Gum Disease and Implant Care

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If you are going to build a house, you want to make sure you have solid foundations... other wise you end up with the Leaning Tower of Pisa!

 

The same applies to your mouth! Your gums are the foundation of your smile. People affected by gum disease can suffer the following problems;

- gums that are red and swollen, bleed easily

- teeth drift out of position and flare out, causing gaps / change in bite

- abscess / infection / boil between the tooth and the gum

- loose and wobbly teeth

- infection into the nerve of the tooth and require root canal treatment

- have bad breath

- need to be extracted 😭

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What is Gum Disease?

Gum disease is a disease of inflammation. Inflammation is what our immune system does in response to an insult (not saying bad things to it....an insult is the medical term for something that threatens our body or causes damage to it).

So, what are these insults we speak of? Well, the insults are toxins released by the bugs in the plaque and tartar on our teeth. Everybody gets plaque - it is the sticky slime that is constantly forming on our teeth. It is soft and white and furry. It is pretty hard to see on our teeth - using a disclosing solution like we use when we clean with the Airflow shows it up really clearly because it changes it from white and invisible to purple and visible!

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Before: invisible plaque. Disclosed: disclosing solution shows up where the plaque is hiding and stains it purple. Image credit Dr Neha Dixit

When we brush our teeth what we are cleaning off is the plaque. (If you suddenly feel the need to clean your teeth check out our videos on the best ways to clean your teeth here). Once plaque has been on our teeth for a while, the minerals in our saliva convert it to tartar. The toxins made by all the gunk and dead bugs in the tartar are even more insulting than the ones being released by the plaque! All the toxins are coming off the teeth right onto the gums, where our immune system is waiting... 

Toxins produced by plaque and tartar bac

So the toxins are being released by the plaque and tartar, insulting our immune system, now what? Well now the immune system reacts! The immune system is like the police, and the bacteria are the baddies. Unfortunately for the immune system, the naughty bacteria in the plaque are protected by the thick slime barrier, and the bacteria causing all the naughtiness in the tartar are also protected with the hard mineral barrier. The poor immune system police will never get to the baddie bacteria.

Immune System and Bacteria

And herewith-in lies the issue.  People who are susceptible to gum disease have immune systems that overreact! Their immune system tries so hard to get the bugs it actually causes damage to the gums, and even the bone! Like a tantrum that causes collateral damage! This collateral damage results in 

  1. bone loss

  2. weakens attachment of gum to tooth

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Where the gum is weak, a gap, or a pocket formsThis pocket is a deep narrow crevice between the tooth and the gum. Because of it's shape it gets more plaque and tartar trapped in it and causes the gum to get infected. If there is no treatment, the cycle continues deepening the pocket and causing more bone loss. 

Periodontal Pocket

Types of gum disease

Gingivitis and Periodontitis

Let's look at an example of Johnny and his friend Bobby.

Johnny brushes his teeth and does an OK job, his gums bleed when he brushes his teeth. He goes to the dentist for a check up and clean. Things look OK. The dentist confirms he has bleeding gums, and no pocketing. Johnny has some x-rays taken and the bone is nice and even around his teeth. Johnny has gingivitisThe dentist shows him how to floss and brush a little more effectively, and after a couple of days Johnny's gums are healthy! Yipee! Johnny can come back again in 6-12 months for another check and clean.

Bobby brushes his teeth and does an OK job as well, his gums also bleed when he brushes. He goes to the dentist for a check up and clean. The dentist confirms he has bleeding gums. Bobby is also told he has pockets where the gum has pulled away from the tooth. These pockets are 4mm, and some deeper. Bobby can see on his x-rays that the bone around the teeth with the deep pockets is shorter than the bone with the healthy gums. Bobby has reduced support to the teeth where the gum isn't attached as much and the bone is shorter; Bobby has periodontitis. He is told he'll need to come back every 3/4 months for gum treatment. Bobby is confused! He brushes his teeth just as well, if not better than Johnny! He doesn't floss either, but neither did Johnny and Johnny doesn't have gum disease! Why?! The reason is that Bobby is more susceptible to gum disease. So, for Bobby's gums to be healthy he has to put in more effort than Johnny. 

Gingivitis
Periodontitis

What this means is that people who are susceptible to gum disease have to work extra hard to care for their gums. That means meticulous cleaning with the brush and between the teeth with floss or interdental brushes. See our videos for some helpful tips!

Susceptibility Risk Factors

What makes me more susceptible to getting gum disease? ​

  • Age is the most significant factor. As we age our risk of getting gum disease increases

  • Smoking may be one of the most significant factors in the development and progression of gum disease. Smoking also reduces your potential to heal after gum treatment 

  • Genetics play a big role.

  • Systemic medical conditions that are involved with inflammation such as cardiovascular disease, uncontrolled diabetes and rheumatoid arthritis can worsen gum disease

  • Stress can make it more difficult for your body to fight infection, including gum disease

  • Clenching and Grinding can overload the support structures of your teeth and can speed up the rate of disease progression

Symptoms of Gum Disease

How will you know if you have gum disease? Well it can be almost impossible to know if you have gum disease because often it is asymptomatic - that means you experience no symptoms.

 

What are the symptoms / warning signs of gum disease?

Some signs you may have gums disease brewing are

- bleeding gums when you brush

- bad breath

- gaps developing between your teeth

- loose and wobbly teeth

Gum Disease and other Diseases

Gum disease is related to other diseases in the body?! What!!!!

Yes, it's true. If you have gum disease it it likely to make theses other inflammatory diseases in other parts of your body worse. Periodontitis is associated;

  • Heart Disease

  • Diabetes

How do you measure gum disease? What is a pocket? 

Gum disease results in a weakened attachment of the gum to the tooth. The weakened attachment results in a gap forming between the gum and the tooth. This gap is called a pocket. The deeper the gap, the more severe the gum disease. The pocket is measured with a special little ruler, called a 'probe'. 

The probe helps us feel if there is tartar under the gum.

Other ways we measure the gum health are if there is bleeding when we use the probe around the teeth, and how much gum has shrunk away from the tooth (recession), and if the teeth are wobbly at all.

Healthy Gum
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Goals of gum treatment

reducing inflammation, reducing bone loss -> keeping your teeth!

our job - thorough cleaning and support. Airflow!

your job - thorough cleaning at home, looking after yourself!

aim to get you healthy!

things you can do to help yourself (and your gums) succeed

1. Smoking. Nicotine is nasty! It drastically reduces your blood flow to your gums... less blood flow means less healing! So your good efforts with having your gum treatment are reduced with each puff!

- if quitting is not available to you right now, then reducing the number is good

- if you have tried to quit before well done! you are much more likely to quit each time you try.

- using an aid to quit can help. There's gum, patches, tablets, hypnosis and others. Consult your GP!

2. cleaning at home

- the three tools for success - electric tooth brush, floss and interdental brushes. see videos here

3. diabetes

What does the treatment involve?

If you are new to gum treatment - we may do the treatment over 2 appointments

you may have sensitivity to cold after your treatment 

All about the maintenance!

What if my gum disease is severe? 

If your gum disease is severe you may be best treated by a gum specialist, known as a Periodontist. A Periodontist has done extra training and is equipped with additional tools to manage deeper pockets.

If you'd like more information about gum disease, or you're considering LASER assisted treatment for gum treatment please visit our colleagues at Alliance Periodontics in West Perth.