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Periodontal disease is an inflammatory disease that affects the supporting structures of a tooth, including the gums and underlying bone. The first stage of periodontitis is called “gingivitis”, a commonly seen gum inflammation. Over time, however, untreated gingivitis can develop into periodontitis, which may result in wobbly teeth or even tooth loss! Periodontal disease is primarily caused by a build-up of bacteria called “dental plaque” around the teeth and gums. The result is bad breath, red gums which bleed easily and soreness. Good oral hygiene can reduce the bacteria accumulation on the teeth and gum, reducing the chances of developing gingivitis and periodontitis. 🦷
Gingivitis and periodontitis are different stages of periodontal disease, caused by bacterial infection leading to inflammation. The mouth is a host to multiple different types of bacteria, most of them are beneficial and contribute to a healthy oral environment. However, if the host’s oral hygiene is inadequate, this can lead to an unhealthy buildup of bacteria on the teeth and gum called dental plaque. The balance in mature plaque can shift from good to bad bacteria, which can then lead to dental problems like periodontal disease.
Did you know that plaque starts accumulating on your tooth surface almost immediately after you brush? However, if you brush your teeth twice a day, this is sufficient to prevent plaque from building up. If enough plaque is built up on the teeth and gums, then over time this could cause the gums to become inflamed, otherwise known as gingivitis. With gingivitis, our gums become red, swollen and can bleed during brushing and flossing. There might also be associated bad breath (halitosis) and yellow-grey discoloration on your teeth.
Over time, long standing gingivitis can deteriorate into periodontitis. During periodontitis, bacteria not only has an effect on the gums, but the supporting structures as well (called the periodontium). The periodontium includes the gums, underlying bone and the attachment the bone has with the roots of the teeth (called the periodontal fibers). During periodontitis, long standing infection will start to cause a gradual loss of this periodontium. When more and more support is eroded away, eventually the teeth will become loose causing difficulty in chewing. If the infection is not treated, then this might eventually lead to tooth loss.
Luckily, gingivitis and periodontitis are both preventable diseases. Brushing your teeth twice a day, flossing daily and having regular dental checkups can significantly lower your risk of developing periodontal disease and can improve your recovery from gingivitis and periodontitis.
Your risk of developing periodontal disease can be influenced by a number of factors, the most common one being poor oral hygiene. Different types of bacteria are naturally present inside the oral cavity. Some of these bacteria can interact with sugar and starches in food, forming a thin, sticky and yellowish film called plaque on your teeth and gums. If you do not clean your teeth properly, plaque will continue to build up. Over time, plaque may mineralize and harden into tartar (also known as calculus), which cannot be removed by brushing and flossing. It then requires professional dental cleaning in order to remove tartar from the teeth.
The longer plaque and tartar remain on your teeth, the more potential damage there could be to your teeth, gums and supporting periodontal structures. Moreover, ongoing gum inflammation can strain the immune system, leading to immunity-related complications.
Aside from poor oral hygiene, a number of risk factors can increase your risk of developing periodontal diseases (gingivitis and periodontitis):
Healthy gums should be pale, pink and firm. If they bleed during brushing or flossing, it could be the first sign of gingivitis or periodontitis!
The following are some of the early signs and symptoms of gingivitis:
Gingivitis can develop into periodontitis if oral hygiene is not improved. Signs and symptoms of periodontitis include:
If early periodontal disease is not managed early, it could lead to a variety of complications:
If you have painful, swollen gums or if you have regular bleeding when you brush your teeth this might mean you are suffering from Periodontal disease. It is prudent to have this examined by a dentist!
Your dentist will perform a thorough dental examination to check the health of your gums and teeth. The dentist may gently insert a probe in the gap beside your teeth to measure any pockets in your gum. A deeper pocket may indicate more support or periodontium loss. Dental X-rays may also be taken to check the condition of your teeth and jawbones. Any periodontal pockets that have been detected may require teeth scaling and root debridement. Root debridement is a method of deep cleaning which aims to remove plaque and tartar from the teeth roots. You may need a local anesthetic for this procedure to numb the area before treatment. After root planning, the gums might feel sore for a couple of days afterward.
After your gum treatment, your dentist will reassess your gum condition after a couple of months. If your condition doesn’t improve, your dentist may refer you to a periodontist (a specialist in treating periodontal diseases) for further treatment.
Periodontal diseases can be prevented by good oral hygiene and regular professional checkup and cleaning. A good oral hygiene routine includes:
Apart from performing good oral hygiene, you should also:
This article was medically reviewed by Dr. Jonathan Lui 雷威鴻醫生. Dr. Jonathan Lui is a specialist in periodontology practicing at the Gum and Implant Dental Center. He is a Fellow of both the Hong Kong Academy of Medicine and the College of Dental Surgeons of HK. He obtained his university education from King's College (GKT) London and his specialist Periodontal training from the University of Hong Kong (HKU).
If plaque is not removed from a tooth, gingivitis can start as early as 1-2 weeks. Untreated gingivitis can have the potential to lead to more serious periodontitis after some time. This period of time depends on each individual, according to their risk profile. People who smoke, suffer from uncontrolled diabetes for example may have more rapid and aggressive periodontium loss than others.
Although kissing or sharing food is unlikely to cause gingivitis, people with poor oral health may be more susceptible to the exchange of bacteria during kissing or sharing food. This exposure to bacteria may lead to periodontal disease if you have poor oral health.
You may have gingivitis if you notice the following signs and symptoms: bright red or purplish gums, tender or swollen gums, bleeding gums, plaque buildup, tartar, sensitive teeth and pain when chewing.
Gingivitis and gum bleeding are caused by bacterial infections in your gums. The most effective way to prevent gingivitis is good oral hygiene. At home, maintain good oral hygiene by brushing your teeth twice daily with fluoride toothpaste, flossing regularly, and DON’T smoke. Short-term use of an antiseptic mouth rinse with chlorhexidine can also help. Regular dental check-ups are necessary as your dentist can more accurately identify signs and symptoms of gum disease.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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