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Gum Disease: Gingivitis and Periodontitis | Hawaii Family Dental

Written by Danica Lacson on April 2, 2018

Gum diseases are often classified as gingivitis and periodontitis. While both are problems with the gums, they have their differences including the extent of the issue.

  • Gingivitis: Known as a mild form of periodontal disease, gingivitis is characterized by gum inflammation which makes the gingivae swollen, red, and bleed easily. Still, people with gingivitis do not experience bone and tissue loss. Moreover, this type of gum disease can be reversed through daily brushing, flossing, and professional dental cleaning. However, when gingivitis is not immediately treated, it can advance to periodontitis.
  • Periodontitis: An advanced case of gum disease, periodontitis can lead to bone, gum, and tissue damage when not treated. Unlike gingivitis, periodontitis can result in the gums pulling away from the teeth and forming pockets that can become infected.

What is gum disease?

Periodontal or gum disease is defined as the infection of the surrounding tissues and supporting bones of the teeth which typically begins with the growth of bacteria in the mouth. When left untreated, gum diseases can result in tooth loss.

Tightly bound to the underlying bone, gums serve as a “seal” around the teeth. They surround the teeth and help them resist the friction brought about by the food consumption. They are effective barriers against bacteria and provide support to the bones.

However, our gums can sometimes fail to maximize their roles due to the deterioration of their health brought about by certain factors that eventually lead to gum or periodontal diseases.

Sometimes, we think having a good set of teeth is enough qualifier for a good oral health standing. But, in reality, oral health is more than the state of our teeth. The equation of oral health includes the teeth’s surrounding structures and other parts of the oral cavity including the gums.

What are gums?

Known as the gingivae, gums are part of the mouth’s soft tissue lining. They are composed of the mucosal tissue which sits over the mandible and maxilla inside the mouth. Anatomically, they are divided into three namely marginal, attached, and interdental.

Marginal gums, which are 0.5 to 2.0 millimeters in width, are found on edge surrounding the teeth. They follow a scalloped pattern which is created by the contour of the cementoenamel junction of the teeth. Meanwhile, attached gums, which have varying width depending on the area, continue from the marginal gums but are tightly bound to the underlying layer of the periosteum, the vascular connective tissues of the alveolar bone. Interdental gums dwell in the interproximal space or the gingival embrasure located beneath the tooth contact area.

What causes gum disease?

Plaque and tartar buildup are the primary causes of periodontal diseases. Nonetheless, other factors can increase the risk of an individual in developing gum disease including:

  • Hormonal changes make the development of gingivitis easy as gums become sensitive. Typically, these affect women during puberty, monthly menstruation, pregnancy, and menopause. Still, men can experience hormonal changes as well in adolescence and during later years due to menopause.
  • Diabetes and other illnesses including their treatments also affect the condition of the gums as they can interfere with the immune system. Moreover, diseases like diabetes provide a higher risk of developing infections. Medications can also reduce saliva production which is essential in protecting the mouth against harmful bacteria.
  • Habits such as smoking and too much alcohol consumption can also trigger periodontal disease as they weaken the gum tissues’ natural tendency to repair itself. In a study conducted by the National Institute of Dental and Craniofacial Research, smoking is one of the most significant risk factors that contribute to the development of gum disease.
  • As mentioned above, plaque and tartar buildup are considered primary causes of periodontal diseases. In turn, plaque and tartar buildup are due to inadequate oral care.
  • Genetic susceptibility is also a contributing factor.

What are the symptoms of gum disease?

The progression of the development of gum disease can be subtle, without telling. Still, the condition can drop symptoms including:

  • Teeth sensitivity
  • Receding gums
  • Bleeding or tender gums
  • Loose teeth
  • Red or swollen gums
  • Bad breath
  • Pus from the gums
  • Pain when chewing

Is gum disease linked to cancer?

Studies have found links between periodontal diseases to systemic diseases including heart diseases, rheumatoid arthritis, and cancer.

Researchers at the New York University Langone Health has found a link between gum disease and esophageal cancer. According to the findings, the likelihood of esophageal cancer can increase by 21 percent due to the presence of gum disease-causing bacteria, Prophyromanco gingivalis and oral bacteria, Tannerella forsythia.

Additionally, in research published in The Lancet Oncology, it was found that men’s susceptibility to various cancers increases. Respondents with gum disease recorded higher risks at 49 percent for kidney cancer, 30 percent for white blood cell cancer, 54 percent for pancreatic cancer, and 36 percent for lung cancer.

Moreover, according to Dr. Thomas Boyden, Jr. of the Spectrum Health Medical Group Cardiovascular Services, inflammation of the gum layer can trigger inflammation throughout the body due to the funneling of bacteria into the bloodstream. The swelling can then harden arteries, leading to a condition called atherosclerosis and a harder time for blood to flow.

How can gum disease be diagnosed?

Signs of gum disease can be observed through a dental examination. It is vital to visit your dentist at least twice a year to detect indications of the problem at its early stages and prevent the advancement of the issue to its severe form.

During a dental evaluation, the dentist will check the following:

  • Your medical and dental history to check for underlying conditions, as well as, risk factors
  • Examine the gums for signs of bleeding, swelling, pocket depth, among others
  • Assess the movement and sensitivity of the teeth
  • Check the alignment of the teeth
  • Examine the jawbone for indications of bone breakdown

Your dentist can use a probe and X-ray images for more accurate diagnosis. If you have gum disease, especially the severe form, your dentist will refer you to a periodontist, a gum specialist.

What are the treatments for gum disease?

There are various treatments available for periodontal diseases which depend on the stage, response to treatment, and overall health condition.
Treatments include:

Non-surgical treatments for gum disease such as:

  • Professional dental cleaning is done to remove plaque and tartar buildup. Although this procedure is not a treatment for active gum disease, it serves as an essential preventive measure to prevent its development.
  • Deep cleaning including scaling and root planing also rid the teeth of plaque and tartar by scrapping them away and smoothing the rough spots.

Surgical treatments for gum disease such as:

  • Flap surgery or a pocket reduction surgery reduces the space between the gum and tooth caused by pocket to decrease the areas where disease-causing bacteria can hide. Through this method, the gums are lifted back, and the tartar is removed.
  • Bone graft is done to replace the bone damaged by the periodontal disease through the regrowth of the bone using your bone, a synthetic bone, or a donated bone. This procedure aims to restore the stability of the teeth.
  • Soft tissue grafts fill in the areas where gums have receded through the stitching of grafted tissue taken from the mouth's roof and stitched in place as an addition to the affected area.
  • Guided tissue regeneration stimulates the growth of the bone and gum tissue done in combination with flap surgery. Through this procedure, the bone and connective tissue can regrow.
  • Bone surgery reshapes the bone around the tooth to decrease the shallow craters in the bone because of moderate to advanced bone loss, making the collection and growth of bacteria difficult.

How can I prevent getting gum disease?

Gingivitis is reversible, and its progression can be halted with proper oral care which includes regular brushing, flossing, rinsing using an anti-bacterial mouthwash, visiting the dentist at least twice a year for professional teeth cleaning, and healthy food intake through well-balanced diet.

Additionally, lifestyle changes like quitting smoking will also be helpful to prevent the development of gum disease.


Disclaimer: The oral health information published on this web page is solely intended for educational purposes. Hawaii Family Dental strongly recommends to always consult licensed dentists or other qualified health care professionals for any questions concerning your oral health.

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