Gum Disease

This page explains how you and your dentist or hygienist can work together to help prevent plaque and periodontal disease.

What's in a tooth?

Enamel covers the crown and is the hardest tissue in the body.

Dentine constitutes the major part of the tooth and gives teeth their colour.

Pulp is rich in nerves and blood vessels.

How are teeth attached to the jaws?

Each tooth has a root which is embedded in the jaw bone. The root is anchored to the bone by many tiny fibres. The jaw bone is covered by soft gum tissue, which acts like a cuff around the neck of the tooth.

What do healthy teeth and gums look like?

Healthy gums are firm and have a stippled 'orange peel' effect. The edges cannot normally be separated from the teeth. Gums should not bleed when teeth are brushed properly.

What is plaque?

Plaque is the film of bacteria which is constantly forming on all teeth. Plaque causes dental caries (tooth decay) and periodontal disease (gum disease).

Where does plaque come from?

Everyone's saliva contains millions of bacteria. These bacteria stick to the surfaces of our teeth and quickly multiply to form layers of plaque.

What does plaque look like?

Plaque is at first a soft, colourless substance which is difficult to see until the coating is quite thick and becomes a white layer. It collects on the surfaces of teeth mainly next to the gums and between the teeth.

Can I prevent plaque from forming?

Not entirely. However, careful tooth cleaning every day will remove plaque, before it builds up in sufficient amounts to damage your teeth and gums. Plaque can be removed from around your teeth with a toothbrush. Special devices, such as Colgate dental tape, are necessary to clean between your teeth, in hard to reach areas.

Is tartar the same thing as plaque?

Not exactly. Tartar (calculus) is formed when minerals such as calcium in the saliva combine with plaque and make it hard. This happens commonly behind the lower front teeth. Once tartar has formed, it will have to be removed by your dentist or hygienist. Regular, effective plaque removal is the best way to prevent build-up of tartar.

What is periodontal disease?

Periodontal disease is inflammation of the tissues which support teeth and attach them to the jaw. If inflammation only involves the soft gum tissue, it is called gingivitis, a precursor to periodontal disease. Once inflammation reaches the underlying bone, it is termed periodontitis.

How does periodontal disease start?

If plaque is allowed to build up on teeth, toxins produced by bacteria inflame the gums. This early stage of periodontal disease is called gingivitis.

What are the signs of periodontal disease?

Periodontal disease can sometimes go unnoticed until it is quite advanced. However, most people will notice some of the following signs:

Red, swollen gums
Bleeding gums
Bad breath
Bad taste
Gum recession
Teeth drifting apart
Loose teeth

The classic sign of gingivitis - red, swollen gums which bleed on brushing - is often the first indication of periodontal disease. Gum recession and loosened teeth occur at later stages of periodontal disease.

What do inflamed gums look like?

Inflamed gums are red, swollen and bleed on brushing. Plaque is often visible on the surfaces of teeth, next to areas of inflammation.

How does gum inflammation spread?

In time, plaque around the crown of the tooth may spread down below gum level. This usually occurs slowly and the inflammation produced results in the formation of 'pockets' (spaces between teeth and gum) and bone destruction. Periodontitis is the name given to the stage of gum disease when inflammation reaches the bone.

As more bone is destroyed, the tooth begins to loosen. As the pockets around it get deeper, abscesses can occur. Sometimes the gum will shrink and part of the tooth root will become exposed. Periodontitis may reach an advanced stage without causing any pain.

Do all teeth in the mouth become affected to the same extent?

No. Teeth that are kept completely clean will stay free from gum disease. When present, periodontal disease is usually more severe towards the back of the mouth and between the teeth; these are areas that are difficult to keep clean and free of plaque.

Is plaque the only cause of periodontal disease?

Yes. However, some people have a very strong inborn resistance and don't experience severe periodontal disease even when their tooth cleaning is poor. Other people. although otherwise perfectly healthy, have a very low resistance to periodontal disease and have to achieve virtually perfect dental hygiene to prevent it. Most people are in between these two extremes.

Is there a cure for gingivitis?

Yes. Teeth which are affected only by gingivitis can be treated relatively easily with very good results. Your dentist or hygienist will ensure your teeth are free from tartar and that you know how to clean them properly. After that, thorough cleaning every day will make the gums firm and healthy again.

Is there a cure for periodontitis?

Yes, unless it has become very advanced. Treatment will depend on how far the inflammation has gone. That is why periodontitis needs to be spotted as soon as possible.

Your dentist or hygienist will remove any deposits from pockets around affected teeth. This is done by scaling and root planing which may require several visits. As the crowns and roots of teeth become clean, gums will tighten up around the root surfaces. Any loose teeth may also become firmer.

Will I need antibiotic treatment?

Your dentist or hygienist will provide you with further information on what you will require in the course of your gum treatment.

Will this treatment stop the bone from being destroyed?

Yes.

Is periodontal disease common?

Yes. Nearly every adult is affected by some form of gum disease at some stage and many teeth are extracted because of advanced periodontitis

If I go back to my old tooth cleaning habits, will the disease recur?

Yes. That is why it is important to ensure that you brush your teeth thoroughly twice a day.

I have always brushed my teeth twice a day. Why should I be affected?

You probably miss the same parts of your mouth every time you brush your teeth, and these will be the areas vulnerable to gum disease. Most people realise how difficult it can be to clean the 'necks' of teeth up against the gums. Also, even when you are an expert at brushing, toothbrush bristles may not reach all the way in between your teeth and that is usually where the disease is most severe.

What is the best way to brush my teeth?

Your hygienist or dentist will advise the best way for you to brush your teeth, which will be tailor-made to your specific requirements. There are many toothbrushes available but not all are as effective at removing plaque. The Colgate 360° toothbrush has been scientifically designed to help you remove more plaque from all areas of your teeth, gums and tongue.

Dentists and hygienists recommend that you change your toothbrush as soon as the bristles are worn or splayed, usually after three months of use, as they become less effective at removing plaque.

Do I need to floss as well?

Flossing is important as it removes plaque from between the teeth. Your hygienist or dentist will advise you how best to floss. They will aslo show you how to use any other useful tools for removing plaque after your treatment for gum disease.

How do I maintain healthy teeth and gums?

You can do five things to ensure you have healthy teeth and gums:

1. Visit your dentist or hygienist regularly and follow their advice on how to look after your teeth and gums.
2. Thoroughly brush your teeth twice daily using a clinically proven toothpaste. Colgate Total toothpaste has a unique, patented formulation which contains triclosan and a copolymer which:
   • provides 12 hour protection against plaque, tartar and cavities.
   • is the first and only toothpaste clinically proven to limit the build up of harmful bacteria above and below the gumline.
3. Use a toothbrush, such as the Colgate 360° toothbrush, that is proven to help remove more plaque from difficult to reach areas than an ordinary toothbrush. Replace your toothbrush every three months.
4. Use interdental cleaning aids to remove plaque from between your teeth.
5. Use an antibacterial mouthwash as recommended by your dentist or hygienist that has been clinically proven to help control plaque and prevent gum disease.

Information from Colgate's Dental Health leaflet.