Having a healthy mouth and a confident smile is more than just about your teeth. As most dentists will tell you, a tooth is only as good as its foundation, which is the gum and the jawbone that support it. Our mouths are filled with a variety of bacteria, many of which can be harmful, resulting in tooth decay and gum problems known as periodontal disease.
Periodontal disease can be chronic (slowly progressing) or acute (painful and rapid progression). Periodontal means “around the tooth” so it describes problems associated with gums, soft tissue and the bones that hold the tooth in place. This also forms a foundation and a barrier to prevent bacteria from entering our system, so it is worthy of defending.
Goor oral health is strongly associated with good general health, and there are proven links between conditions such as heart disease, diabetes and Alzheimer’s. The explanation centres around the fact that gum disease results in bacteria entering our bloodstream at the tooth- gum interface. The body then increases its immune response, and this can have some undesirable side effects on your system. If your teeth and gums are not clean, and not allowed to heal, it is the equivalent of having an open wound that is present for years and years.
So, what are the gum disease symptoms you need to look out for? In many scenarios, it is a case of thinking “no pain = no problem.” This is understandable as our bodies typically tell us there is something wrong by signalling us with pain. In the case of chronic periodontal disease, the signs are often a little more subtle.
If you notice blood after brushing, (even when doing it gently) it is a strong indication that you have an issue. Healthy gums rarely bleed. Gums are pink because they contain lots of blood vessel that are close to the surface, however, gums that are infected have a much more significant blood flow. This is known as inflammation. Think of it as turning the tap on a hose up to full strength. There is more blood flowing and some of the pressure pushes some of the blood contents out through the hose and into the surrounding tissue. This makes the gum appear redder and puffier as the blood is even closer to the surface. Therefore, even a small bump with a brush can cause more dramatic bleeding.
The same can be said for flossing, known as one of the world’s least popular hobbies! People report to dentists that they are sometimes scared to floss because they think it makes their gums bleed. The reality is that the cleaner your teeth and gums are, the fewer bacteria are present, the less inflammation occurs, and the bleeding reduces. Yay for flossing! The only issue is that often a professional clean by a dentist, hygienist or oral health therapist is required to remove stubborn build-up from below the gumline that your regular brush or floss won’t be able to shift.
Red, puffy, bleeding gums are the most common periodontal disease symptoms. The other is halitosis or bad breath. This is another bacterial issue and one that can also be improved with good cleaning techniques. Food debris, trapped between the teeth begins to rot and break down, feeding the bacteria that live there. Some of the waste products of this process emit nasty odours that contribute to bad breath. Whilst bacteria that live in the small grooves of the tongue also contribute to bad breath, gum issues are more commonly responsible. Once again, cleaning is paramount. The fewer bacteria, plaque and food debris, the less bad breath.
Mouthwashes containing Chlorhexidine (such as Savacol or Curasept) are able to reduce inflammation, but can only be used for up to 2 weeks. Brushing and flossing regularly and effectively is still the most important pathway to good oral health.
The end of the road for advanced gum disease is often tooth loss. If the gum and bone that anchors the tooth are badly destroyed, the tooth becomes loose and, in many cases, very tender. Trying to chew on a loose tooth is very challenging, which means that one may not be able to enjoy the same foods with confidence. What follows can be the requirement to wear dentures to replace missing teeth, as the placing of implants can be made more difficult in situations where the bone has been lost.
Your oral health professional will examine you for gum disease at your regular check-up, and most of the time, a thorough scale and clean, and good at-home care is all that is required to maintain good oral health.
In cases of advanced periodontal disease, more regular and thorough professional cleaning or a referral to a Periodontist are other available options.