About Gum Disease

Keeping your gums healthy is one of the main purposes of maintaining proper oral hygiene.

The gums or gingiva play an important role in protecting your teeth and holding them in place by creating a tight seal around them. These soft tissues (gums) work as a protective layer to keep disease-causing bacteria away from your pearly whites.

Unhealthy gums are not able to provide a proper barrier against bacteria, and once bacteria penetrate the deeper parts of your teeth, they put your teeth’ entire structure in danger. People may experience loose teeth or even tooth loss as a result of unhealthy gums.

Your gums’ health is not to be overlooked because unhealthy gums can negatively impact your dental health and your overall well-being.

Healthy gums

1. are often pink in colour or a darker shade of pink
2. are not inflamed and have a firm texture
3. won’t bleed when you are brushing or flossing

Your gums may need urgent care if you have the following symptoms. Signs and symptoms of unhealthy gums include:

• your gums are red or darker
• swollen and inflamed gums
• loose permanent teeth
• gums that are tender or sore
• bleeding gums
• receding gums
• halitosis or persistent bad breath
• pus coming out of your gums
• tooth sensitivity

Receding gums refers to a dental condition in which gums pull away from the teeth’ surface, causing the teeth’ roots to become exposed.

If your gums look red and swollen, have a less firm structure, if they are tender to touch or bleed while you’re brushing or flossing, or if you feel a sudden change to your natural bite, you’d better have your gums checked up by a dental professional as it may be a sign of some sort of gum disease.

Now open your mouth and take a look at your gums! What do they look like? How do they feel around your teeth?

A lot of patients with gum issues often ask what does the colour of their gums mean?, what causes gums to turn purple or brown? and why are my gums purple? Is having purple gums normal? While healthy gums are often associated with the colour pink or a shade of pink, darker shades do not necessarily equal unhealthy gums. Just like we have different skin colours, the colour of our gums can vary according to our ethnicity or our age.

Brown Gums or Dark Brown Gums

Having brown gums is natural if you have a darker skin tone. Dark brown gums are also expected for those with naturally dark skins; moreover, gums tend to turn darker as we age.

Purple Gums

Purple or brown gums can also be healthy and look firm; therefore, as long as you are not experiencing swollen gums, tender or sore gums, sensitivity, or gum bleeding, having darker shades of pink like purple or brownish gums should not be a concern. If you notice your gums have turned purple, accompanied by any sensitivity, swelling, pain, or soreness, you will need to visit your dental expert because it may indicate an infection.

Pale Gums

Pale gums may indicate anemia, leukoplakia, or menopause.

Red Gums

Red gums can be a sign of infection and inflammation of your gums and the first sign of gingivitis. Red gums may also bleed easily and be sore and tender to touch, which requires urgent oral care.

Grey gums

A weakened immune system can cause your gums to have a greyish film over them. Seek medical attention if your gums have turned grey since it can be a sign of bacterial infection.

White Gums

A fungal or viral infection can change the colour of your natural gums to white. You will need medical care in this situation.

Black Gums

Black gums are only expected if your skin tone is also very dark; otherwise, black gums can need to be examined carefully. In some cases, tobacco use or certain medications may have caused your gums to turn black.

Plaque and tartar accumulation over time will cause gum disease.

Poor oral hygiene can compromise your gums’ health. Dental plaque is defined as a thin, sticky film of bacteria that regularly covers your teeth. Plaque is actually a byproduct of bacteria, acids, and carbohydrates (sugars and starches).

The combination of the saliva, food, and fluids in the mouth allows bacteria to grow. The bacteria in plaque feed on the sugars from sugary or starchy foods and produce acids. Over time, these acids in the plaque can attack your teeth’ enamel and destroy them, causing you many dental issues, including cavities and “gingivitis,” which is the early stage of gum disease.

Enamel erosion makes your teeth more susceptible to developing decay.

Dental plaque, this biofilm or coating, forms between your teeth and along the gum line and will grow and thrive if not removed by proper brushing and flossing.

Plaque starts forming 4-12 hours after brushing!

Buildup plaque can create many oral health issues for you. By accumulating minerals from the saliva in the mouth, buildup plaque can harden into a hard deposit called tartar.

Tartar or calculus is a hard, porous, yellow substance that builds upon the teeth if plaque is not removed properly and regularly.

Tartar is bad news for your teeth and gums because it mostly forms along (below and above) the gum line and can make teeth cleaning difficult because the gum tissues are now swollen and inflamed and may bleed easily. Swollen gums may stop you from removing dental plaque, resulting in more accumulation of tartar.

The accumulated tartar along the gum line makes your gums sensitive and inflamed; you may experience bleeding gums which can indicate the mildest form of gum disease called “gingivitis.”

You must seek professional oral care to get rid of tartar to prevent more serious oral health problems like periodontal disease.

Tartar removal is not achievable at home, your need professional dental cleaning at your dentist’s office.

The mouth is home to millions of bacteria. Daily brushing teeth flossing and general oral hygiene will ensure your oral health and prevent tooth decay by controlling the level of the bacteria in the mouth. Without proper oral hygiene, bacteria can form dental plaque, which can turn into dental calculus or tartar over time if not removed regularly. Tartar is not easy to remove at home, and the building up of tartar can make it really hard for you to brush your teeth; therefore, bacteria can easily penetrate below the gum line and cause gum infection.

Gum infection results from improper oral hygiene and the building up of harmful bacteria in the mouth and in the tissue around the teeth, which cause the gum tissues to get infected. The infected gums will get inflamed and swollen as a natural body response to infections. Make sure you practice good oral hygiene to prevent infection.

Periodontal disease or gum disease occurs due to the infections and inflammation of the gums that damage the soft tissue and the bones that support the teeth. Gum disease can be defined as an ongoing gum infection. Gum disease is a severe chronic inflammatory condition; if left untreated, it can jeopardize your oral health by affecting all the tissues, including the gums, periodontal ligament, and alveolar bone. Periodontal disease affects about 20% to 50% of the global population, mainly affecting adults rather than children.

Generally speaking, infections and inflammation of the gums and the teeth supporting tissues can lead to Periodontal Disease.

Therefore, gum infection can be considered the first sign of periodontal disease.

Risk Factors for Gum Infection

These factors may increase your risk of developing gum infections:

• Smoking cigarettes or using any other tobacco products
• Having a weakened immune system
• Genetics
• Hormonal changes in women (pregnancy)
• Having crooked teeth
• Certain medication

Gum disease can result from poor oral hygiene, smoking, hereditary, age, stress, illnesses like AIDS, and some medication.

The periodontal disease varies in severity. While it’s easily treatable in its mildest stage by practising good dental hygiene, it may become a more serious condition in its advanced stage, which is not reversible.

Gingivitis and Periodontitis are two main types of gum disease.

Gingivitis

Gingivitis is considered an early stage of periodontal disease which can be cured easily by brushing and flossing daily and arranging regular dental checkups. In this stage, the infection has made the gums swollen and red; the patient may also experience bleeding. Gingivitis is caused by a buildup of plaque around the teeth.

Since gingivitis can be painless and silent, most people ignore the signs and leave their inflamed gums untreated. However, gingivitis or gum inflammation can cause you more serious oral health problems without prompt treatment. Although the gums are swollen and irritated and bleed when brushing or flossing in gingivitis, tooth loss won’t occur at this stage. Teeth will not shift in place and are perfectly in the socket.

Gingivitis is a reversible condition; at this stage of periodontal disease, the infection has caused inflammation in your gums and has not affected the bone yet.

Symptoms of gingivitis

 Take these signs seriously and consider dental care promptly:

• Swollen and inflamed gums
• Bad breath
• Sensitive and tender gums
• Bleeding gums
• Red gums

Periodontitis

Without proper treatment, gingivitis may progress to Periodontitis, a more advanced stage of periodontal disease. Periodontitis refers to a severe common gum infection that can damage the soft tissue. If not treated, Periodontitis can also damage the supporting tissues of the teeth and causes tooth loss. In Periodontitis, the infection has spread to the bones.

Unlike gingivitis, Periodontitis is considered an irreversible stage of periodontal disease. In other words, practising proper oral hygiene will no longer work at this stage of the disease.

The patient may experience:

• bone loss
• loss of the periodontal ligament attachment
• tooth mobility (loose teeth)
• tooth loss in severe cases
• gum inflammation
• gum recession
• gum bleeding
• red or purple gums
• feeling pain while chewing or biting
• drainage of pus
• recurrent painful abscesses
• spaces opening between the teeth
• having a foul-like taste in your mouth
• bad breath

Our patients often ask if Periodontitis can go away on its own. unfortunately, Periodontitis will not go away on its own and needs urgent oral care by a dental expert. If Periodontitis is left untreated, the infection will continue, and bacteria will turn into disease-causing bacteria that can destroy the teeth and their supporting tissues (bone and periodontal ligament).

As a result of untreated Advanced Periodontitis:

• Bone loss will occur.
• The patient will experience severe halitosis.
• Gums will become extremely inflamed, with pus coming out of them.
• The patient will experience loosening of the teeth and even tooth loss.

Untreated advanced Periodontitis will increase people’s risk of tooth loss and the need for dentures.

Gum disease is preventable. Modifying your oral hygiene routine can help prevent gum disease.

• Brush your teeth at least twice daily
• Make sure you clean between your teeth; using interdental brushes can help
• Clean your tongue every time you brush your teeth
• Floss teeth to get rid of food debris from between your teeth
• Rinse your mouth with a therapeutic mouthwash to reduce plaque buildup
• Avoid tobacco products as much as you can
• Use fluoride toothpaste
• Limit your intake of sugary foods and drinks
• Wash your mouth after eating and drinking sugary foods and drinks
• Schedule professional teeth cleanings

Patients with gum disease tend to ask if gum disease can be cured. The treatment options for gum disease treatment will be different from person to person and based on the severity of the gum disease.

For early to moderate stages of periodontal disease, your dental expert may opt for non-surgical procedures such as Scaling, root planning, and Antibiotics.

For more advanced stages, surgical options like Flap surgery, Soft tissue grafts, Bone grafting, Guided tissue regeneration, and Tissue-stimulating proteins may be required.

Non-surgical Procedures for gum disease treatment include:

Scaling and Root planning (conventional periodontal therapy). Scaling and root planing is a dental procedure known as “deep cleaning” that is used to remove plaque and tartar from under the gum line.

Scaling involves removing calculus and deep plaque from above and below the gum line. Root planing involves smoothing the root surfaces to encourage your gums to reattach to the teeth. Root planing prevents further accumulation of bacteria and calculus.

More than one visit to your dentist’s office may be required for scaling and root planning.

Is scaling and planing painful?

No, scaling and planning are not painful since your dentist will use a local anesthetic to minimize any pain or discomfort. To accelerate the healing process, avoid smoking or using spit tobacco.

Surgical Procedures for gum disease treatment include:

Flap Surgery

Gum flap surgery is done to prevent the gum disease from progressing further. The periodontist will first administer a local anesthetic to numb the area and then start by making small incisions in your gums to temporarily lift away the gum tissue. The roots will be exposed, and the dental expert can perform a more extensive scaling and root planning to remove tartar buildup. After tartar removal, the gum tissue will be stitched back in place.

Flap surgery is performed to reduce the pocket by removing diseased tissue from the pocket. Flap surgery procedure will usually take about 45 minutes to complete.

Soft tissue grafts

Losing gum tissue can eventually lead to gum recession. To perform soft tissue grafting, dental professionals will take a small amount of healthy tissue from your palate (the roof of your mouth) or other donor sources and attach it to the affected area to cover the exposed tooth roots and prevent further gum recession.

Bone grafting

If periodontal disease has destroyed the teeth’ supporting bones, you will need a bone graft to prevent tooth loss. This regenerative surgery is done to regenerate bone support around the teeth. The graft might be from a part of your body, like the hip bone or back of the jaw, donated, or from synthetic material.

Guided tissue regeneration (GTR)

GTR is a surgical procedure during which the bacterial infection will be removed to encourage the growth of new bone. The dental professional will place a special artificial membrane between the gum and bone. The material prevents the soft tissue from growing into the site where the new bones are supposed to grow. Inserting this membrane is crucial because it keeps the gum tissue away from the healing area and allows the bone to grow naturally.

The dental expert may also prescribe oral and topical antibiotics as a supplement to the scaling and root planning procedure to reduce the risk of disease-causing bacteria. The common antibiotics typically prescribed for gum disease include Amoxicillin, Metronidazole, Tetracycline, Clindamycin, Ciprofloxacin, and Azithromycin. Please consult with your medical doctor before using any medications.

The patient may experience:

• bone loss
• loss of the periodontal ligament attachment
• tooth mobility (loose teeth)
• tooth loss in severe cases
• gum inflammation
• gum recession
• gum bleeding
• red or purple gums
• feeling pain while chewing or biting
• drainage of pus
• recurrent painful abscesses
• spaces opening between the teeth
• having a foul-like taste in your mouth
• bad breath

Our patients often ask if Periodontitis can go away on its own. unfortunately, Periodontitis will not go away on its own and needs urgent oral care by a dental expert. If Periodontitis is left untreated, the infection will continue, and bacteria will turn into disease-causing bacteria that can destroy the teeth and their supporting tissues (bone and periodontal ligament).

As a result of untreated Advanced Periodontitis:

• Bone loss will occur.
• The patient will experience severe halitosis.
• Gums will become extremely inflamed, with pus coming out of them.
• The patient will experience loosening of the teeth and even tooth loss.

Untreated advanced Periodontitis will increase people’s risk of tooth loss and the need for dentures.

Gum disease is preventable. Modifying your oral hygiene routine can help prevent gum disease.

• Brush your teeth at least twice daily
• Make sure you clean between your teeth; using interdental brushes can help
• Clean your tongue every time you brush your teeth
• Floss to get rid of food debris from between your teeth
• Rinse your mouth with a therapeutic mouthwash to reduce plaque buildup
• Avoid tobacco products as much as you can
• Use fluoride toothpaste
• Limit your intake of sugary foods and drinks
• Wash your mouth after eating and drinking sugary foods and drinks
• Schedule professional teeth cleanings