Gums are as important as teeth.
Just as a good frame enhances a fine painting, firm healthy gums improve the appearance of sound, white teeth. Healthy gums, or to give them their correct name, gingiva, do not bleed when brushed. If bleeding does occur it is invariably the first sign of gum (periodontal) disease.
If allowed to progress, periodontal disease can lead to tooth loss.
What is Periodontal disease?
It is a disease that affects the tissue around the roots of teeth. It can destroy the fibres and bone that hold a tooth in place.
Quite often the disease progresses without causing any pain and without being noticed by the sufferer.
What do Healthy Gums look like?
Healthy gums are pale pink, firm, and do not bleed when brushed.
What do Inflamed Gums look like?
Inflamed gums are red and often shiny in appearance. Inflammation usually starts between the teeth and gradually spreads. Inflamed gums bleed easily especially when brushed, and are sometimes tender.
What are the signs of Periodontal Disease?
The earliest sign is noticed at the gum margins. This area bleeds easily when brushed and sometimes has swollen, reddened appearance. Older people may first notice periodontal disease when a tooth becomes loose or teeth start to move from their normal position. Receding gums or a persistent bad taste or bad breath are other signs.
Signs of Periodontal Disease
- Bleeding gums
- Receding gums
- Gaps appearing between teeth
- Loose teeth
- Persistent bad taste or bad breath
How are the teeth supported in the jaw?
- Teeth are kept in place by bone and periodontal fibres. These fibres run from the root of the tooth into the surrounding bone.
- The gum covers the bone and forms a tight collar round the neck of the tooth.
- Between the tooth and the gum is a small space called crevice.
- Right: cross-section of a front tooth in the jaw.
What can cause Gum Disease?
- The major cause is plaque. Plaque is a colourless, sticky film of bacteria that forms on the teeth.
- If plaque is allowed to accumulate in the gum margins, toxins produced by the bacteria can cause inflammation.
- After a time the plaque can harden and form a hard deposit (calculus). New, soft plaque forms on the rough surface of the calculus, which causes more inflammation.
- Right: this diagram shows bacterial film (plaque) around the gum margins. There is also inflammation of the gum.
What does Calculus look like?
Calculus on the front of the lower teeth
Calculus on the backs of the lower teeth.
How does the Inflammation Spread?
The gums become enlarged and detached from the teeth. The crevice between the gum and tooth begins to deepen, forms a pocket and the inflammation spreads deeper.
The periodontal fibres become damaged and the surrounding bone starts to disappear. Hard black calculus appears on the root of the tooth.
Without treatment the pocket will continue to deepen, bone loss continues and eventually the tooth may become loose and fall out.
The gums are red and swollen. A pocket has formed and plaque and calculus have collected on the root of the tooth inside the pocket. The top part of the bone has disappeared.
The disease has advanced and there is considerable bone loss. The tooth begins to feel loose. The disease may take several years to reach this stage.
Can Gum Disease be seen on x-rays?
X-rays are frequently used to determine the extent of bone loss. The x-rays below provide an indication of the amount of bone that can be lost from around the teeth as a result of periodontal disease.
These are x-rays photographs of the upper front teeth. The top photo shows healthy bone. The bottom photo shows that nearly all the bone has disappeared as a result of periodontal disease.
Is Periodontal Disease Hereditary?
Not really, but some people have a lower resistance to the disease than others. On the other hand some people have a strong inborn resistance.
Source: “Healthy Gums” Dental Health Foundation Australia