What you need to know about gum disease

When you brush or clean in between your teeth, you notice your gums bleed. A little blood is no big deal, right? Wrong! Bleeding is the first sign of gum disease, an infection caused by bacteria. If you wash your hands and they started to bleed, you’d be concerned. The same thing goes for your mouth.  

So what’s the difference between the different types of gum disease? What can you do to prevent infection in your mouth? Why does it matter if your mouth is infected? For the answers to these and other questions, read on!

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What is gingivitis?

Gingivitis is inflammation of your gums. Signs of inflammation include swelling of the gum tissue, bleeding, tenderness, bad breath and gums that look bright red in color instead of a healthy, pale pink. Inflammation is caused by the body’s response to a bacterial infection, most often caused by poor, or less than thorough, oral hygiene. Breaking it down a bit, the fuzzy feeling you get on your teeth is plaque and is full of live and dead bacteria and its toxic byproducts. As this bacteria eats sugar and starches (that you eat), it excretes acidic toxins. You read that right -- bacteria poops acidic toxins in your mouth. These toxins irritate your gums and cause infection. These same toxins are what cause cavities. Yes, cavities (decay) in your teeth are a bacterial infection. 

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If this bacteria/plaque isn’t thoroughly removed, your body’s immune system can’t fight the infection. However, your body will try and inflammation will occur. Inflammation, especially chronic inflammation, anywhere in your body is not good. It’s worth writing again, inflammation is not good!

Also, if left for too long, plaque can harden into calculus (tartar). Brushing and cleaning in between your teeth cannot remove calculus, like it can disrupt plaque. A dental hygienist with specialized instruments and training can only remove it at this point.

Besides a lack in oral hygiene, other risk factors for gingivitis include mouth breathing while sleeping, dry mouth, which many medications can cause, smoking and poor nutrition. Poor fitting dental restorations and crooked teeth can cause nooks and crannies for bacteria to hide, which can lead to gingivitis. Hormonal changes and medical conditions can also lower the body’s immunity to fight infection, including gingivitis.

Gingivitis is the earliest stage of periodontal (gum) disease. If gingivitis goes unchecked it can progress to a more severe form of gum disease called periodontitis.

What is periodontitis?

The longer bacteria go undisturbed and unremoved by brushing and cleaning in between your teeth, the more virulent or strong the bacteria gets. This can lead to more than gingivitis, which only affects your gums. In your body’s fight against this bacteria, the tissue holding in your teeth (for instance, connective tissue and bone) begins to break down. This tissue cannot grow back. If left unchecked and the infection continues, you are simply left without the supporting structures that hold your teeth in, like bone and ligaments, and your teeth may need to be extracted.

When bone, ligaments, gums and supporting structures of teeth begin to break down, this is periodontitis. When your gums and supporting structures start to break down, a pocket is created around your tooth where a toothbrush, floss or other homecare aides cannot clean as well. When your gums break down it can also cause them to recede, exposing the roots of teeth. The roots of teeth are not covered or protected by strong enamel. They are covered by cementum, which is softer, so tooth sensitivity can become a problem and the exposed roots can decay (get cavities) easier.

Like with gingivitis, dental hygienists have specialized instruments and training to remove this bacteria.

Up next: Can gum disease be reversed?

Can gingivitis and periodontitis be reversed or healed?

Gingivitis can be reversed because in this early stage of gum disease no tissue has been destroyed. Having a dental hygienist remove the bacteria and any plaque that has hardened into calculus, along with twice per day brushing and daily cleaning in between your teeth on your part, makes gingivitis reversible.

However, once tissue destruction has occurred (periodontitis) the disease can only be halted where it’s at and maintained. Once you have periodontitis, this virulent bacteria that leads to tissue destruction can repopulate quickly, so more frequent hygiene visits to remove it and very thorough oral homecare is key.

While gums and bone in your mouth don’t grow back, surgery such as bone and tissue grafting can replace gum tissue and bone. However, depending on if you are a good candidate for these procedures or if they will be successful totally depends on an individual basis.

What can I do to prevent gum disease and infection in my mouth?

Consistent and thorough oral homecare is imperative in preventing gum disease and infection in your mouth. Brushing your teeth twice per day for at least two minutes with a soft bristled toothbrush using fluoridated toothpaste and correct technique (which your dental hygienist can help you with) is a great start to disrupt and remove bacteria. Cleaning in between your teeth in whichever way works for you (string floss, floss aide, interproximal brush, water flosser, etc.) once per day is a must. Brushing alone simply cannot reach in between your teeth and gums. If you don’t clean in between your teeth and below your gums, about 35 percent of teeth surfaces are missed. Your dental hygienist and you can work together to find the best way for you to clean in between your teeth. When your dental hygienist asks you if you clean in between your teeth, they aren’t asking to give you a lecture or to nag, they honestly want to help you. So don’t lie, let them help!

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As mentioned at the beginning, there are several risk factors that can lead to gum disease. Cutting down on these risk factors (smoking, frequent snacking, poor diet, etc.) can make a big difference. Sugar, starchy, and acidic food and drinks wreak havoc on your teeth. Starches and sugar are what oral bacteria live on, which allow them to grow and multiply. If you cut these down in your diet, you can slow down or cut off oral bacteria’s food supply.

Regular dental visits to prevent disease and watch for problems before they become big problems is an important part to staying healthy. “Prevention is the best medicine,” rings true not only for your body, but for your mouth.  Don’t skip those dental appointments!

Why does it matter if my mouth has an infection?

Having a healthy mouth leads to a healthy body. You are swallowing the bacteria in your mouth all day, every day. If your mouth is infected, you are exposing your entire body to virulent bacteria. Emerging research is showing links to gum disease and other bodily diseases. Gum disease has been linked to increased risk of heart disease, including atherosclerosis (narrowing and hardening of arteries), Alzheimer’s/dementia, and lung, breast, pancreatic and oral/pharyngeal cancers. Disease and infection in your mouth also increases the risk for pneumonia, low testosterone, prostate disease, kidney disease and stroke. Even further, it increases the risk for low birth weight/preterm babies, trouble regulating blood sugar in diabetics and can increase the rate at which HIV replicates.

The list of bodily diseases infection/inflammation in your mouth can increase your risk of is already long; however, as more research emerges, the link between bodily diseases and gum disease will probably get substantially longer. Simply put, visiting your dental hygienist is more than “just a teeth cleaning.” Having a healthy mouth is imperative to overall health!