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Gum Disease

What is gum disease?

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Gum Disease explained

Dr. Sarah explains everything you need to know
about gum disease related services at the dentist

Along with tooth decay, gum disease is one of the leading causes of tooth loss in the world.  The trouble is, this silent and slow-developing chronic disease often goes unnoticed and undiagnosed until it causes irreversible, sometimes painful damage to the bone and overall health of the mouth.  Gum disease contributes not only to the slow decline of the function in the person’s chewing ability – but it can also cause potent bad breath, the type that can clear a room, infection and pain, bleeding gums and impact severely on one’s self-esteem and confidence in social situations.  

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Understanding your condition is the key to making the right choices for you


The cost of treating gum disease is extremely difficult to answer.  There are many factors that will contribute to the cost of returning the gums to a healthy and manageable state. 

These will include;

  • Which dental professional will be performing the treatment ie: Dentist, periodontal specialist or a hygienist or oral health therapist. 
  • The extent and damage caused by the gum disease
  • Time in the chair needed to complete each session of treatment
  • The number of appointments needed
  • Location of the practice
  • Business overheads

As a rough guide, a straightforward routine hygiene appointment will cost between $79 – $180.  The cost to treat stage four gum disease with a periodontist could be up to $2000, in severe cases – not including ongoing care to ensure the disease does not return.  In short, gum disease treatment can become very expensive.  The best news is that it is completely preventable with a simple home care regime and six-monthly visits to the dentist for teeth cleaning.  

In almost all cases, if gum disease is diagnosed and treated before too much bone loss from around the teeth has occurred, there is no reason a person can’t keep their teeth if they have gum disease.  However, if the gum disease is not treated and continues to worsen over time, a person may eventually lose teeth in response to the damage caused by the condition.

Since the gum disease infection is both above and below the gum line, a dentist or dental professional must manually remove the build-up of bacteria that has cemented itself to the side of the teeth.  To do this, they use a combination of tools and equipment designed specifically to be tough enough to remove the hardened bacteria without causing damage to the surrounding gum and tooth structure underneath.  Various handheld instruments and an ultrasonic water scaler are the two most common tools used during deep teeth cleaning appointment, however, with the advancements in dental equipment powerful air abrasion tools are now also being added to the process of treating gum disease for a more effective and comfortable service.  

Active gum disease does make the gums inflamed, tender and sensitive to touch.  This can make treatment of the disease unpleasant without numbing the area.  A dental professional treating gum disease will usually offer anesthetic in the form of a gel that suspends inside the pocket surrounding the tooth that will numb the gum area for a short time while they work, or for more advanced treatments, a local anesthetic can be administered providing complete numbing of the entire area so you don’t feel a thing. 

Depending on which stage of gum disease you have reached, and your level of tolerance and sensitivity to discomfort in the mouth will determine how things feel post gum disease treatment.  For most people, no pain relief is required following deep teeth cleaning.  Just a day’s rest and a soft diet, while the gums settle, is usually all that is needed.  For more advanced gum disease cases, taking paracetamol before the numbness wears off might be recommended by the dentist just to take the edge off any lingering discomfort.  Within a few days, you should find you’re feeling better than ever and your mouth has returned to a healthy state.

Gum disease can be easily prevented by brushing twice a day with a manual or electric toothbrush and regular fluoride toothpaste and flossing at least once a day.  This regular and manual removal of soft plaque, food debris and minerals in the saliva will prevent the heavy build-up of the hardened bacteria which causes gum disease.  However, a good homecare routine is often not enough.  To ensure gum disease does not occur, it is advised to visit the dentist every six months for a professional teeth cleaning and oral hygiene instructions to identify any areas you may be missing.  If you follow these two recommendations you will have the best chance of preventing gum disease in your mouth.

In short, no.  The treatment of gum disease requires the manual removal of the hardened bacteria and tartar that has cemented itself to the side of the tooth, both above and below the gum line.  If you attempt to remove this yourself at home you may cause significant damage to the gum tissue or the protective layer of the tooth leading to further problems down the track.  If you have been diagnosed with having any stage of gum disease it is strongly advised you have this treated by a dental professional as soon as possible and avoid DIY treatment advice from well meaning friends or those on YouTube! 

Unfortunately, advancements in dental have not led us to a point where you can purchase products that will cure your gum disease.  The only way to rid your mouth of this bone destroying condition is manual removal of the hardened bacteria buried deep below the gumline where you can’t see or access it yourself and support from a dental expert to help you better care for your teeth and gums between dental visits.  

As minty fresh and feel good as mouthwash is, sadly most will not do a great job of preventing or curing gum disease.  Mouthwash is designed to kill certain types of bacteria and reduce the risk of gum disease and cavities yes however, its fighting properties only last a short time before the bacteria gains its strength back and begins to attack the teeth and gums once more.  One side effect you may notice if you do choose to use mouthwash several times a day in an effort to decrease your risks is an unsightly stain on the surfaces of the teeth, and nobody wants that!  This is one reason you will never really have long term protection from gum disease from using mouthwash once or twice a day.  

That said, there are medicated mouthwash products that can be prescribed by a dental professional, GP or purchased over the counter at your local pharmacy that have the strength to help fight the growth of the bacteria and slow down the disease process.  However, if you choose to only use mouthwash as your gum disease prevention plan and not include regular visits to the dentist and other home care practices, you will most likely still develop gum disease to some degree overtime.

Yes!  Those with parents who have a history of gum disease are said to be at higher risk of developing the condition themselves throughout life.  The same bacteria that causes gum disease, and even tooth decay, can be passed on through genetics making a patient whose parents have suffered from gum disease more likely to be diagnosed with the same disease if they do not follow a strict hygiene care plan.  However, family genetics are not always to blame.  

One of the main avenues of transfer of the bacteria which causes gum disease is through saliva.  Parents will often share spoons when feeding their babies and toddlers, suck on a child’s pacifier before putting it in their mouth to ‘clean it’, or even by giving them a sweet goodnight kiss on the lips.  If the parent has active periodontal disease and a mouth overpowered by the strain of bacteria that causes gum disease, the bacteria will enter a child’s mouth and become part of their flora for the rest of their life thereby increasing their risk of developing gum disease. 

Gum Disease

Gum disease is caused by a build-up of hardened bacteria and minerals excreted from the saliva.  The gum disease process can be sped up by a diet high in sugar, acid, and carbohydrates, smoking, alcohol, medical conditions and medications, and most commonly poor oral health care practices. 

Gum disease progresses through four stages from mild to severe.  This does not include healthy gums, being the ideal stage for everyone.  A patient is deemed from moving from healthy gums to having gum disease when they begin to show signs of inflammation of the gums tissue.  This is the first stage of gum disease known as gingivitis.  

The Four Stages of Gum Disease.

  1. Gingivitis
  2. Slight periodontal disease
  3. Moderate periodontal disease
  4. Severe or advanced periodontal disease

Stage 1: Gingivitis gum disease.

The first sign your gums are not in a healthy state is usually the sight of blood in the sink when you rinse after brushing and flossing.  However, bleeding gums may not always occur even if you do have gingivitis as in the case of heavy smokers or those on medication designed to reduce blood flow.  This can make self-diagnosis and an awareness that things are not quite right difficult for some people.  Gingivitis occurs when a build-up of hardened bacteria and continual soft plaque surrounds the necks of the teeth for too long, irritating the soft gum tissue and causing inflammation, redness, and bleeding, as mentioned.  

The most fortunate thing about this stage of gum disease is that it is completely reversible.  With a visit to the dentist for thorough professional teeth cleaning, and the right tools and techniques being used daily at home, a patient can easily return their gums to a perfectly healthy state in no time.  And since there has been no damage to the boney foundations that keep a tooth standing strong and permanently fixed in place, a patient can feel confident they will continue to keep their teeth for life, if they continue with maintaining proper daily oral hygiene care and six-monthly dental visits for teeth cleaning.  

Stage 2: Slight periodontal (gum) disease.

If you fail to treat the early signs of gum disease, gingivitis, your gums will continue to become more irritated and inflamed, however, this is not the most concerning part of stage two gum disease.  To be diagnosed as having slight periodontal gum disease means you have started to lose bone from around the teeth themselves.  This bone supports and holds your teeth in place and is vital to maintain if you wish to keep your teeth for life.  Unfortunately what is now happening is this bone has started to deteriorate, from the constant attack of hardened bacteria and plaque trapped in the natural pockets surrounding each tooth, and has become a chronic condition your body is now forced to fight on a daily basis.  In a healthy mouth, the natural pocket depth that surrounds each tooth is 1-2mm.  If you are diagnosed with stage two periodontal gum disease this means this pocket depth has increased to measure between 4-6mm.  

To treat stage two gum disease you will need more thorough and deeper professional teeth cleaning with a dental professional trained in treating chronic gum disease.  Over one or two appointments they will remove the trapped bacteria and hardened debris effectively which has attached itself to the side of your tooth and become wedged deep inside the gum pocket.  Home care and DIY remedies will not cure this condition – only manual removal by a dental expert will halt any further progression of the gum disease process and give you the best chance of keeping your teeth.

Stage 3: Moderate periodontal (gum) disease.

If no intervention or treatment takes place, the gum disease process will continue to worsen, albeit slowly over time often making it a silent condition that usually goes completely unnoticed to the person.  

Signs that your gum disease has progressed into stage three may include; 

  • Gums bleed easily when touched, brushed, or eating hard foods
  • The color of the gums are red (not pink) and are puffy and inflamed 
  • Your breath smells like rotten eggs – often not obvious to you yourself, yet those around you will show signs of smelling a bad odor when you talk
  • There is a heavy build-up of creamy colored, hardened tartar around the necks of the teeth that can not be removed by a toothbrush
  • You get a bad taste in your mouth

If you have reached stage three gum disease you have now lost between 20% – 50% of the bone that surrounds the teeth.  Not all teeth will be affected to the same degree, however, the gum disease process has now taken over the mouth and will continue to spread and infect opposing teeth over time.  To treat this level of gum disease will require a longer and more costly commitment to remove the infection and cure the symptoms.  To maintain stability and prevent the disease from returning, a vigilant daily home care routine is imperative along with 3 – 4 monthly dental visits for review of the health of the gum and professional teeth cleaning to remove any bacteria that has built up early, before it has a chance to take hold once more.  

Stage 4: Severe periodontal (gum) disease.

Stage four is the final stage of gum disease and of course is the most damaging.  At this late stage, which usually takes many years of neglect and poor oral health to develop into, a patient may start to notice mobile or loose teeth.  This is due to 50% – 85% of the bone is lost over time during the gum disease process.  Much like the symptoms outlined in stage three, a person will have bleeding, red and inflamed gums, bad breath, and often a heavy build-up of creamy bacteria that’s cemented itself to the teeth both above and below the gumline. 

A referral for extensive treatment by a periodontal specialist is most often required to treat this advanced stage of gum disease.  In extreme and severe cases, a patient may be forced to have teeth removed to help the body heal in an attempt to return the mouth to a healthy and more manageable state.

It is important to note that when the bone is lost from around the teeth such as in stage two to four gum disease, this bone can never grow back or be replaced without the intervention of surgery to graft more bone and gum into the area.  This is an expensive and time-consuming process and one that can be easily avoided with simple, yet consistent oral hygiene care rituals.

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