Patient Education

Gum Disease, Periodontal Disease (Pyorrhoea): The Tooth Loss Culprit

Gum disease or periodontal disease or periodontitis, (also known as pyorrhoea) is an inflammatory condition affecting the tissues surrounding a tooth. It is recognized as the leading cause of tooth loss. Gum disease may initially appear as gingivitis and may progress to periodontitis, if left untreated.

The Signs of Gum Disease

As the infection progresses, the bone may recede and the gums may or may not recede. In some cases, the roots of the tooth may become exposed; this exposure may cause tooth sensitivity. Furthermore, pus may be produced, and pockets may form between the gum and tooth. These symptoms are possibly reflective of periodontal disease. It is important to visit your dentist for professional examinations and dental cleanings to identify gum disease. For example, bone recession is not visible to the naked eye and, if left undetected, may contribute to tooth loss. Let’s explore some of the common signs of gum disease:

Bleeding gums during tooth brushing or otherwise
Sensitive, red or swollen gums
Bad breath
Teeth that are loose or appear to have shifted

Improper Dental Hygiene:

If plaque is not removed through daily dental hygiene practices and regular professional dental cleanings, bacteria may set in and cause gingivitis. Organic Changes in the Mouth: Changes in hormone levels during pregnancy, puberty, and menopause may make teeth more susceptible to gum disease. This is because changes that occur in metabolism during these time periods may affect the organic balance in the mouth.

Medical Conditions:

Serious conditions that affect the body’s ability to produce sugar (such as diabetes or kidney disease) may contribute to periodontal disease. Furthermore, the Center for Disease Control has found an association between illnesses and gum disease. These diseases include stroke, heart attack, lungs disease- pneumonia or chronic bronchitis, osteoporosis and diabetes. Finally, certain medical conditions and medications used to treat medical conditions may produce the overgrowth of gums. Overgrown gums are more susceptible to bacteria that can contribute to gum disease. Saliva Flow Inhibitors: Certain medications that may produce oral side effects or dry mouth syndrome (xerostoma) may contribute to reduction of protective saliva flow, potentially leading to gum disease. Seniors may be more susceptible to dry mouth syndrome because of the natural reduction of salivary flow that is associated with age. Poor Functional Habits: Teeth grinding or clenching may impair the surrounding tissue and is a possible contributor to gum disease.

Dental Hygiene: Getting and keeping a healthy, beautiful smile

Brushing and Flossing Your Teeth

You’ve been brushing your teeth for years and years. But how do you know if you’re brushing properly? Shoving your toothbrush every which way inside your mouth in vigorous strokes hardly equates an efficient brushing technique. Periodontists and cosmetic dentists explain how to properly brush their teeth in order to prevent cavities, gum disease and gingivitis to their clients. Maintaining dental hygiene requires some work. To brush your teeth properly, use gentle, circular motions on the inner and outer surfaces of your teeth. Dentists strongly remind their clients to brush gently as forceful strokes result in gum reduction. While most people brush for only about a minute, dentists recommend that people brush their teeth for at least two minutes. In order to maintain good dental hygiene, invest in a power toothbrush with a two-minute timer so that you give yourself adequate time to clean your teeth. What about flossing? Every dentist will tell you that flossing is a crucial part of keeping healthy dental hygiene. Like brushing, most people don’t even know the proper way to floss. First of all, wrap 15 inches of floss around your middle fingers of both hands. Shift the floss back and forth until you hit your gums, and manoeuvre the floss gently up and down. Avoid pressing the floss further down once you hit your gums. Sustaining a healthy dental hygiene requires skill and dedication. Most people brush their teeth carelessly, as they only focus on finishing their morning/nightly regimen. Dentists and cosmetic dentists urge their clients to brush and floss regularly, properly and efficiently.

A Healthy Diet Enhances your Dental Hygiene

What does a healthy dental routine consist of? How can you improve your dental hygiene? Other than the obvious regular brushing and flossing regimen, a healthy, balanced diet also optimizes a great dental routine. Adopting a diet rich in antioxidants and vitamins improves your dental health and the aesthetics of your teeth. Eating a diet full of essential nutrients promotes healthy teeth and gums. Developing a healthy diet from an early age increases your chances of maintaining that lifestyle into adulthood. Incorporating a healthy diet full of fresh fruit and vegetables such as carrots, broccoli, kale, red and yellow peppers, apples, berries and plums as well as calcium creates a healthy dental routine. Stay away from refined sugars and eat more of fresh, vitamin-rich foods to ensure better dental health and hygiene. Good dental hygiene makes you look younger and healthier with more aesthetically pleasing gums and teeth. And when you look better and younger, you feel better and younger. Healthy diets promote good dental hygiene. By eating right, you’re already improving your dental hygiene.

How to brush your teeth ?
  •   Always use a soft toothbrush for thorough but gentle cleaning. After each meal, or at least twice a day.
  •   Hold your brush at a 45-degree angle. Begin by brushing the outside of the front teeth. Use a gentle back -and-forth motion.
  •   Next, brush the outside back teeth, steering along the gum line.
  •   Inside back teeth: Use short angled brush strokes.
  •   Inside front teeth: title the brush vertically; use an up-and-down motion
  •   Chewing surfaces: hold the brush flat. Use a gentle scrubbing motion.
  • Important: always replace your old toothbrush at least every 3-4 months.
How to Floss ?
  •   Wind 18" of floss around your two middle fingers.
  •  Gently guide the floss between teeth
  •   To remove plaque and debris, gently move the floss up and down against the tooth
  •  As you move from tooth to tooth, use a fresh section of floss each time.

What causes Bad Breath?

Bad breath, or halitosis, can be caused by many things. It may be the result of odour-causing foods, tooth decay, periodontal (gum) disease, continued mouth dryness, use of tobacco products, sinus or respiratory infections, some medical disorders, inadequate oral hygiene or some medications. Your dentist can help identify the cause and, if it's due to an oral condition, can develop a treatment plan to eliminate this common source of embarrassment.

Hygiene-related causes for bad breath :

What you eat affects the air you exhale. Certain foods, such as garlic and onions, contribute to objectionable breath odour. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is expelled. Brushing, flossing and mouthwash will only mask the odour temporarily. Odours continue until the body eliminates the food. Dieters may develop unpleasant breath from infrequent eating. If you do not brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath. Food that collects between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odour. Dentures that are not cleaned properly can also harbour odour-causing bacteria and food particles.

Diseases-related causes for bad breath :

One of the warning signs of periodontal (gum) disease is persistent bad breath or a bad taste in the mouth. Periodontal disease is caused by plaque, the sticky, colourless film of bacteria that constantly forms on teeth. The bacteria create toxins that irritate the gums. In the advanced stage of the disease, that gums, bone and other structures that support the teeth become damaged. With regular dental checkups, your dentist can detect and treat periodontal disease early. Bad breath is also caused by dry mouth (xerostomia), which occurs when the flow of saliva decreases. Saliva is necessary to cleanse the mouth and remove particles that may cause odour. Dry mouth may be caused by various medications, salivary gland problems or continuously breathing through the mouth. If you suffer from dry mouth, your dentist may prescribe artificial saliva, or suggest using sugarless candy and increasing your fluid intake. Tobacco products cause bad breath, stain teeth, reduce one's ability to taste foods and irritate gum tissues. Tobacco users are more likely to suffer from periodontal disease and are at greater risk for developing oral cancer. If you use tobacco, ask your dentist for tips on kicking the habit. Bad breath may be the sign of a medical disorder, such as a local infection in the respiratory tract (nose, throat windpipe, lungs), chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment. If your dentist determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath.

What is remedy for Tooth Sensitivity?

Tooth sensitivity is a common problem for most people. Our teeth can be greatly affected by hot, cold, sweet, and sour food or drink. Over-enthusiastic brushing, recession of gums, gum disease (periodontitis) all can expose the soft, porous structure of the tooth (dentin), making it susceptible to external stimuli. Pain can be mild and tingly or sharp and intense. This symptom sometimes is a sign for more serious diseases. Whenever you are suffering from pain of sensitivity, you should go see your dentist before it persists or worsens.

Helpful Hints

A review of brushing techniques and diet can help reveal causes of sensitivity. Avoid over-brushing because it can cause damage to your teeth and/or gums. Sensitivity protection toothpaste works by blocking the opening of the exposed dentin or by preventing the transfer of the pain signal from the nerve to the brain. You should feel relief by using sensitivity protection toothpaste for two weeks. If you stop brushing with this kind of toothpaste, the sensitivity pain may return. Also, some prescribed desensitizing agents may help you. Consult your dentist about it.

What is bruxism?

Bruxism is the technical term for forcible grinding and clenching of the teeth. It usually happens at night, during sleep, although some people grind their teeth during the day as well.

How common is bruxism?

Most people who grind their teeth are over 25 years old, and the disorder affects women and men about equally. Children also grind their teeth, but usually in response to discomfort caused by colds, ear infections or allergies. Most cases of bruxism in children resolve on their own without causing tooth damage or other problems.

What causes bruxism?

Bruxism can have a variety of causes, but the most common are probably emotional factors such as daytime stress, anxiety, anger, pain and frustration. Certain sleep disorders can trigger grinding of the teeth as well. People who are competitive, aggressive, and rushed may also be at greater risk for bruxism. Lastly, alcohol and some types of medications may worsen tooth grinding.

Why bruxism can be a serious problem?

When you chew your food, your deliver a force of about 175 pounds per square inch (psi) to your teeth. But when you grind your teeth at night, there's no food to absorb the impact, so the force on your teeth can be 300 psi or more. That's enough to cause permanent damage to your teeth, including cracked and chipped enamel, hairline fractures, and even wearing down of the teeth to the gumline & loosning of the dental implant screws The enamel may become so worn that the inside of the tooth (called the dentin) is exposed. If bruxism isn't treated, it can lead to gum damage, loss of both natural teeth and restorations, and other more complicated jaw-related disorders (such as TMJ known disorders). Over time, your teeth may become sensitive due to exposed dentin, and your jaws may even move out of proper balance. Grinding your teeth can also cause a wide variety of other symptoms including soreness and fatigue in your jaw and facial muscles, and earaches or headaches-especially when you wake up in the morning. There is no known cure for bruxism. Fortunately, with night-guard trays there are ways to reduce or stop your grinding and even ways to limit further damage and pain due to grinding.

Do You Grind Your Teeth?

Because most bruxism happens at night, most sufferers aren't even aware of it until a sleep partner mentions the noise or until a dentist notices that their teeth are damaged. Here are some typical symptoms that may indicate nighttime teeth grinding: Symptom checklist:

  • Jaw or facial pain and tenderness on awakening that lessens throughout the day
  • Headaches or earaches in the morning that go away as the day wears on
  • Spouse or sleep partner complains that the noise is keeping them awake at night
  • Teeth have become sensitive to cold, pressure, or other stimuli
  • Tips of teeth appear flattened
What to do if you think you may be grinding your teeth?

If you think you might be grinding your teeth at night, the first thing to do is visit your dentist to assess any possible damage. It's essential to halt the course of the disease to prevent or arrest damage to your teeth, gums, and jaws.

Caring for your smile

Eliminating periodontal disease and maintaining good oral health is essential to reducing bad breath. Schedule regular dental visits for a professional cleaning and checkup. If you think you have constant bad breath, keep a log of the foods you eat and make a list of medications you take. Some medications may play a role in creating mouth odours. Let your dentist know if you've had any surgery or illness since your last appointment. Brush twice a day with a fluoride toothpaste to remove food debris and plaque. Brush your tongue, too. Once a day, use floss or an interdental cleaner to clean between teeth. If you wear removable dentures, take them out at night. Clean them thoroughly before replacing them the next morning. Mouthwashes are generally cosmetic and do not have a long lasting effect on bad breath. If you must constantly use a breath freshener to hide unpleasant mouth odour, see your dentist. If you need extra help in controlling plaque, your dentist may recommend using a special antimicrobial mouth rinse. A fluoride mouth rinse, used along with brushing and flossing, can help prevent tooth decay. Look for products that carry the American Dental Association Seal of Acceptance. Products that display the seal have undergone strict testing for safety and effectiveness.

How gums infection can cause medical problems?

Research has established that periodontal infection is a probable risk factor for various systemic diseases such as heart disease, diabetes, preterm low-birth weight babies, brain stroke, osteoporosis, pulmonary disease (chest infections such as bronchitis or pneumonia). This dual relationship between systemic diseases and periodontitis has been vastly described under the new branch of Periodontology, “Periodontal Medicine”. Dentists, especially periodontists, may be able to play a significant role in the reduction of severity of these systemic diseases by redoubling their efforts to prevent periodontitis and arresting the progression in patients already afflicted by periodontitis. Hence, in addition to an evaluation of the factors contributing to the associated risk, the patient should be educated regarding the risk, and when appropriate, suitable intervention strategies should be implemented.