What Is Gum Disease?
Gum Disease is a very common disease affecting great numbers of the population. It is the most common disease in humankind. It used to be called Pyorrhea. These days it is called periodontitis or periodontal disease. ‘Perio-’ means around, ‘-dont-’ means tooth, and ‘-itis’ means inflammation. Putting it all together you get,- ‘inflammation around tooth’ or ’disease around tooth’ and that is the literal meaning of periodontitis. A better name would be “tooth support disease”. This actually explains what is happening with the disease, – the destruction of the supporting tissues of the tooth. As the tooth support is broken down more and more, the tooth begins to get loose and eventually the tooth is lost, either because it gets very painful to bite on and is extracted, or sometimes in very severe situations it can literally fall out.
What Does Gum Disease Do?
As we have said, tooth support disease breaks down the supporting structures of the teeth. In the early and middle stages there may be very few signs that anything is wrong. Bleeding when brushing or bleeding on biting and sometimes bleeding for no apparent reason is a good indication that something is wrong. Sometimes there can be a bad taste or odour in the mouth. As the disease progresses, the teeth can become progressively more loose, they may drift apart creating spaces between the teeth, and finally they may become so loose that they are painful and need to be extracted.
Symptoms & Causes
What Causes Gum Disease?
Gum Disease has many factors involved in it, including genetic factors. There are many factors (multifactorial). We can think about this as the ingredients that are brought together to make a cake. All the ingredients are involved and are mixed in the right proportions to create the result. Gum disease is a little like this. Each person has a unique mix of these ingredients so each person has a different version of the disease although it is essentially the same tooth support problem.
So the factors or ingredients in the condition are:
- Genetic factors such size and shape of roots, size and shape of upper and lower jaws and how the upper and lower relate to each other. (some help with this relationship can be achieved with bite adjustment known as occlusal adjustment)
- Genetic factors (many unknown) that predispose a person to the disease
- Immune factors – This is where the body does not identify it own tissue and breaks it down something like rheumatoid arthritis (there may also be a genetic factor here)
- Inflammatory factors related to the buildup of a bacterial film under the gum
- Force factors that relate to the bite
- Force factors that relate to stress Bruxism (Clenching and Grinding)
Our Strategy For Dealing With Gum Disease
Improve Relationship Between The Upper And Lower Arch
While we can do nothing about the genetic size and shape of a person’s teeth, we can often improve the relationship between the upper and lower arch with what is called occlusal adjustment. This helps to distribute the force more evenly across the teeth and the tooth support systems. A very weak tooth can be made to do less work while a stronger one can be allowed to do more. We often recommend this as a first line treatment especially where there is significant looseness in the teeth. Sometimes there is a need to splint together very loose teeth in order to allow them to continue to function. This is often evaluated at the end of the other treatments.
Scaling and Root Planing
Bacteria and hard deposits of tartar grow into and underneath the gum. The gum tissue responds by creating an attempt to remove these irritants. This is called an inflammatory response. The gums may bleed when brushing or eating or sometimes for no obvious reason. People often complain of blood on the pillow in the mornings when a disease is very active. We can treat this aspect of the disease with what is called Scaling and Root Planing. This is done under Local Anaesthetic usually and involves either a non-surgical or surgical approach. Often we will use a combination of surgical and non-surgical approaches depending on the severity of the disease in a particular location. We will often do this procedure a quarter of the mouth at a visit over 4 visits. We will show you how this can be maintained over time with simple daily measures allowing you to keep this inflammatory component in check. That’s our strategy for dealing with Gum Disease.
IMPORTANT NOTICE BEFORE BOOKING AN APPOINTMENT
***Attention Non-English Speaking Patients***
If you are unable to communicate effectively in the English language, please bring someone with you who can communicate with us on your behalf when attending your dental appointment