As you eat, food particles become lodged in every crevice of your mouth. If left untouched, these food particles will provide the perfect breeding ground for bacteria. The bacteria then eat away at the food particles, your teeth, and your gums. As the bacteria builds, it collects in a slimy, colorless film on the teeth called plaque. In its early stage, plaque is easy to get rid of. If not removed, however, it will calcify into hardened tartar that must be removed by professional dental equipment.
When the bacteria eat holes in the teeth, it’s considered a cavity. When the bacteria eat away at the gum line causing receding gums, this is considered gum disease. To learn more about gum disease, how to spot it, and how to treat it, read ahead.
Gingivitis and Periodontitis: The Culprits
The two types of gum disease are gingivitis and periodontitis. Both are caused by the buildup of bacteria along the gum lines and insufficient oral care. Gingivitis is the precursor to periodontitis, and left untreated, will progress to halitosis, the loss of teeth, and more.
The stages of gum disease are as follows:
- Stage 1: Gingivitis – The beginning stage of gum disease involves the buildup of plaque. When brushing and flossing aren’t enough to rid the bacteria from building up, the plaque hardens and begins to produce toxins. These toxins irritate the gums, causing bleeding when brushing or flossing. Because the gum disease is in its early stage, it hasn’t progressed to the underlying root structure beneath the gums.
- Stage 2: Halitosis – Once the bacteria and plaque have built up, you might notice the smell of your breath is getting worse. Halitosis is this next stage and is another sign that the gum disease is progressing.
- Stage 3: Bone loss – Once bacteria causes receding gums, gum pockets are formed. These pockets deepen until the bacteria reaches the jawbone holding the teeth in place. Once you start experiencing bone loss, it’s not long before you have periodontal disease.
- Stage 4: Periodontitis – Once the plaque grows beneath the gums and the bacteria degrades the bones and fibers supporting the teeth, this is known as periodontitis. This type of damage is irreversible, and once it occurs, the only solution is to prevent the gum disease from worsening. Professional care, including surgery, might be necessary to regain proper stability of the teeth.
- Stage 5: Advanced Periodontitis – At this stage, the gum disease has progressed to the root structure of the teeth and has caused the teeth to shake and come loose. Surgery is typically the only solution to stage 5 gum disease, and it may result in the loss of teeth.
Causes of Gum Disease
The next question now is: What is gum disease caused by? You might think it’s strictly whether or not you say “no” to that dreaded question at the dentist—are you flossing regularly—but gum diseases have been linked to everything from genetics and hormones to oral hygiene and diet.
Here is a full list of gum disease causes:
- Tobacco Products – Cigarettes and chewing tobacco have long been known to produce many adverse health effects. However, the consequences of oral health—teeth discoloration, gum disease, and hairy tongue—are particularly damaging. Not only does it increase the risk of periodontal disease, but tobacco also negatively affects the treatment’s success rate.1
- Plaque Buildup – This is the primary cause of gum disease and can be mitigated by proper oral care (discussed below).
- Hormonal Shifts – A change in hormones will have various effects throughout the body, including within your mouth. Women who are experiencing pregnancy, menopause, or monthly menstrual cycles are prone to developing periodontal disease while the hormone levels rise and fall. During this time, be sure to take extra care of your teeth and gums to ensure maximum protection.
- Diet and Nutritional Deficiency – Your mouth is full of bones, nerve endings, veins, blood, muscles, and a healthy dose of enzymes. To ensure all these different parts have the energy they need to work optimally, you need to eat a nutrient-rich diet. Try to include vitamin-C rich foods for healthy gums and stay hydrated to keep your mouth moist and full of healthy enzymes.
- Genetics – Unfortunately for some people, despite all their efforts to ensure proper oral care, they still develop gum disease. This could be due to genetics. It should be noted that having a genetic predisposition to gum disease does not guarantee it will develop—the bacterial infection is still needed.
- Dry Mouth – The saliva coating your mouth contains enzymes that not only help to break down food prior to entering the digestive tract, but they also help sterilize your mouth and rid your teeth of harmful bacteria. It’s why people have stinky breath when they wake up. Less saliva is produced while you sleep, and the dry environment allows bacteria to proliferate.
- Prescription medication – One common side effect of prescription medication is dry mouth. If you take medications before bed, try rinsing your mouth with water just before falling asleep and keeping a glass of water next to your bed for the morning.
- Crooked Teeth – With crooked teeth, it’s harder to get the bristles of the toothbrush or floss between all the crevices. This creates a breeding ground for bacteria and gum disease. If traditional floss is ineffective, try a water flosser to clean hard to reach areas.
Symptoms and Telltale Signs of Gum Disease
Because gum disease progresses through five stages, there are a number of symptoms along the way. Be on the lookout for these signs of periodontitis:
- Swollen gums – Red gums that bleed easily (especially after flossing) are a sign that your gums are experiencing some level of inflammation and gum disease. Much like how your finger will bleed when a splinter is pulled out, the gums bleed when bacteria, plaque, or food particles are removed. Some bleeding is normal and is to be expected. A lot of blood, however, is an indication that the disease has progressed.
- Sensitive teeth – Dentin is the layer of the tooth between the enamel and the nerve endings. When it is exposed, due to bacteria eating away at the gums and causing gum recession, the nerve endings also become exposed. If drinking cold water or eating ice cream comes with an intense or painful sensation in your teeth, chances are, it’s because of the exposed dentin.
- Constant bad breath – Nobody can escape the inevitable morning breath. It comes from a buildup of bacteria in our mouths while we sleep. But if people are offering you gum three times a day, it might be time to check in on your gums. Excessive dental plaque and the buildup of bacteria can cause constant bad breath.
Apart from these, there are other subtle signs of having gum disease. Because the bacteria eat away at different parts of the gums and teeth slowly, you might not notice them until it’s too late. Think of these like watching your hair grow. You know it happens every day but noticing the difference day-by-day is impossible.
- Gums look smaller or teeth look bigger – If you have a self-conscious thought that your teeth are looking bigger or that your gums are smaller, you might have just caught gum disease in action. Receding gum lines are an indication that something is wrong with your oral hygiene.
- Loose or shifting teeth – Most of us had to suffer through a period of time with metal attached to our teeth. Braces align our smiles so the teeth can grow optimally, allowing us the best chance at good oral hygiene and a beautiful smile. Although, if you’ve noticed your teeth feeling looser or have seen a shift in your teeth, it might be your oral care to blame. Gum disease often targets the roots of teeth, making them subject to weaken and shift over time.
When it comes to treating gum disease, there are surgical and non-surgical interventions. Of course, whenever possible, non-surgical intervention should always be prioritized. The following are all non-surgical treatments for gum disease:
- Root scaling – When plaque and tartar form above and beneath the gum line, it must be scraped away. With local anesthetic to numb the gums, the dentist will peel back the gum line and clean off the teeth. This is usually combined with root planing.
- Root planing – Root planing is when the dentist smoothens rough patches on the teeth. Doing so allows the gums to reattach to the teeth more easily.
- Professional cleaning – By having a professional oral hygienist clean your teeth and remove all built-up plaque and tartar from the surface, you can sufficiently stave off most forms of periodontal disease.
If the gum tissue is too unhealthy to be repaired, the next option is to undergo surgery. However, there are many different types of surgery corresponding to the types of gum disease.
- Soft tissue graft – In places where the gums have receded too far, soft tissue from the top of the mouth can be grafted and stitched into place. By adding soft tissue to the affected area, the size of the gum pocket reduces or are eliminated entirely.
- Bone graft – Part of gum disease is the degradation of the root structure that stabilizes the teeth. When too much bone has been destroyed, bone grafts taken from your bones or synthetic bones can be used to repair the root structure.
- Pocket reduction surgery – Otherwise known as “flap surgery,” this type of surgery involves lifting the gums back like a flap and removing all signs of gum disease, including plaque, tartar, and uneven surfaces that can house bacteria.
- Bone surgery – Often following pocket reduction surgery, each tooth is inspected for shallow craters. The teeth are then reshaped to make it harder for bacteria to grow.
- Guided tissue regeneration and restoration – When the bones supporting your teeth degrade, the gums will sometimes fill in where the deterioration is happening. This prevents the bone from regenerating. By placing a mesh fabric between the bone and gums, the bone and connective tissue can regrow to reinforce the teeth.
Medication for Gum Disease
There are instances where medication can be provided as a supplement to surgery or as a standalone treatment for gum disease. The function of these medications is to fight against the buildup of plaque by eliminating the bacteria that allow for plaque to arise.
- Antibiotics – Minocycline, doxycycline, and tetracycline are all antibiotics that have been known to treat different forms of gum disease. These are typically given over a period of one month to help fight against the bacteria in the mouth. From there, proper care is needed to sustain long-term oral health.
- Chlorhexidine – This is a prescription-only chemical found in mouthwashes (or in some cases as a slow-release gel), that is used to rinse out the mouth. This helps control and reduce plaque, gingivitis, and periodontal pockets.
Preventing Gum Disease
Once you know what gum disease is, you also understand how to prevent it. Because receding gum lines are irreversible, the best way to fight against gum disease is to prevent the proliferation of bacteria and the buildup of dental plaque. To do this, you need to use proper hygiene techniques and equipment.
Proper Oral Healthcare
Most people believe that brushing your teeth twice a day is enough to prevent gum disease. But brushing only takes care of the outer surfaces of the teeth. That’s why, for proper oral healthcare, you need to do all the following:
- Brushing – Brushing removes most of the bacteria and food particles from your teeth.
- Flossing – Flossing removes the bacteria collecting in hard to reach crevices between teeth.
- Massaging – Massaging the gums stimulates blood flow and breaks up biofilms developing on the gums.
These can be greatly improved with the use of oral hygiene tools made to fight bacteria and gum disease.
- Mouthwash – Swishing mouthwash for 30-60 seconds will allow for anti-bacterial liquid to kill bacteria along the tongue, cheek, and any other hard to clean areas of the mouth.
- Water-powered flossers – By using a gentle stream of water to clear teeth and gums of food particles, you’re able to effectively floss your teeth and massage your gums without having to deal with string floss.
Is Gum Disease Common?
According to the National Health and Nutrition Examination Survey, more than 8% of adults ages 20 to 64 are afflicted by periodontal disease.2 On top of that, 5% suffer from advanced periodontal disease. Knowing both what is gum disease and how to prevent it will help you to avoid being included in these statistics.
If you want to prevent gum disease, consider using tooth flossers and water picks to eliminate food particles and bacteria in hard to reach areas. If you don’t want to make a mess in your bathroom, consider ToothShower, a water flosser that lives in your shower.
1) NCBI. Smoking and Periodontal Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633395/
2) NIDCR. Periodontal Disease in Adults (Age 20 to 64). https://www.nidcr.nih.gov/research/data-statistics/periodontal-disease/adults