Managing bacteria in your mouth
Our mouths are full of bacteria which constantly forms a sticky, colourless “plaque” on teeth and around the gum line. Brushing and flossing correctly help get rid of plaque. Any plaque that is not removed usually hardens and forms “tartar” which will require a professional clean by a dentist or hygienist for its removal, as brushing alone does not remove tartar.
When bacteria in the mouth is not “managed” and plaque and tartar are left untreated, inflammation of the gums occurs and this is called gingivitis. Gingivitis is a mild form of gum disease, characterised by red, swollen and bleeding gums. Often, there is little or no discomfort at this stage. The good news is that gingivitis can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or hygienist.
If gingivitis is left untreated, it can advance to periodontitis. In periodontitis gums pull away from the teeth and form spaces (called pockets) and these then become infected. If this is not treated, the bones, gums and tissue that support the teeth start to break down until eventually the teeth become loose or have to be removed.
Symptoms of gum disease:
- Red or swollen gums
- Bleeding gums when you brush your teeth
- Bad breath or a bad taste in your mouth
- Sensitive teeth
- Painful chewing
- Receding gums or teeth that appear to be longer
- Loose teeth or teeth that have moved
Risk factors associated with gum disease:
- Smoking. Probably the most significant risk factor of all.
- Pregnancy and hormonal changes in girls/women. Hormonal changes make gums more sensitive and vulnerable to gum disease.
- Diabetes. Diabetes in general increases your risk of developing infections, including gum disease.
- Medical conditions affecting the immune system. Diseases such as cancer and AIDS negatively affect the health of gums.
- Medications that reduce the flow of saliva. Many medications (prescription and over-the-counter) can reduce the flow of saliva, which has a protective effect in the mouth. Without enough saliva neutralising the acids in the mouth, the environment becomes more susceptible to gum disease.
- Genetic predisposition. Some people are more susceptible than others.
How does the dentist or hygienist check for gum disease?
- They will ask about your medical history to identify any of the above risk factors.
- Examine your gums and note any signs of inflammation.
- Perform a (painless) test using a probe to measure any ‘pockets’ (where the gum has pulled away from the teeth).
- They may take an xray to see whether there is any bone loss.
- They may refer you to a periodontist if your condition needs more advanced care.
Treatment of gum disease
- The main goal of preventive dentistry is to control any infection and stop the progression of the disease.
- The dentist, periodontist or hygienist removes the plaque using a deep-cleaning technique called scaling and root planning. A number of appointments may be necessary to reduce the bacteria in your mouth to acceptable levels.
- Many people do not understand that the most valuable treatment we can do for you is to inform you of what is happening, why it is happening and what you can do about it. This particularly applies to two conditions – gum recession and toothbrush abrasion. These conditions are amazingly common and people are unaware it is largely self-inflicted (i.e. brushing too hard in certain places). If you are right-handed, you would usually have a good “forehand” and typically have more abrasion and recession on your left hand side, usually on the outside surfaces that are easy to get to. We are particularly careful to point out to people what is happening and try and train you out of doing it, but change is difficult. It is like changing your golf swing – just about impossible!