WHAT MAY begin as occasional bleeding during brushing can develop into a serious condition that damages the tissues and bone supporting the teeth.
Severe gum disease, commonly associated with advanced periodontitis, can eventually cause loose teeth and tooth loss if it is not treated.
Gum disease begins with plaque, a sticky film containing bacteria that constantly forms on teeth. When plaque is not adequately removed, it can trigger inflammation of the gums, known as gingivitis. At this early stage, the condition can often be controlled with improved oral hygiene and professional dental care.
The problem becomes more serious when inflammation extends into the tissues supporting the teeth.
As periodontal disease progresses, the gums can pull away from the teeth, creating spaces known as periodontal pockets. These pockets can trap bacteria and make thorough cleaning more difficult.
Persistent inflammation can damage the ligaments and bone that hold teeth in place. As supporting bone is lost, teeth may become loose, shift position or change the way they meet when a person bites. In advanced cases, tooth loss may occur.
Severe gum disease does not always produce intense pain. This is one reason people may delay seeking treatment. Warning signs can include persistent gum bleeding, swollen or tender gums, receding gums, persistent bad breath, pus around the gums, loose teeth and changes in the fit of dentures or the bite.
Who is at greater risk? Poor plaque control is a major risk factor, but several other factors can influence the development and progression of periodontal disease.
Tobacco use significantly increases the risk of gum disease and can interfere with treatment and healing. Diabetes is another important risk factor, particularly when blood glucose is not well controlled.
Genetic susceptibility, certain medications, hormonal changes and some medical conditions can also affect gum health.
Age can increase the likelihood of having accumulated periodontal damage, although severe gum disease is not an inevitable part of getting older.
Treatment for severe gum disease depends on its extent and the condition of the teeth and supporting structures.
A dentist or periodontist may perform a detailed examination, measure periodontal pockets and use dental X-rays to evaluate bone loss.
Treatment may begin with professional removal of plaque and tartar from above and below the gumline, commonly through procedures known as scaling and root planing. More advanced cases may require periodontal surgery or other specialized treatments.
If a tooth has lost too much supporting structure to be saved, extraction may sometimes be necessary.
Daily care remains essential. Professional treatment cannot replace daily oral hygiene. Brushing twice a day with fluoride toothpaste and cleaning between the teeth can help control plaque and reduce the risk of further inflammation.
Stopping tobacco use, managing conditions such as diabetes and maintaining regular dental appointments can also be important components of periodontal care.
Do not wait for loose teeth. Severe gum disease is not simply a problem of bleeding gums. It can progressively destroy the structures that keep teeth anchored in the jaw.
The earlier periodontal disease is identified, the more opportunity there is to control it and protect the remaining supporting tissues.
Persistent bleeding, gum swelling, recession, pus, bad breath or loose teeth should therefore prompt a dental examination. Healthy gums provide the foundation for healthy teeth, and protecting that foundation becomes increasingly important when early warning signs appear.
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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
