Gum disease and its treatment

Contrary to what most people believe, gum disease rather than tooth decay is the biggest cause of tooth loss in adults. According to experts, at least 3 out of 4 of adults above 35 in the UK are suffering from gum disease at some stage of progression. If caught in the early stages, however, it’s entirely possible to reverse the progress of gum disease.

Types of Gum Disease


When people talk of gum disease, they generally mean gingivitis, a condition in which the gums turn red and inflamed. They may bleed when you brush your teeth, and often, this bleeding is the very first sign of gingivitis that you actually notice. Gingivitis affects more people than you think, and can be reversed if caught in the early stages, simply by following proper dental hygiene practices. Brush twice a day, make dental floss your best friend, and your gums should begin to lose the redness and swelling after a few days.


If left unchecked, however, gingivitis could lead to a host of other gum diseases. Periodontitis, for instance, is a more extreme stage of gingivitis in which the inflammation of the gums spreads to the bones holding the tooth in place. Soon, the tooth can begin to shake loose, and will, in time, fall out if left untreated.

Acute Necrotizing Ulcerative Gingivitis (ANUG)

An extreme variation of gum disease is acute necrotizing ulcerative gingivitis (ANUG). This is an extremely rare condition that usually affects people who are severely malnourished, and can be linked to a weak immune system. In this condition, ulcers form in your gums after the gums become infected with bacteria. These ulcers can be extremely painful, and can be combined with swelling of the gums. This may interfere with eating and drinking. The tissue that surrounds the gums can become weak and disintegrate, causing your teeth to become loose.

Symptoms of gum disease

In many cases, you may not even be aware that you have gum disease. Very often, gum disease is not a painful condition, and f you may not even see any symptoms for quite some time.

  • The first sign that most people see is bleeding while brushing their teeth.
  • There may also be redness, swelling, and unpleasant breath.
  • Some people also experience an odd metallic taste in their mouth.
  • Your teeth may also become highly sensitive to changes in temperature.
  • In some cases, you may notice reddish-blue patches at the corners of the gums.
  • There could be slight changes in the way your teeth function while eating food, or they may not fit in properly.
  • Also, look out for pockets forming between the teeth and gums.

Causes of gum disease

Gum disease begins when there is a plaque build-up on your teeth. When the teeth are not brushed properly, or when certain areas of the teeth are not cleaned well, due to the presence of braces or dentures, this leads to plaque build-up. Some people might have irregular teeth, making it hard to clean with a regular toothbrush.

What is plaque?

Plaque is a sticky layer that forms on your teeth when bacteria accumulate on the surface. If plaque is left to stand as it is, it can become hard and form tartar. Tartar is tougher than plaque, and adheres to the teeth much more strongly. It cannot be removed by brushing or flossing, and your dentist will have to use a scaling procedure to remove tartar. When this plaque and tartar build-up begins to take place, the bacteria that are produced inflame the gums. This inflammation is what leads to gingivitis.

There are other factors that can also cause gum disease:

  • Smoking, for instance, decreases the flow of blood to the gums, and this slows down the healing process.
  • People who suffer from diabetes are also more susceptible to gum disease.
  • During certain life conditions, pregnancy for instance, hormonal fluctuations can cause gum disease to develop.

Diagnosis of gum disease

Bleeding, soreness and inflammation are the visible symptoms of Gingivitis, and you don’t need to conduct any tests to confirm the presence of Gingivitis.

However, if your dentist or hygienist suspects Periodontitis, then he will refer you to a periodontist. Your periodontist will need to conduct a complete dental examination to confirm the diagnosis. He will use a periodontal probe to check the size of the groove that has been formed between your teeth and gums. If he finds the groove is deeper than is acceptable, he will take this to be a strong indication of Periodontitis. He may even recommend an X-ray to verify if there has been any damage to the teeth and jaw-bone.

In the case of Acute Necrotizing Ulcerative Gingivitis (ANUG) the symptoms themselves serve as a diagnosis, because they are so severe and unmistakable.

Treatment of gum disease

Oral Hygiene

The early signs of gum disease can be treated simply by incorporating healthy eating habits in your lifestyle, and a complete and regular brushing and flossing routine. Brushing can only remove plaque from the teeth surface, while flossing can get to plaque build-up in between the teeth. Motorized toothbrushes that have smaller and flexible heads can be more effective at getting to plaque and eliminating it, than a regular toothbrush.


Typically, your dentist or dental hygienist will treat Gingivitis using a scaler, as well as an electric toothbrush in combination with a rough textured tooth paste. Antiseptic mouthwashes that contain chlorhexidine can also prevent the formation of plaque. Your dentist may also recommend a series of cleaning sessions, at least or more than twice a year.

Root Planing

If there is gum recession (where the gums have moved away from the teeth) or bone loss, then treatment involves scaling as well as root planing. Root planing works to remove any rough spots on the root where bacteria can easily accumulate. When the surface of the root is smoothened out, the gums can easily reattach themselves back to the teeth. You may require local anesthesia before beginning the scaling procedure.

Gum Surgery

In the most severe cases, where the pockets are simply too deep to be cleaned by scaling, your dentist may recommend gum surgery. This is performed by a periodontist. This specialist will undertake extensive scaling on an even deeper level, and will also use other methods to remove the plaque.


Some dentists recommend using lasers to improve the effectiveness of scaling and root planing. Lasers, when used in the proper manner, can reduce the amount of swelling and bleeding during surgery. Laser provides an effective means for gum disinfection.


Antibiotics can be used to reduce the amount of bacteria produced. These can be combined with surgery, or can be prescribed on their own.

For any sort of treatment to work, you must follow a comprehensive dental hygiene program. Your dentist will give you a list of precautions to follow after treatment to prevent any return of the plaque build-up. For instance, chronic smokers will often see weaker results of their dental treatment.

Complications of Gum Disease

Gingivitis by itself is not an intensely painful condition. If however, you neglect its symptoms and don’t take any measures to remove the plaque from your teeth, then you expose yourself to a number of other complications.

Acute Necrotizing Ulcerative Gingivitis (ANUG)

One of these is Acute Necrotizing Ulcerative Gingivitis (ANUG). In this condition, the gum infection quickly spreads all across the area, including the bones, and ravages the gum tissue. There can be severe halitosis, tooth loss, and in extreme cases, gangrene can set in.

Cardiovascular Disease

Some research indicates a correlation between the prevalence of gum disease and the incidence of heart disease and stroke. There is strong evidence that points to the inflammatory responses caused during gum disease and the bacteria that’s produced in this condition being responsible for the increased risk of coronary artery disease (CAD) in those who have Periodontitis.


Periodontitis has also been found to not only aggravate diabetes, but some research also suggests that it can actually cause this condition.

Respiratory Disease

Persons suffering from emphysema could find that the bacteria produced in the mouth travels through the airways, aggravating respiratory conditions like emphysema.


In pregnant women, periodontitis enhances the risk of premature delivery and low birth weight in infants. There is also higher risk of preeclampsia, a condition that manifests itself mid pregnancy, and is characterized by an increase in blood pressure.

Risk Factors for gum disease

Although gum disease affects 90% of the population at some time or the other in their lives, there are certain people who are more at risk than others.


Smokers form up to 50% of gum disease patients. This is because smoking slows down the delivery of blood, including nutrients and oxygen to the gums, and thus increases bacterial plaque. It also decelerates the heeling process, exposing the gums to the risk of infection.


Women are more prone to gum disease than men because of the hormonal fluctuations that they experience during various stages of their lives. Besides puberty, menopause and menstruation, which can cause major hormonal changes, the use of oral contraceptives can also put women at risk for Gingivitis and Periodontitis. These hormonal changes make gums extra sensitive, exposing them to disease.


A pregnant woman experiences intense hormonal changes which make the gums extra sensitive. These sensitive gums are prone to bleeding.


People with diabetes are generally more vulnerable to infections, and these include gum infections. In fact, gum disease is regarded as one of the many health complications that diabetes brings about. In diabetics, it is important that the gums be inspected regularly for sores or wounds, and antibiotic treatment for the infection begins as quickly as possible. Otherwise, the wound may take very long to heal.


People who are under stress have a weakened immune system, and their bodies are susceptible to infections, including gum disease.


Research indicates that people who have suffered a stroke, are more likely to develop gum disease than the general population.

Immune Deficiency

People who have a weak immune system are generally more susceptible to gum disease. Persons who suffer from AIDS, or are undergoing chemotherapy can find their immune system considerably weakened, exposing them to a variety of infections, including those of the gums.

Teeth Grinding

People who clench and grind their teeth excessively may also find themselves at risk for gum disease. Grinding can place excessive force on the gums, and could accelerate the rate at which gum tissues wear out.


Certain medications like anti angina medicines can decrease the flow of saliva, thus increasing the risk of gum disease. This is because saliva is very essential for the health of teeth and gums, and its scarcity can expose the gums to infections. Other drugs can even cause abnormal development of gum tissue.


People who neglect their diet, or consume too much sugar and acidic foods can find themselves more vulnerable to gum disease. Acidic foods cause prime conditions for the development of the bacteria responsible for gingivitis.

Prevention of Gum Disease

Prevention at home involves following a regular brushing and flossing program that works to get rid of plaque not only from the surface of the teeth, but also from between the teeth.

  • Visit your dentist regularly to catch the earliest signs of gingivitis.
  • Follow a healthy diet, and stop smoking.
  • If your dentist recommends an interdental brush, use this to remove plaque and food that has been lodged between the teeth, and other areas where a regular toothbrush just can’t reach.
  • If your teeth are irregularly shaped, than you may find it hard to remove plaque by mere brushing and flossing. Spots that you can’t reach can quickly begin to see plaque formation. In such case, a dentist will undertake scaling to remove the plaque.
  • Diabetics should take care to keep their blood sugar close to acceptable levels.
  • People who wear dentures should take care to keep these clean.
  • If you notice bleeding while brushing, inflammation or soreness in your gums, or notice that your gums are receding from your teeth, consult a dentist immediately. Don’t wait for gum disease to strike – get your gums and teeth checked at least once every 6 months.
  • If your dentist prescribes a treatment program for your gum disease, follow it stringently. If he asks you to avoid certain foods or stop smoking, heed his advice.

To sum it up, gum disease is the inflammation of gums, caused due to plaque build up. This coating of plaque by itself does not have serious health repercussions, but if left unchecked, can quickly lead to more severe dental conditions, like Periodontitis, and Acute Necrotizing Ulcerative Gingivitis (ANUG). Depending on the intensity of your symptoms, treatment can range from simple incorporation of good dental hygiene practices into your lifestyle and minor scaling to surgery.