Dr Murphy attended a course on gum disease led by the Faculty of General Dental Practitioners, of which he is a member. The course was called Periodontal Disease and Treatment.
You might be surprised to learn gum disease is the sixth most common global disease.
Cause of Gum Disease
The attending dentists heard that the main causes of gum disease are linked to poor oral hygiene or lack of regular hygiene related dental appointments such as a scale and polish with the dental hygienist who also provides oral hygiene instruction.
The other main causes are
Genetic where the person’s response to harmful bacteria may be inherently weak.
Diabetes, which weakens the immune system and response to oral bacteria.
Smoking, as nicotine affects the inflammatory response in the gums around teeth and dental implants.
Stressful lifestyle – an example might be lack of sleep amongst night works.
Obesity. There is well-documented evidence now for links to diabetes and elevated blood sugar levels which are detrimental to dental healing.
Side effects from medication which can impact on the body’s immune system.
Categories of Gum Disease
Aggressive periodontitis. This often has a genetic or ethnic predisposition. Many Asian populations are more affected. Also, and worryingly, oral hygiene is often quite good in many case. The condition affects mainly local areas within the mouth ie individual teeth in one or two areas. Patients are usually relatively young and the associated bone loss around teeth is usually localised to certain areas in the mouth.
Chronic periodontitis This is generally more likely to affect older patients and is slowly progressive. It affects most patients teeth to a certain degree: mild, moderate or severe.
The signs are bleeding on brushing, flossing, bad breath, foul taste, suppuration, visible gum shrinkage (associated bone loss).
Implant related mucositis Avery mild form involving redness of gums around implants. This is treatable and usually occurs after several years. Forty eight percent of implant patients are affected and 33% of all dental implants are affected after 11years.
Peri-implantitis A more advanced disease. Twenty percent are affected after 10 years according to recent dental clinical research.
Treatment of gum disease
Screening is fundamental. Annual dental or implant examinations are crucial. Gum probing checks and readings should be recorded and regularly monitored every 6 months.
We have a dental hygienist in Glasgow and hygiene visits should be 3-6 months apart depending on patient hygiene levels which relate to brushing and cleaning between teeth.
The latter involves either flossing or use of interdental brushes. This is particularly relevant to patients with crowns or fixed bridgework on teeth or dental implants. These cosmetic restorations, even when well designed, create stagnation areas. There are many areas which are not reachable with normal toothbrushes.
Patients should remember that antibacterial mouthwashes and systemic antibiotics are generally temporary measures. It is the work done by the patient at home and the dental professionals which will best aid treatment of any form of periodontitis or gingivitis.