The Periodontic Unit, Department of Restorative Dentistry at National Dental Centre Singapore describes how gum disease develops.
If warning signs of gum disease go unheeded, it may become too late to save the teeth
END-STAGE GUM DISEASE is a sad state of affairs. Even a skilled dentist will usually shake his head in despair, as perfectly healthy teeth, already shaky, cannot be saved.
But this does not happen overnight. Gum disease (also known as periodontal disease) proceeds in stages. There is usually time to nip it in the bud.
Healthy gums are pink, firm and nicely structured. But bad dental habits, like brushing teeth incorrectly or not brushing at all, can make oral bacteria called plaque accumulate and result in gingivitis.
“Gingivitis is the earliest and mildest form of gum disease,” said
Dr Lee Wan Zhen, Associate Consultant,
Periodontic Unit, Department of Restorative Dentistry,
National Dental Centre Singapore (NDCS), a member of the
“You might not know this, but within two hours of tooth brushing, plaque will build up; if teeth are not brushed for just a day, the accumulated plaque can result in the development of gingivitis. A study found that more than 80 per cent of the population has gingivitis but most of them are unaware they have it,” said Dr Lee.
In time, the plaque spreads below the gum line and produces toxins that irritate gums and cause chronic inflammation.
Gum disease is usually painless, but there are warning signs. The gums get slightly swollen and bleed easily during tooth brushing, with or without accompanying pain. There is also bad breath for no apparent reason and, for some patients, a taste of blood in the mouth in the morning. Untreated gingivitis may lead to periodontitis. The main difference between them is the accompanying attachment loss around the teeth in periodontitis, as the gum fibres and bone that support the teeth are broken down and destroyed.
As the disease progresses, teeth may move out of alignment. The gums start to separate from the teeth, forming gum pockets. Spaces between teeth may become more obvious. Gum pockets deepen, as more gum tissue and bone are destroyed. Other signs are gum abscesses (or pus), receding gums, shaky teeth and a dull ache in the gums and teeth.
Although bad dental habits are mostly to blame, other risk factors include smoking, raised sugar levels in poorly-controlled diabetes, genetics, and hormonal imbalances during pregnancy and puberty. Giving up smoking and controlling one’s sugar levels will help in managing the condition.
“Dentists strongly encourage patients to brush at least twice a day and to seek treatment early if any tell-tale signs are detected. Timely diagnosis and treatment of the disease in its earliest stages have the best success rates,” said Dr Lee. The inflammation resolves and everything returns back to the way it was after treatment.
Read on to find out more about the different stages of gum disease