Gum disease can start when you are a child, however chronic periodontitis is normally only a problem for adults.
You might be worried about bad breath or your teeth looking longer as the gum covers less of them.
Some people are more likely to have periodontal disease than others:
- Crooked teeth are more difficult to keep clean so you might have gum disease in just one part of your mouth
- People have different bacteria in their mouths. This may explain why gum disease can get worse very quickly for some people but not for others
- Smoking and drinking a lot of alcohol can make gum disease worse. Both are also linked with mouth cancer
- Drugs and medicines can affect your gums so your dentist will ask you about your general health
- Diabetes and some other diseases can reduce how resistant gums and bones are to damage
- Hormonal changes can also affect gum health. It could make a difference if you are pregnant or using an oral contraceptive
However healthy and strong your teeth are, they need to be supported by healthy gums and bone. Periodontal disease can lead to you losing teeth and all the difficulties that this can cause for eating and speaking.
Scientists are now discovering that periodontal disease is linked to coronary heart disease and stroke, especially for people who are already at risk in other ways (through poor diet, smoking or high blood pressure).
The possibility of regenerating hard (bone) and soft (gum) tissues in the mouth is now a reality, through the application of advanced techniques and superior materials. In the past if a patient had suffered bone loss or receding gums there was very little which could be done to reverse this condition. However, we now have the capability to regrow bone and soft tissues using several techniques.
The majority of bone loss and receding gums is caused by periodontal (gum) disease. There are many contributing factors which cause periodontal disease, such as stress, genetics, pregnancy, puberty, medications, diabetes, clenching or grinding of the teeth, or poor nutrition. Receding gums can also be seen in individual areas of abrasion through over-vigorous use of the toothbrush.
Common symptoms of receding gums and bone loss are listed below.
- You may notice that the teeth look longer than before or that the gum looks like it is pulling back from the teeth
- You may notice a yellow edge at the margin of the tooth where it meets the gum (exposed tooth structure called Dentine)
- You may suffer sensitivity at the gumline
- You may notice deep pockets of gum forming in between the teeth
- You may see or feel spaces between the teeth developing
- You may notice a change in the way the teeth come together when you bite
- Your teeth may be mobile (moving)
- Your gums may be swollen, tender or bleed easily
- You may suffer from bad breath or notice pus from the gum
A conservative and non-invasive approach via preventative hygiene, root planing and regular dental examinations is always the ultimate aim, however there are occasions when unhealthy tissue cannot be repaired in this way. Advanced techniques and superior materials can now be used to treat irreversible damage caused by periodontal disease or tooth brush abrasion.
These include:
- Soft tissue grafts
- Crown lengthening procedures
- Regenerative procedures
- Pocket reduction (flap) procedures
Receding gums can cause the teeth to look longer, and may expose the root of the tooth, an area which should be covered by the gum. This can also result in sensitivity to hot and cold when eating or drinking.
Gum recession can be caused by a number of factors, such as an aggressive tooth brushing technique or periodontal disease. The dentist will try to identify the cause of this problem, and advise you on ways to minimise further gum recession.
Once these factors have been identified and controlled, your dentist may advise you to undergo a Soft Tissue Graft on the affected areas to minimise sensitivity and improve your smile.
This procedure aims to repair the receding area to prevent further bone loss and recession and also to improve cosmetics. The soft tissue graft procedure involves taking a piece of gum tissue from the roof of your mouth (the palate) or another area and covering the exposed tooth root where the recession has occurred.
Crown lengthening is a procedure which is often used to enhance your smile line. Sometimes, although the teeth may be the correct length, they can appear short as there is excessive gum tissue growing down the tooth, resulting in a ‘gummy’ smile.
Crown lengthening involves reshaping the hard and soft tissues around the teeth to expose more tooth structure and therefore improve the aesthetics of your smile.
Your dentist may also advise a crown lengthening procedure as a foundation for restorative work. Perhaps your tooth has broken below the gumline, or you have decay in the tooth below the gumline or there is not enough tooth structure to retain a bridge or crown. Crown lengthening may be advised in these situations to expose more tooth structure and thus enable the dentist to remove any decay, and provide a foundation for the new restoration.
Periodontal disease destroys the gum tissue and supporting bone which surrounds the teeth. The roots of the teeth are anchored in the jaw bone and when bone is lost as a result of periodontal disease, the teeth can become mobile. If no corrective action is taken, the teeth will eventually be lost.
Advances in science and technology mean it is now possible to regenerate some of the lost bone and soft tissue, reversing the damage and reducing the need to extract loose teeth.
There are various techniques available to regenerate lost tissue and your dentist will recommend the best option for you.
The aim of regeneration procedures is to remove the disease and rebuild the natural tooth attachment required to support your teeth in the jaw bone.
Regeneration of bone and soft tissue is achieved by folding the gum back, removing the disease-causing bacteria and applying a protein which stimulates the regrowth of the natural tooth attachment tissues.
Regeneration procedures are very successful when supported by regular preventative hygiene appointments and examinations.
Healthy gums should fit snugly around the necks of your teeth. The bacteria responsible for Periodontal disease causes the supporting tissues of the teeth including the gums and bone, to degenerate, resulting in ‘pockets’ forming around the teeth. These pockets provide areas for the disease-causing bacteria to grow and multiply and thus, over time, cause further damage to the supporting tissues, resulting in larger pockets, bone loss and eventually the teeth will need to be extracted.
The dentist and hygienist regularly measure the depths of pocketing of your gums. The dentist may advise a pocket-reduction procedure if the depth of these pockets is such that your daily home cleaning routine is impossible to maintain.
Pocket depth reduction procedures involve folding back the gum tissue and removing the disease-causing bacteria which is accumulating in these areas. It may also be necessary to smooth the surface of the bone, where damage may have caused the texture of the bone to become irregular, providing a haven for bad bacteria to multiply and cause more damage to the surrounding tissues.
The removal of this bacteria by your dentist must be complimented by a thorough oral hygiene home-maintenance program and regular professional dental cleanings to ensure that a recurrence of pocketing caused by periodontal disease does not occur.