.

Are there Different Types of Gum Disease?

You’ll find there are different reference points or stages when it comes to gum disease and it really depends on how advanced it is.

If it’s just in your gums and it hasn’t affected the part where your bone is attached, then it’s merely gingivitis.

Stages of gum disease

If that ligament of yours has started to fall apart where the bone’s attached, then you might have a mild case or an initial stage of gum disease.

As it progresses, the gum will start to deteriorate and create what’s called a pocket.

What is a Periodontal Pocket?

A pocket is an area of space that forms between the gum and the tooth.

As time goes by, the pocket will get bigger causing bacteria to multiply much more rapidly in this space.

Illustration showing gum disease pockets

To measure how deeply the infection has set in, your dentist will use a dental probe.

Measuring Pockets

If your pocket is only two millimetres say, it’s not great, but it’s not that bad.

There’s still an attachment of the gum to the tooth. The gum might be red, and it needs a clean, but it’s fixable.

If you’ve got a pocket that is three millimetres, that is where you’ve broken through the biological zone.

At this stage, you’ve already started at the bone level, and it becomes serious.

If my patient has a three-millimetre pocket, I get worried.

Dr V

At 3mm you’re at the initial stages where the calculus has started to invade the ligament that’s holding your bone.

If you are in this situation paying attention to what your dentist is saying is deeply important.

A dentist consulting with her patient

If you leave it and it’s not treated, it will continue to eat away at the ligament.

Anything more than 3 millimetres, you’re into where the bone’s attached.

Maintenance is required more often at this point where you need to allow your dentist to scrape away the calculus on a regular basis.

If you have a pocket that is five millimetres in depth the bacteria actually change.

It becomes nasty, so nasty that it’s the type of bacteria that produces pus and eats the bone away.

Gum Disease and its Magic Number

As soon as you reach a pocket of six millimetres, your dentist will officially classify this as gum disease.

Six millimetres means that your bacteria now have inhabited a very deep pocket where it’s got a lovely abundant blood supply, and it can continue eating your bone.

It is important to note, the bone that you’ve lost will never come back again.

The only thing you can do is maintain your dental hygiene regularly.

A mixture of brushing and flossing your teeth as well as routine visits to your dentist will help.

What Increases the Rate of Bone Loss at this Stage?

Lifestyle factors are significant indicators here. These include:

Everyone knows or should know that smoking is bad for you period.

Smoking in relation to gum disease increases your health risks such as heart disease as well as increasing your risks of losing your teeth early.

Dr V painted this picture – Let’s say you’re a smoker and you’ve got a pocket about five or six millimetres deep, you’ve got two choices, you can either choose your cigarettes, or you can have your teeth, but you can’t have both.

One of the side effects of drinking alcohol is dehydration. This drys out your mouth and increases your risk of tooth decay by lowering your salvia levels which provide the first line of defence in your mouth.

Another thing to remember about alcohol is that a lot of them are mixed with soft drinks. These drinks are high in sugar causing multiple health-related issues that can fast track your path to gum disease.

Another example of lifestyle affecting your gums is a poor diet that’s high in sugar.

Things to stay away from are fast foods and especially soft drinks. It is shocking to see the damage they cause.

If you must have a soft drink, try drinking a glass of water afterwards to rinse away the sugar content.

Mouth breathing might not sound like much, but it’s also a major factor which accelerates bone loss at this stage of gum disease.

Mouth breathing dries up the saliva so that the bacteria can get in there. Saliva has antibodies in it which is your first line of defence from decay and for gum disease.

What Causes Gum Disease?

Before we speak about the causes, gum disease is preventable. That must be known.

Lifestyle and genetic factors are significant contributors to gum disease.

Understanding these factors and what your options are for each can be enough to swing the balance in your favour and prevent gum disease.

3 Causes of Gum Disease

#1 Smoking

Smoking is a major cause of gum disease for many reasons.

As you smoke, it will dry out your mouth and reduce the amount of salvia that fights infection.

A cigarette

It can also impair the blood cells in your mouth, making you have an inadequate blood supply to those gums of yours.

This can create a false sense of security as smoker’s gums don’t necessarily bleed until the disease has progressed.

I haven’t seen many smokers still have their teeth in their 50s or 60s.

Dr V

A Personal Reflection

I had a very wonderful, what can I say? Early life, misspent youth. I started smoking when I was 17 and loved it. But with my cigarette smoking went coffee drinking, went a little bit of alcohol. I wasn’t excessive, but it went with it.

By the age of 34, I had already lost two teeth. And I went through university cigarette smoking. You know, it was such a strong addiction for me, I used to see all the effects of it, and it just didn’t make any difference. I chose cigarettes.

We used to have cadavers at university when we were doing anatomy. The colour of the lungs stood out to me; I saw how black they were. I said to the tutor, “Geez, the lungs are really black, what caused that?” He says, “Oh, lifestyle factors. It’s pollution, you know, city living.”

“But, it’s also cigarette smoking. City living is quite bad, with the pollution and the toxins, yes, but when you add cigarette smoking to city living, these are the effects that you get.”

And I went, “That’s interesting,” and I walked out and lit up a cigarette. But that’s what happens with addiction.

The reason we put this little snapshot of Dr V’s earlier life in this post is that it’s a great lesson that you can become so blissfully unaware of what damage you are causing to yourself.

A lot of the time it just doesn’t hit home. Not until you get a major catastrophe or a life-threatening situation.

We don’t want that to happen to you and hope that with Dr V’s little life lesson you won’t have to experience the trauma of gum disease.

#2  Diet

What you eat is another primary factor in your dental health generally. The types of foods you eat can impact your teeth and gums severely.

We’ve discussed this in most of our posts, and it keeps coming up when we ask Dr V about dental causes relating to problems people face with their teeth and gums.

Sugar filled treats

Sugar is the most significant threat to your mouth.

I hope you read that in slow motion or wrote it down because it is so important to understand.

The diet you choose can actually accelerate your tooth loss.

Dr V

Important because without sugar, the bacteria that are found in gum disease won’t have the food source to sustain the adverse effects on your mouth.

Please don’t misunderstand, yes there will be bacteria and calculus will form around your teeth over time but the extent of the damage will not be as bad.

It seems sugar now is added to so many foods that are prepacked and processed.

Remember, most things that have been prepared and packaged as a quick meal are usually pretty high in sugar and salt.

#3 Hereditary Causes

Your genes can tell you a lot about who you are and what things might arise in the future.

During your routine dental visits, have a chat with your dentist about your family history as well as your own personal dental health.

This information is invaluable and can give them an extra level of understanding of your situation.

Discussing dental hygiene with your dentist

Don’t stress when speaking with your dentist about your dental hygiene routines. Within 20 seconds, they will see exactly how you have been taking care of your teeth so just be honest and take in any information they might share with you.

Having gum disease or any disease for that matter in your bloodlines is a strong indicator. It’s not 100% of course, but it’s very likely.

If your parents have had gum disease, unfortunately, it is genetic.

The chances are you might have inherited those genes that will destroy the bone holding the teeth in, and you may lose your teeth early in life.

What Can You Do About it?

A study showed that epigenetics is a way you can switch on and off the genes of disease.

If you realise that you do have a family history of gum disease, take precautions so that you can change the outcome.

Visiting your dentist or dental hygienist will help keep you on track with your oral health and will highlight early any potential issues that may come up.

You might also be able to prolong the time before those genes are switched on.

We know now that with epigenetics we can switch on and off those genes with environmental factors.

Dr V

Symptoms of Gum Disease: Are there Warning Signs?

4 main warning signs pop up before and during the stages leading to gum disease.

#1 Odour

Bacteria that is evident in your mouth have a particular smell, and as gum disease progresses, the smell will get almost putrid.

Bacteria in your mouth

Your diet and what you eat and drink plays a big part in this as well in the initial stages.

If you are a coffee drinker, milk has this terrible ability to cause bad breath.

Other lifestyle factors might produce a smell in your mouth creating a slight odour and then halitosis in the process.

#2 Red and Swollen Gums

If you don’t follow a dental hygiene routine daily, you are very likely to develop red and swollen gums.

Now, this can happen pretty quickly and silently causing the process of gingivitis to occur almost without you knowing.

But how does this occur?

Well as you enjoy tasty food, this debris (as it’s known) sits and gets trapped between your teeth. Should it not be removed on a regular basis, it will react and start showing signs of swelling.

Red, swollen and bleeding gums

#3  Bleeding Gums

Bleeding is a good indicator that something is not right with your teeth and gums.

Your gums will start to bleed because initially you might have skipped brushing or flossing your teeth twice a day. It is so easy to turn an all-important routine into a harmful habit.

A lot of people feel like not brushing and flossing is a better option because your gums are bleeding, but this is the worst thing to do!

If your gums are bleeding, get to the dentist immediately, because there’s a cause for that bleeding.

Healthy gums do not bleed. It’s one of the great indicators that I use.

Dr V

#4 Receding Gums

The recession of your gums occurs when gum disease has advanced, exposing your teeth and providing more space for pockets and bacteria to grow.

Besides periodontal disease is one of the reasons why gums recede, there are a handful of other reasons why your gums will recede. They include:

Most people who brush their teeth think “as long as I brush everything will be okay”.

Unfortunately, this can cause more problems than it’s worth and most of the time you don’t even know about it.

Your gums should be treated softly and with respect. A good recommendation by Dr V is to use a soft toothbrush and gently brush for at least 2 minutes, twice a day.

Sometimes it doesn’t matter how well you brush and floss your teeth, some people are unfortunately unable to stop specific effects like that of receding gums.

It is still worth doing all you can if your genes are against you, but it does help understand your position and to keep an eye on it.

Receding gums can occur on their own if dental health is non-existent. You basically allow the bacteria to have a party inside your mouth. The only problem is this party gets out of hand (so to speak) and can cause havoc with your gums over the long run.

This can occur in females when your body is going through specific changes that can cause increased sensitivity. Stages in a woman’s life that can increase the risk of gums issues are:

  • Puberty
  • Pregnancy
  • Menopause

Reversing Gum Disease

We are sorry to disappoint you, but gum disease is not reversible. Preventable yes, but not reversed.

Bring back your bone means you have to bring back the periodontal ligament. It’s just not possible.

I’ve been looking at the literature and I’ve been studying it. There is nothing on the market that I’ve seen that has been able to regenerate that periodontal ligament, plus regenerating the actual bone.

Dr V

Extracting Teeth and Bone Grafts

Damaged teeth that are beyond repair from gum disease can be removed or extracted.

Now because bacteria have usually changed the quality and quantity of your jawbone, your dentist may need to restore the area by completing a bone graft.

The only catch is you must have a periodontal ligament to help the process of bone growth. Without it, it is fruitless and pointless.

If you do have enough bone, a bone graft will allow your bone to grow back and create a stable foundation.

Timeframes range anywhere from 3-9 months depending on how severely the gum disease has affected your jawbone.

Most dentists’ will use calcium hydroxide which is like scaffolding or a better description, like coral from the ocean and insert it into your socket (the gap where your tooth used to be).

When your bone has sufficiently come back, you’re now able to look at options to replace your damaged teeth.

Things such as dental implants are an excellent way to restore your smile and add confidence.

Gum Disease Treatment

The easiest way to explain the treatment of gum disease is to think in terms of foundation.

When you have built the proper foundation for anything in life, things are more likely to succeed. Right?

The same is true for the treatment of gum disease.

You can’t build a great building on a weak foundation. You must have a solid foundation if you’re going to have a strong superstructure.

Gordon B. Hinckley

Dr V our resident dentist has informed us many times that she is a stickler for gums and the importance of getting those foundations right.

Early Stages of Treatment

This involves a deep clean of the whole area where your gum disease bacteria is present.

Your dentist will measure how deep your periodontal pocket is with the help of a unique instrument that calculates how many millimetres the pocket is.

This is particularly useful so your dentist can reach the depth at which the bad bacteria is and clean it out properly.

A dentist giving a thorough clean

If you don’t remove the Bacteria, it will continue to send toxins and dissolve your bone, so it is a must that your dentist does an outstanding job at cleaning the site out.

The growth of bone and the integrity of your gums depends on it.

Thoughts on Bleeding Gums

It is quite normal for your gums to bleed during this cleaning process.

It’s an indication that something is wrong and there is active gingivitis or gum disease present.

Depending on how deep your dentist must go to remove the bacteria from your periodontal pockets, a local anaesthetic can be used to provide relief from pain in this situation.

Ongoing Dental Maintenance

Most dentists’ will provide you with a home care maintenance kit which usually includes floss, interdental picks and fluoride toothpaste.

Now some people prefer to use an interdental pick over floss.

This is purely a personal preference but the main thing is that you follow the advice that your dentist gives you.

We reviewed a couple of different types of interdental brushes recently. Click on the links below to see our in-depth reviews:

  1. Piksters Interdental Brushes
  2. Colgate Interdental Brushes
  3. Piksters Bamboo Brushes

For people who prefer floss, below are some of our reviews on different floss products:

  1. Oral B Essential Floss
  2. Dental Lace Refillable Floss
  3. Piksters Silk Floss 
  4. Piksters SupaGrip

Cleaning between those teeth of yours will keep you on track for a successful gum disease treatment, plus get you into a positive dental hygiene routine that will hopefully endure.

The purpose of using floss or more particularly interdental picks at this time is to nurture your gums and to make sure no debris gets stuck in the gaps, causing further bacteria to multiply.

A lady using interdental pick

After a few weeks, your dentist will recheck your gums and teeth, locating any areas that need further cleaning attention.

A local anaesthetic will probably again be used to get into those deep areas where bacteria is still lingering.

How Long Does the Treatment Take?

Now this will vary depending on how your dentist decides to proceed with treatment and what stage your gum disease is at.

Treatment is split up into 4 zones, top left and right and bottom left and right.

During each of these sections, bacteria which has been residing in those dental pockets of yours will be cleaned out.

This type of cleaning is professionally called ‘scaling’ or ‘root planing’, and it aims to smooth the area out so that gum attachment can come back.

The timeframe for treatment is over 4 appointments long and then continued routine visits.

Gum Disease Treatment Cost

Just like treatment options can vary case to case, so do the costs.

They are dependant on a range of factors including but not limited to:

  1. The stage in which your teeth and gums are at
  2. How deep your periodontal pockets are
  3. The number of bacteria evident in those pockets
  4. If surgery is required
  5. A specialist may be required

Gum disease treatment costs are not expensive in the whole scheme of things, especially if you want to keep your teeth.

Most health insurance companies do provide cover, so check with your health insurance to find out what are your limits and gaps etc.

The treatment cost by your dentist can range from $500 to $2000.

If your gum disease has created deep pockets and you require a specialist or gum surgery than expect to pay above this amount.

A specialist – Periodontist

When gum disease has evolved and created deep pockets around your teeth and gums, your dentist will advise you that visiting a specialist or a Periodontist (as they are formally referred to) is required.

A Periodontist will advise and treat your gum disease at a much more thorough level than your standard dentist.

They will also charge a lot more for their services but it is the price you pay for this type of treatment and consultation.

Preventing Gum Disease

As we said before, gum disease is preventable. Even if you do have genetic factors to deal with.

If you take enough care, you can prevent gum disease and keep your teeth for life.

Clean between your teeth will help significantly in preventing the onset of gingivitis and gum disease.

Should I Use Floss or Interdental Brushes?

Unfortunately, for some reason, flossing is just not favoured by many people. It’s almost like it’s an effort to floss.

You must clean between your teeth. Whether you do it with toothpicks, whether you do it with floss, whether you do it with the little brushes called Piksters (interdental brushes).

If you don’t clean between those teeth of yours, the problems will begin.

Brushing your teeth takes care of the outside surfaces of your teeth and gums, but the brushing doesn’t clean between the teeth, and that’s where the problem starts.

Cleaning between the teeth on a regular basis is a must!

Thoughts on Floss – Question and Answer

Did you hear an article that came out not too long ago about someone saying that flossing was a waste of time? What’s your take on that?

The simple truth is that anything that can get in between the teeth to clean is advantageous.

The reason is that if you leave debris between your teeth, you can imagine the bacteria will feed on that debris. It will stick to your teeth and start breaking away your bone.

In my professional opinion flossing is a crucial part of dental hygiene.

7 Tips to Prevent Gum Disease

#1 Brush Your Teeth Daily

Getting into a good, healthy, dental hygiene habit is probably one of the most important things you can do to prevent gum disease and any relating dental problem.

Spending 2 quality minutes, twice a day brushing your teeth will increase your chances of removing the debris from around your teeth and gums and starving the food source of the bacteria we’ve spoken about.

Brushing your teeth together with your partner

#2 Use a Soft Toothbrush

Brushing your teeth is one thing, but if done incorrectly, it’s going to affect and damage your teeth’s enamel and wear away your gums, permanently.

Try using a soft toothbrush and relax the pressure you apply when brushing. A soft, smooth movement around your upper and lower teeth and gums will give you excellent results with no potential damage either.

#3 Replace Your Toothbrush Regularly

The standard timeframe for opting for a new toothbrush is around 3 months. This keeps your toothbrush fresh and in good working order.

#4 Floss or Use Interdental Brushes

The other crucial part of your dental hygiene routine which is as essential as brushing your teeth is flossing your teeth.

Flossing or using interdental picks or brushes will remove the debris that is trapped between your teeth and around your gums. We can’t stress this enough!

Floss

#5 Use Toothpaste with Fluoride in it

This kind of toothpaste gives you extra protection between dental visits. There are many to choose from, and some even whiten your teeth!

#6 Give up Smoking

This is another massive positive thing to do to reduce your chances of getting gum disease.

Other health-related risks dramatically increase as well when you smoke so do the right thing and quit before it is too late.

Quit smoking

#7 Eat a Healthy Diet

Our final tip is to eat healthy wholesome foods that have reduced salts and sugars.

This will improve your way of life overall and help you hold off mouth related issues.

Natural Home Remedies for Gum Disease

Home remedies are more like preventative measures that can be added to your dental hygiene routine.

Some of the remedies that people use today are:

  • Hydrogen peroxide
  • Aloe vera
  • Oil pulling
  • Tea tree oil
  • Coconut oil and baking soda

The video below will provide some information on each of the remedies mentioned above that people use at home.

Another good way to remove the debris and bacteria from your teeth and gums is a product called Waterpik.

It is similar to the water jet you get when you’re at the dentist.

It’s a preventative measure you can take to reduce the risk of plaque build-up and ultimately gum disease developing in your mouth.

Conclusion

After speaking with Dr V about gum disease, it is clear that preventing it in the first place is what people should be focusing on.

The sooner you start to look after your teeth and gums through proper dental hygiene and consistently achieve this on a daily basis the better off you will be.

We understand that it can be hard when you haven’t been shown how to look after your teeth correctly, and you probably feel like it’s all too late to start later in life.

Well, this isn’t true.

It is never too late to start a positive health routine.

Looking after your mouth is probably one of the most important things you can do for your overall health.

So, whether you are researching this topic and you’re in school, or you have gum disease and are going through the treatment process, start today or tomorrow (whatever the case may be) with a positive dental routine.

Waking up and brushing and flossing your teeth will put you on the right path to reduce your chances of gum disease.

Do you have gum disease prevention tips that have worked for you?

Dr Veronica Roller

By Dr Veronica Roller

Created at March 29, 2018, Updated at February 03, 2021

4 Comments

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    Travis Walker2 years ago

    Really helpful information about gum disease! Thanks a lot.

    reply
    • Avatar

      Dental Aware2 years ago

      Thanks Travis! Glad we could help

      reply
  • Avatar

    Belinda Orrock1 month ago

    Fantastic article!! Would be great if you could mention the role of a dental hygienist in the treatment and management of periodontal disease – I work rurally and easily 40% (probably more) of my practice is perio and perio maintenance 🙂 Please keep up the great informative work!!

    reply

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