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Gum disease is common in adults over 30. There are many signs of the different stages of gum disease and a change in tooth position in the mouth or partial denture fit may be an indication of the presence of gum disease that you need to look out for.

Gum disease - what is it?

The Center for Disease Control and Prevention (CDC) purport that as many as half of all adults over 30 display some form of periodontal disease, which could mean there are millions of people who are at risk of tooth and bone loss, alongside other possibly grave health issues.

Gum disease, also termed periodontal disease, refers to infection of the teeth-surrounding gums and is one of the main reasons for loss of teeth in adults; because it is typically devoid of discomfort, many are unaware that they have it until it is too late. However, during regular dental exams, a clinician will inspect for signs of the disease by, in part, measuring the space between teeth and gums.

What leads to disease of the gingiva (gums)?

Gingival disease is caused by a plaque build-up, which is an adhesive form of bacteria that develops on the teeth. If it is not removed through good dental hygiene (flossing, brushing, and regular dental checkups), it will continue to grow and result in gum-damaging toxins. Periodontal disease develops just below the gum line and makes small pockets that lead to separation of the teeth from the gums.

While its development is often insidious over time (months, years or decades), there are generally three key stages of observable gum disease:

  • Gingivitis: In this initial stage, inflammation results from plaque build-up around the lines of the gums. At this point, an individual may observe bleeding and gum sensitivity while flossing or brushing;  if addressed now, periodontal disease can be reversed as the connective tissue and bone are as yet undamaged.

  • Periodontitis: Here, the supporting tissue and bone securing the teeth have become irreversibly impaired: gums may begin to form pockets below the gum line which means that food and bacteria can build. However, the good news is that with correct dental hygiene and care, further deterioration may still be halted.

  • Advanced Periodontitis: During this final stage, the connecting tissues and bone are irrevocably damaged which leads to a loosening or shifting of teeth. Unfortunately, if concerted efforts at treatment do not yield successful results, teeth may still need to be extracted.

Is a change in the way teeth converge or the fit of partial dentures a sign of gum disease?

While it is possible to have periodontal disease and be unaware, some symptoms can include:

  • Gums that are quick to bleed

  • Sore, inflamed, or red gums

  • Receding gums (gums that retract from the teeth)

  • Persistent halitosis (unpleasant mouth odor) or dysgeusia (unpleasant taste in the mouth)

  • White, yellow or green discharge between teeth and gums

  • Wobbly or separating (permanent) teeth 

  • Change in tooth positioning such as formation of new spaces between teeth

  • Alteration in your tooth fit, known as bite

  • A difference in prosthesis (partial denture) fit

A difference in your teeth bite (the way your teeth fit together) or any change in partial denture fit is a likely indication of periodontitis or even advanced periodontitis. Dental bridges fitted many years previously may no longer fit and are a further factor increasing the risk of an acceleration of the development of periodontal disease. If these signs are noted, it should alert you to contact your dentist to have your gums examined.

How can you prevent gum disease if you are a denture wearer?

With correct maintenance and sound oral hygiene habits, you can ensure you keep your mouth healthy and don't develop gum disease.

When you take your dentures out, use a soft-bristled brush to daily brush all parts of your oral cavity including your gums, tongue, cheeks, and the roof of your mouth. This ensures the removal of plaque and also stimulates tissue circulation in your mouth; it can also help prevent mouth odor and reduce the likelihood of experiencing irritation.

To assist with cleaning your gums, regular rinsing of your mouth with lukewarm salt water is also beneficial.

well-balanced diet consisting of nutritious foods that are low in sugar is also recommended; sweets should only be consumed in moderation.

You must also refrain from smoking or using other tobacco products as it can result in candida (yeast) in your mouth, which renders you more susceptible to developing gum disease and infections.

Dentures should also be removed and not worn for more than 24 hours continuously so as to ensure your mouth can rest. 

Regular dental inspections are also essential - a general recommendation is six-monthly. However, if your dentures loosen, this must be looked at as poorly-fitting dentures can irritate and cause to sores and infection.

Should periodontitis be treated?

Unequivocally, yes.

If not treated, periodontal disease can impact negatively upon the quality of your life in several ways. With no teeth, a healthy diet can be very difficult and this can cause health issues owing to malnutrition. Furthermore, research indicates that periodontitis-causing bacteria may get into your bloodstream via gum tissue and travel to your lungs, heart and other organs: for example, researchers have correlated gum disease and cardiovascular problems such as heart attack and stroke. This is the reason dentists will never extract teeth when an infection is present but always seek to resolve it beforehand to prevent the spread to vital organs.

Treatments can include:

1. Scaling and root planing (deep cleaning)

2. Prescribed medicines

  • Prescription antibacterial mouthwash

  • Antiseptic chips placed in pockets for slow release medication

  • Antibiotic slow release gel applied to periodontal pockets

  • Antibiotic microspheres (miniscule balls again used as slow release medication in periodontal pockets)

  • Enzyme suppressants to manage detrimental oral enzymatic processes

  • Oral antibiotics

3. Surgical treatment

  • Flap Surgery - removal of bacteria from deep in the dental pockets

  • Bone and Soft- tissue Grafts

The primary treatment aim is to stem infection. The frequency and mode of treatment will vary, dependent upon the extent of the disease. Any form of treatment necessitates that patients independently maintain good daily dental-care habits outside of the dental surgery. Dental professionals may also suggest adopting different lifestyle behaviors, such as ceasing the use of tobacco products to assist with treatment outcome. If you have dental bridges or dentures that fit poorly, it is likely that they will be replaced with prosthetics that are correctly aligned.

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