What is gum disease ?

Gum disease describes swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.

What is gingivitis?

Gingivitis means inflammation of the gums. This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning.

What is periodontal disease?

Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out.

Am I likely to suffer from gum disease?

Probably. Most people suffer from some form of gum disease, and it is the major cause of tooth loss in adults. However, the disease develops very slowly in most people, and it can be slowed down to a rate that should allow you to keep most of your teeth for life.

What is the cause of gum disease?

All gum disease is caused by plaque. Plaque is a film of bacteria, which forms on the surface of the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day. This is done by brushing and flossing.

What happens if gum disease is not treated?

Unfortunately, gum disease progresses painlessly on the whole so that you do notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can become more difficult.

How do I know if I have gum disease?

The first sign is blood on the toothbrush or in the rinsing water when you clean your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant.

What do I do if I think I have gum disease?

The first thing to do is visit your dentist for a thorough check-up of your teeth and gums. The dentist can measure the ‘cuff’ of gum around each tooth to see if there is any sign that periodontal disease has started. X-rays may also be needed to see the amount of bone that has been lost. This assessment is very important, so the correct treatment can be prescribed for you.

What treatments are needed?

A Your dentist will usually give your teeth a thorough clean. You’ll also be shown how to remove plaque successfully yourself, cleaning all surfaces of your teeth thoroughly and effectively. This may take a number of sessions with the dentist or hygienist.

What else may be needed?

Once your teeth are clean, your dentist may decide to carry out further cleaning of the roots of the teeth, to make sure that the last pockets of bacteria are removed. You’ll probably need the treatment area to be numbered before anything is done. Afterwards, you may feel some discomfort for up to 48 hour.

Once I have had periodontal disease, can I get it again?

Periodontal disease is never cured. But as long as you keep up the home care you have been taught, any further loss of bone will be very slow and it may stop altogether. However, you must make sure you remove plaque every day, and go for regular check ups by the dentist and hygienist.

What is acid erosion?

Many foods and drinks contain acid. Sweet-and-sour is a universally accepted ‘nice taste’. We find it in Chinese cuisine, pickles, sauces, lemon meringue pie, and many others. It is a good combination. The trouble is both sugar and acids are extremely bad for teeth.

Some drinks (and other foods) are now made with artificial sweeteners, which do not cause decay. However, as yet there are no artificial acids. There are different types of acid, and although they may all taste sour they do not all have the same aggressive action on calcium based compounds (enamel and dentine etc.).

The commonly used acids in foods and drinks include the following:

  • Citric (Lemons, Oranges etc. and their juices)
  • Phosphoric (Coca Cola, Pepsi etc)
  • Oxalic (Rhubarb, spinach)
  • Acetic (Vinegars, mayonnaise)

The acid that produces the most tooth damage is phosphoric – found in most (if not all) colas. Coke, Pepsi etc. ‘Diet’ or otherwise. After drinking, teeth feel ‘rough’ – this is the etched feeling of loss of tooth surface.

Dentists are now seeing a most alarming increase in the amount of tooth destruction by erosion – which is when the teeth literally dissolve in the acid, especially in the child/youth and young adult group. Possibly this is due to an increase in the availability of this type of drink at schools, sports centres and burger restaurants.

Why is there phosphoric acid in cola?

Phosphoric acid is used as an acidifying agent. Look for E338. Cola is a very acid drink, more acidic than well-known acid products such as lemon juice or vinegar. As cola also contains either sugar or sweeteners, we do not realise the acidity; the sweet taste makes the acid taste nice. Lemons contain much less sugar and thus taste more acidic. The acid is also responsible for the rust removing effect of cola.

Why phosphoric acid is used is not clear; most recipes are still secret. Due to the acidity, micro organisms such as fungi and bacteria will not be able to grow; the acid thus also acts as a preservative. Acid is also considered a pleasant and refreshing taste.

Other acids may cause the same sensation; however, the widespread use of phosphoric acid is probably due to the fact that when the drink was developed (in the 19th century) phosphoric acid was cheap and easy to obtain.

What is an interdental brush?

It is a small brush that can be held between your thumb and your fingers. Interdental brushes are available in various sizes which enables you to choose which size is most suitable for you. You may need to use more than one size to enable you to effectively clean all spaces between your teeth.

Why clean between teeth?

Over the course of a day, food and debris get lodged in between your teeth, and in any gaps you may have. If left, this debris can cause dental decay and gum disease. Removing food debris with an interdental brush will help keep your breath fresh. Cleaning in between your teeth makes sure that you are cleaning your mouth as thoroughly as possible.

Should I use an interdental brush instead of my normal toothbrush?

No. These small brushes should be used as part of your normal oral hygiene routine to be effective.

Why is my normal toothbrush not enough?

You will know that there are certain places in your mouth that are difficult to reach with your normal brush. There are also some gaps between your teeth that your toothbrush will not be able to access.

How can the interdental brush help?

With its small bristles and tiny bottle type head the brush can be moved between the teeth to remove debris and plaque that will not have been removed by your usual toothbrush.

How do I use it?

Select a suitable sized interdental brush. Never force the brush between the teeth. Between front teeth, use a finer brush, a twisting movement eases the brush comfortably between the teeth. Remove the brush by gently pulling thereby removing plaque and debris. Repeat the twisting motion to re-insert and pull out several times until you are satisfied the space is clean. For larger spaces nearer the back of the mouth, a larger headed brush should be selected. To be as effective as possible, shape the head into a “banana” curve. You will then be able to easily locate and clean the space effectively. Rinsing the brush enables you to use the brush again.

When should I use it?

You don’t need to be in the bathroom to be able to clean interdentally. You don’t even need to do it at the same as you brush your teeth. You could be anywhere.

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