GUM DISEASE A BALANCING ACT!

By Joanne Duggan, Principal Dental Surgeon at Bedlingtonshire Dental Practice

As a dental team we all have a commitment to continue our education, attending dental courses and lectures during the year as we strive to improve the dental care we provide to our patients. After attending a course delivered by a periodontal specialist, (specialises in gum disease), I wanted to share some interesting information about gum disease.

WHAT IS GUM DISEASE?

Gum disease is a destructive process caused by harmful bacteria in the plaque that forms on our teeth. The toxins produced by the bacteria can cause inflammation of the gums that can lead to loosening of the gums and teeth. Once the gum is loose it is easier for this harmful plaque to get under the surface of the gum and therefore it is difficult for you to brush it away at home. The harmful toxins produced by the bacteria destroys the bone that holds the tooth in place in the jaw. This can lead to loosening of teeth, pain, abscesses, inability to eat and eventually tooth loss! Sounds scary doesn’t it, but unfortunately it is quite common.

You now know that gum disease is destructive and is caused by the harmful bacteria in plaque, however what was really of interest at this course was the impact of how our body responds and defends against the harmful bacteria and includes our inflammation and immune systems. Whether we develop gum disease really depends on lots of other factors as well.

HARMFUL PLAQUE BACTERIA V HOST RESPONSE!

What does the host response actually mean?

The host response, or how well our bodies respond to harmful bacteria, is our defence mechanism and involves our inflammation and autoimmune response. How well our bodies defend against toxic bacteria around our gums can determine whether we develop gum disease. This is significant and includes factors such as:

Genetics - There is a definite link between gum disease and our genes. If anyone in your family has gum disease then you too may be more at risk of having gum problems. It really is hard to fight your genes and if you have a strong family genetic predisposition to gum disease then it will be more difficult to manage and the treatment you receive may be less effective.

Diabetes - Diabetics are 3 times more likely to have gum disease, particularly if the diabetes is poorly controlled. Diabetics are generally not as good at wound healing. In fact, the link between gum disease and diabetes is so strong that the risk works both ways. What do I mean by this? Well, if you have diabetes you are at risk of having gum disease, but also if you have gum disease you have an increased risk of being diabetic.

Smoking - The most important known risk factor for gum disease is cigarette smoking. There is a very definite link between smoking and gum disease. Studies and research has proved that smokers do loose more teeth due to gum disease than non- smokers. Smoking has a profound impact on the progression of the disease, the response to treatment and the likelihood of relapse. Smoking impairs how well the body deals with harmful plaque bacteria and also reduces the success of any treatment you may receive for gum disease. Being a non-smoker is therefore one of the best ways to improve your gum health.

Smokers have more hard calculus and plaque build up on their teeth. Smoking reduces the blood supply to the gums, meaning infected gums do not heal as well. A reduced blood supply is not healthy and could hide the fact you have gum disease as your gums may not bleed. This is why it is important to visit your dentist regularly as at

“Even smoking 1-4 cigarettes a day can increase your risk of developing gum disease by almost 50%.¹” every check up they will screen for the presence of gum disease.

Stress - If we are stressed, it can affect our general health but also the health of our gums. When we under intense or prolonged periods of stress our bodies defence mechanism does not work as effectively. Stress therefore suppresses our immune system, tipping the balance in favour of the harmful bacteria. Also if you are stressed you may not be looking after yourself as well, for example not brushing your teeth before bed or using interdental brushes.

Toxic bacteria on teeth that causes gum disease.

Smoking Stress

Diabetes Lifestyle factors and Nutrition

Genetics Hormones

Nutrition - Reducing your carbohydrate and processed food intake and adopting a healthy diet including fruit and vegetables helps to improve your host response and maintain healthy gums.

Life style factors - such as obesity, sleep deprivation, lack of exercise, depression can all reduce how well our bodies defence mechanism works.

Hormones - Hormonal changes are known to affect the gums, especially in pregnancy as even a small amount of plaque can cause a lot of inflammation and bleeding of the gums. With good plaque removal, after the baby is born and hormone levels have returned to normal your gum health should also improve.

All of these factors have an impact on how well the body fights the toxic bacteria that causes inflammation and gum disease. Whether we develop gum disease appears to be a balancing act of how much harmful bacteria there is on our teeth and gums versus how our body defends and protects us against it.

It is logical then that the best thing anyone can do to prevent gum disease is to have beautifully clean teeth: if there is no plaque and bacteria, there cannot be any gum disease! It is obviously very difficult to change our host response to bacteria, therefore good oral hygiene is the cornerstone of gum treatment combined with help, advice and support to manage the other factors listed above, such as smoking cessation advice or referral to your diabetic nurse. To diagnose, prevent and treat gum disease you need to make sure you attend the dentist for regular examinations, advice and treatment.

Treatment provided by a dentist or dental hygienist for gum disease will only be successful if you fully engage in their recommended oral hygiene regime. I’m afraid there is a lot of homework for you to do in between dental appointments; you cannot rely on your three monthly hygiene visits to do all the work for you.

Treatment of periodontal disease will not be successful if you don’t clean the plaque off your teeth; being really clean means to remove the harmful bacteria which will prevent the disease process progressing. So you must brush your teeth twice a day for two minutes, especially before bed and clean interdentally every day.

Your dental team will advice you of the best products to use for every area of your mouth. Examples of some of the products are floss, interdental brushes and single tufted brushes.

If you like to arrange an appointment or would like more information about any of the services we provide then give the practice a call on 01670 828402.

Bedlingtonshire Dental Practice

30 Front Street East, Bedlington, NE22 5AA. Tel: 01670 828402 www.bedlingtonshiredental.co.uk