Regional Dental Surgeon, Kandy and President of the Sri Lanka Dental Association (Kandy Branch) Dr.Uditha Pradeepa Herath speaks to T n'C about a commonly found dental disease - gum disease.
Q : What is Gum (Periodontal) Disease ?
A - Gum disease is a very common condition where the gums become red, swollen, sore and infected. In Sri Lanka more than 90 percent of adults have gum disease to some degree and most people experience it at least once.
Gum or periodontal diseases can be divided into two groups according to the extent of the disease. If the disease is only in the superficial parts of the gum, not extending to the deeper parts of the gum tissues, it is called gingivitis which is reversible state whereas if the disease is extended to deeper tissues causing damage to the attachment of the gum tissue and tooth, it is periodontal disease which is an irreversible state.
Initial symptoms of the gum disease are redness, swelling and bleeding of the gum, usually healthy gum doesn't bleed during brushing. When the disease spreads further pain, pus discharging, bad breath, mobility of teeth and discomfort of biting will be experienced.
Main cause of gum disease is dental plaque which is a bio-film. Dental plaque formation is a constant process. It can be deposited and grown on teeth and gum. When the plaque is not controlled it damages the periodontal tissues by bacterial by products released by the plaque bacteria.
Diagnosis is mainly clinical. The initial sign of gum disease is bleeding especially during brushing. During examination of gum tissues red and swollen gums are noticeable.
Texture of the gum (orange peel appearance of normal gum) is changed. In advanced disease pus discharge, root exposure, sensitivity, pain and mobility of teeth followed by drifting and spacing between teeth are marked signs. At this stage patients complain of impaired functions of thtse teeth, inability to bite, pain on biting, swelling or abscess formation.
Q : What is the link between Gum disease and heart attacks, strokes etc?
A - There are now several studies that seem to indicate that there are associations between cardiovascular disease and periodontal disease. Patients with periodontal disease have an increased risk of developing coronary heart disease relative to those without it. There are good evidences to indicate that relationship between gum diseases and atherosclerosis, in the presence of periodontal lesions there could be exacerbation of atherosclerosis leading to coronary artery disease.
Some studies have shown that periodontal disease is an independent risk factor for strokes. It has been shown that people with uncontrolled diabetes get periodontal problems more often and more severely and they loose more teeth than do person with good control of diabetes.
Q : What are the treatments available for Gum disease ?
A -
(A) Maintenance of good oral hygiene is the best way to prevent gum disease.
Brushing your teeth is one of the easiest ways of maintaining good oral hygiene.
It is very important to select a correct brush, bristle of the brush preferably be flexible or soft, not the medium or hard bristled brushes. When the bristles are bent or distorted you should discard the brush.
Frequency of brushing is twice a day with lighter forces reaching each and every corner of teeth and gums with a fluoridated tooth paste.
(B) If you have bleeding gums it may be a sign of gum disease. It is advisable to consult your dentist soon. He will examine you and advise you the correct way of brushing, and if there are deposits cleaning and polishing your teeth will be done.
(C) If the disease has spread to the deeper tissues, it is necessary to intervene surgically.
But plaque control is very important in all these instances. It can be done either manually or chemically.
Manual plaque control methods are brushing and flossing.Chemical plaque control methods are mouth washes, gel and systemic antibiotics.
Q: How can we prevent these complications?
A - Maintaining good oral hygiene is the best way to prevent gum disease. Gum disease is caused by plaque. Controlling plaque building up will control gum diseases.
It is important to have regular dental check ups so that any problems with your teeth and gums can be detected and treated early. If you never had gum disease and have good oral health, you may only need to visit your dentist every one or two years for check ups.
It is necessary to visit your dentist more frequently if you have had problems with the gum disease in the past. At each visit your dentist will advice when you need your next appointment. If you are in the category of increased risk of developing gum disease -for example, if you smoke or have diabetes, you are required to visit your dentist more often so your teeth and gums need very close monitoring.
Risk Factors for gum diseases
1. Plaque retaining factors (deposits, stains, bad fillings)
2.Mal aligned teeth (crooked teeth)
3.Faulty restorations, crowns, bridges
4.Appliances (denture, some Orthodontic appliances )
5. Medical problems (diabetes, leukemia, HIV/AIDS)
6. Hormonal changes in the body (pregnancy)
7. Smoking, betel chewing
Pregnancy and gum disease
Pregnancy causes hormonal changes that increase risk of developing gum diseases.
Varying hormone levels in the body, increased levels of progesterone in pregnancy may make it easier for certain gingivitis causing bacteria to grow, and also make gum tissues more sensitive to plaque and exaggerate the body response to the toxins that release by the plaque. If you are already having gum diseases, being pregnant make it worse.
Therefore if you are planning for a pregnancy maintain your oral hygiene well in advance.
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