Conditions

Gum Diseases

Gum disease is an inflammation of the gum surrounding the teeth, which is a response to the build up of bacteria. Once bacteria builds up in your mouth, your immune system attempts to get rid of it through the inflamed gum as an innate immune response.

However, as gum disease becomes severe and advances, it can cause bone loss in the jaws and subsequent loss of teeth. It can also be accelerated by a variety of factors such as poor oral hygiene, smoking, diabetes, old crowns and oral bridges that are ill fitting etc.

It is fundamental for all readers of this information to acknowledge gum diseases are often not a stand alone condition; it is reflective of your body’s inflammatory burden and often accompanies by systemic conditions. This stresses the importance of holistic approaches in treatment and remembering the concept of Periodontal Medicine. Despite the highly specialised skills and knowledge, I do not intend to treat a compartment of the body (i.e. gum) but individuals (i.e. the patients). My philosophy is to look at my patients’ entire body as a whole.

The two main stages of Gum Disease

Gingivitis

Gingivitis is a common and mild form of gum disease (periodontal disease) that presents as irritation, redness and swelling (inflammation) of your gingiva, the part of your gum surrounding the emergence of your teeth. It is important to take gingivitis seriously and treat it promptly. Gingivitis can lead to much more serious gum disease called periodontitis and tooth loss.

The most common cause of gingivitis is poor oral hygiene, lack of regular professional check-ups, although it can also underlies systemic conditions.

Efficient daily cleaning, especially in the interdental areas and getting regular dental checkups, can help prevent and resolve gingivitis.

Periodontitis

Periodontitis is a destructive inflammation of the gum and supporting structures of the teeth. It is one of the most common human diseases.

Periodontitis is caused by periodontal bacteria and by the local inflammation triggered by these bacteria. They can be naturally present in the mouth, but become harmful when the conditions are favourable for them to increase in numbers dramatically and their pathogenicity alters. This happens when a layer of bacteria and food debris, also known as dental plaque or biofilm, builds up and is left undisturbed on the teeth, commonly in hard-to-reach areas such as between the teeth.

The more dangerous bacteria are able to thrive and multiply, producing some harmful by-products which stimulate the body’s defensive inflammatory response in the gums. As the disease progresses, chronic inflammation causes the bone of the jaw to be destroyed and the teeth to be lost. In many people, this is a gradual process that takes place over many years and, if detected and treated, can be halted or significantly slowed down. Having said that, there are also unfortunate scenarios where patients are immunocompromised and subjective to rapid and aggressive form of the disease.

Other forms of presentation can include but not limited to suppuration (abscess, pus), mobile teeth, recession (gum shrinkage), increased thermal sensitivity to heat/ cold, foul smell/ taste, pain.

Dental Implant Diseases

Implants are artificial metal dental roots that are placed into the jawbone through minor periodontal surgery. False tooth/ teeth, named crown/ bridges are then connected onto the implant(s) after an appropriate healing period.

The bone and gum grow around the implant to hold it in place.

These tissues are extremely delicate and need regular professional check-up and patient’s meticulous cleaning in correct manners.

Dental implant (peri-implant) disease is an inflammation of the gum surrounding the dental implants, which is a response to the build up of bacteria. Once bacteria builds up in your mouth, your immune system attempts to get rid of it through inflaming the gum around the implant.

Peri-implant disease can cause bone loss and exfoliation (loss) of implants and can be accelerated by a variety of factors such as poor oral hygiene, untreated periodontitis, smoking, diabetes , ill fitting dental crowns bridges.

Peri-Implant Mucositis

Peri-implant mucositis is a common and mild form of dental implant disease that presents with irritation, redness and swelling (inflammation) of your gum around the implant. It is usually resolvable but it is important to take it seriously and treat it promptly. Peri-implant mucositis can lead to much more serious peri-implant disease, called peri-implantitis and eventual implant loss.

The most common cause of peri-implant mucositis is poor oral hygiene and lack of regular professional check-ups. Good oral health habits, such as brushing at least twice a day, daily cleaning in the interdental areas with correct technique and getting regular dental checkups, can help prevent and resolve peri-implant mucositis.

Peri-Implantitis

Peri-implantitis is an advanced inflammation of the gums and supporting bone of the implants. It can be a fast, self-progressing oral disease.

Peri-implantitis is caused by certain bacteria (the same periodontal bacteria) and by the local inflammation triggered by those bacteria. Although these periodontal bacteria are naturally present in the mouth, they are only harmful when the conditions are favourable for them to increase dramatically in numbers and their pathogenicity to alter. This happens when a layer of bacteria and food debris, known as dental plaque or biofilm, builds up and is left undisturbed on the teeth, commonly in hard-to-reach areas such as between the teeth or the implants.

If detected, peri-implantitis can be treated with advanced and sophisticated surgical procedures and the process of bone loss can be arrested.

Other Conditions

Bad Breath (Halitosis)

Bad breath (Halitosis) can be determined by dental factors such as home oral hygiene, periodontitis, tooth decay, dry mouth or non dental conditions like medical diseases, food habits and tobacco smoking

Dry Mouth

In addition to gum disease or tooth decay, dry mouth is one of the dental conditions that may result in halitosis. It is a condition with limited saliva flow production that dries out your mouth, increasing the risk of bad breath.Dry mouth can be related to medications, salivary gland problems and tobacco use.

Medical conditions or medications

Some diseases have symptoms related to bad breath (sinus or lung infections, tonsillitis, gastrointestinal disorders, bronchitis, diabetes, and some liver or kidney diseases). A number of medications may also produce an unpleasant taste or odour or cause dry mouth, which in turn leads to bad breath. You may want to discuss this with a specialist in Periodontics.

Poor oral hygiene

If food residuals are not removed with proper oral hygiene regularly, they can accumulate along your gumline, between your teeth, and on the tongue surface, where bacteria break them down, and release oral odour.

Foods and drinks

Some foods and drinks contain odour-causing components that, following digestion, will be later exhaled or secreted in the saliva.

Tobacco use

Smoking is a risk factor for gum diseases and can contribute to halitosis heavily.

Treatment 
During your initial specialist consultation a diagnosis and individually customised periodontal treatment plan will be discussed with you. Initially, a debridement (deep cleansing) of the roots of your teeth or implants is performed along with possible application of an antimicrobial products and tailor-made review of home oral hygiene.

Subsequent specialist treatment following your initial debridement will be discussed during a re-evaluation visit and often include surgical treatment of the condition. 

As for possible bad breath, the first step is tracking down the cause. A Periodontist can be of great help by examining your mouth screening for oral health problems; such as gum diseases, tooth decay, or low salivary flow. If concerns about oral health are found to be associated with general health, your specialist may refer you to your physician to check for other medical causes and assess your medications.

Rome was not built in one day and so were not gum diseases. To treat, it is important ones’ acknowledge it will not be resolved in one day but requires good on-going rapport between the patients and the treating Periodontist. It is essential you find one that you can befriend with, despite it is also each practitioners’ goal to give you the best care and discharge you at the earliest possibility.