In the US today, half of all adults over the age of 30 have some stage of gum disease. If left untreated, gum disease leads to loss of tissue and bone that support the teeth, eventually leading to tooth loss. And in large part due to the inflammation of the gums and bacterial spread, gum disease has also been linked to numerous other health issues including heart and lung diseases, diabetes, stroke, dementia, and pregnancy complications.
The good news is that gum disease is almost entirely preventable with good oral hygiene and regular dental check ups. In its early stage, it can usually be reversed simply by brushing and flossing daily and properly, and perhaps a regular cleaning at your dentist’s office. And even in moderate to advanced stages, it can often still be reversed with appropriate dental treatment.
Stages of Gum Disease
There are three stages periodontal (gum) disease: gingivitis, periodontitis, and advanced periodontitis. Gum disease is often completely painless so it is important to be aware of the signs and symptoms!
Gingivitis is the mildest form of periodontal disease. At this stage, bacteria in plaque has built up, leaving the gums irritated, inflamed, red, and sometimes prone to bleeding easily when teeth are brushed. The space between teeth and gum begin to get deeper, forming pockets. Only the gums are affected and it is highly treatable; there has been no damage to bone or other tissue yet. Starting from this stage, persistent bad breath or metallic taste in the mouth can occur. Though it is sometimes difficult to detect any of these symptoms without a dental examination, if left untreated gingivitis can progress to periodontitis.
Periodontitis is a serious gum infection that has spread to the bone supporting the teeth. Pockets between the teeth get deeper, in which debris, bacteria and plaque can accumulate and spread below the gum line. Redness, swelling and bleeding develop or worsen. In this stage of periodontal disease, some irreversible bone and tissue loss occurs, and teeth may start to feel a bit loose.
In Advanced Periodontitis, pockets deepen even more and can fill with pus. Toxins from the buildup of bacterial plaque and tartar cause further deterioration of gum tissue, bone and ligaments that support the teeth. Teeth often feel extremely sensitive to hot and cold, loose, and may even need to be removed to prevent the disease from spreading further.
Non-Surgical and Surgical Gum Disease Treatments
Though the effects of gum disease sound (and are!) quite scary, fortunately, modern dentistry provides us with many treatment options that can halt progression and even reverse the disease entirely!
Gingivitis is typically easily reversed with a professional regular dental cleaning and good daily oral hygiene (brushing and flossing), but more advanced stages of gum disease require professional dental treatment. There are several surgical and non-surgical options that your dentist can recommend according to your specific case.
Scaling and Root Planing is typically the first step to treating periodontitis. It is a non-surgical process, known colloquially as a dental “deep cleaning.” Scaling removes plaque, tartar and bacterial toxins on your teeth both above and below the gum line. Root planing smooths the tooth root surfaces, making it more difficult for bacteria to adhere and easier for the gums to reattach to the teeth and heal. After a few weeks, your dentist will evaluate how well your gums have healed and determine whether or not further treatment is necessary. In most periodontitis cases, scaling and root planing coupled with continuous good oral hygiene reverses the disease entirely!
Surgical Treatments are necessary when scaling and root planing alone is not sufficient in healing this disease, usually in cases of advanced periodontitis. When scaling and root planing is done first, the amount of surgery required usually decreases. Surgical options can include: pocket reduction or flap surgery, gum or bone grafts, and regenerative therapy.