GUM disease can begin with something that many people dismiss as harmless: a little blood on the toothbrush or in the sink.
Bleeding gums can be an early warning sign of inflammation caused by plaque, and ignoring the problem can allow it to progress and eventually threaten the teeth.
Also known as periodontal disease, gum disease is an infection and inflammation affecting the tissues that surround and support the teeth. It ranges from an early, reversible stage called gingivitis to more advanced periodontal disease, which can cause permanent damage.
Dental plaque is a sticky film of bacteria that continually forms on teeth. When plaque is not adequately removed by brushing and cleaning between the teeth, it can irritate the gums.
The gums may become red, swollen and tender and may bleed during brushing or flossing. This early stage is generally known as gingivitis.
Gingivitis can often be controlled by improving oral hygiene and receiving appropriate professional dental care. But if plaque remains for a prolonged period, it can harden into tartar, also called calculus. Tartar cannot be effectively removed through ordinary brushing alone.
As inflammation progresses, the tissues supporting the teeth can become damaged.
Advanced periodontal disease can cause gums to pull away from the teeth, creating pockets where bacteria can accumulate. Continued inflammation can damage the bone and other structures supporting the teeth.
As the supporting tissues deteriorate, teeth may become loose. In severe cases, tooth loss can occur.
Unlike a cavity, gum disease may not always cause obvious pain in its early stages. This makes regular dental examinations particularly important.
Warning signs include persistent bad breath, red or swollen gums, bleeding during brushing, receding gums, changes in the way teeth fit together and loose or shifting teeth.
Who is at risk? Poor oral hygiene is an important risk factor, but gum disease is influenced by several factors.
Smoking and tobacco use can significantly increase the risk and can also make gum disease more difficult to treat. Diabetes is another important risk factor, particularly when blood glucose is poorly controlled.
Age, genetics, hormonal changes, certain medications and other health conditions can also affect gum health.
Prevention starts with daily plaque control. Brushing twice a day with fluoride toothpaste and cleaning between the teeth can help keep plaque under control.
Floss, interdental brushes or other cleaning devices may be useful depending on the spaces between the teeth and an individual’s dental needs.
Regular dental visits are also important. A dentist or dental hygienist can identify early gum problems and remove tartar that cannot be eliminated at home.
People should not stop cleaning their teeth simply because their gums bleed. Persistent bleeding should instead prompt a dental assessment to determine the cause.
Gum disease is primarily an oral health condition, but its importance extends beyond the mouth. Research has found associations between periodontal disease and several systemic health conditions. However, an association does not necessarily prove that gum disease directly causes those diseases, and researchers continue to study the relationships.
The most important message is straightforward: healthy gums are essential for keeping natural teeth.
Bleeding, swelling or persistent bad breath should not simply be accepted as normal. Early attention can help prevent inflammation from progressing to irreversible damage.
With consistent home care, professional dental treatment when necessary and attention to risk factors such as tobacco use, gum disease can often be prevented, controlled or treated before it results in tooth loss.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
