Gum Disease (Gingvitis)
Gum disease is a set of conditions which affect the supporting structures around your teeth. It causes inflammation (swelling) of your gums (gingivae). If it gets worse, it can damage the bone and ligaments that hold your teeth in place.
There are three main types of gum disease:
- Acute necrotising ulcerative gingivitis (ANUG).
Gum disease is very common – at least half the people in the UK have some gingivitis, even if only a little amount. It can be treated by a dentist or hygienist. You need to look after your teeth and gums well to prevent gum disease, or to stop it getting worse.
Gingivitis is the least serious type of gum disease. If you have gingivitis, your gums have become irritated, most often by plaque. Plaque is a soft, sticky substance caused by bacteria that can build up on your teeth.
If you don’t clean plaque off your teeth regularly, it can get under your gums. This can irritate your gums. They may become red, swollen and bleed when you brush them.
If you remove the plaque and look after your teeth and gums well, it is very likely to get better. If you don’t get the plaque off properly, you may develop a more serious type of gum disease called periodontitis.
If you don’t get treatment for gingivitis, the inflammation may spread to the ligaments and bones that hold your teeth in place. This is called periodontitis. Your gums may begin to pull away from your teeth, leaving pockets. These pockets trap plaque that you can’t then reach with a toothbrush.
Over time, the plaque will harden to become tartar (calculus). This can cause further irritation and infection. As time goes on, the pockets can get deeper and more difficult to clean, making the problem worse. Pus may collect under your gums if the infection is bad (known as abscesses).
Periodontitis can cause your gums to shrink back from your teeth (recession). If this happens, it can expose some of the roots of your teeth, making them sensitive. If you have bone loss, your teeth may become loose. If you don’t get treatment for a number of years, you may lose some teeth.
Periodontitis can’t be completely cured. But you will need to get treatment and make sure you floss and brush your teeth well in the future. This way, any further damage to your teeth and gums is likely to be slow or may stop.
Acute necrotising ulcerative gingivitis (ANUG)
ANUG, also known as ‘trench mouth’, is a severe type of gum disease that develops suddenly. It causes swelling, ulcers, bad breath (halitosis) and pain.
Symptoms of gum disease
You may not know you have gum disease because it’s not always painful. This is one of the reasons why it’s important that you attend regular check-ups with your dentist.
Usually the first signs of gingivitis are:
- bleeding gums when you brush your teeth
- red and swollen gums
If gingivitis has developed into periodontitis, you may have:
- bad breath (halitosis)
- a bad taste in your mouth
- gum recession and sensitivity
- a wobbly tooth or teeth
- gum abscesses (pus that collects under your gum)
The symptoms of acute necrotising ulcerative gingivitis (ANUG) include:
- very painful ulcers that bleed easily
- bad breath (halitosis)
- a metallic taste in your mouth
- difficulty swallowing or talking
- having a lot of saliva in your mouth
- feeling generally unwell – possibly with a fever
ANUG often occurs in the V-shaped bit of gum between your teeth. If you have any of these symptoms, you should see your dentist straight away.
Diagnosis of gum disease
Your dentist can usually diagnose gingivitis by looking at your teeth. If your dentist thinks you have periodontitis, he or she may look at your mouth more thoroughly. They will check for gum disease using a periodontal probe. This is a small, thin metal measuring tool. It measures how deep any gaps are between your teeth and gums.
You may also need to have X-rays to check the condition of your teeth and jaw bone.
Treatment of gum disease
If you have gingivitis, your dentist or hygienist will clean your teeth thoroughly above and below the gums. This can also be called a scale and polish. They will clean any plaque or tartar from your teeth using handheld or electric (ultrasonic) instruments. Your hygienist may also recommend a mouthwash that will help to prevent plaque forming. He or she will help you learn how to brush and floss your teeth properly.
If you have periodontitis or acute necrotising ulcerative gingivitis (ANUG), you may need extra treatment. This will remove plaque, tartar and damaged tooth covering. This is called root planing. You may need to have several appointments.
Your dentist or hygienist may inject a local anaesthetic into your gums beforehand if you need this. This will completely block the feeling from your gums. You’ll remain awake during the treatment.
Your dentist or hygienist will check the size of any pockets in your gums during the following months to make sure your treatment has worked.
If you’re having scaling, root planing or treatment for ANUG, your dentist or hygienist may prescribe you antibiotics.
You may need to have gum surgery if your gum disease is severe. Your dentist may refer you to a periodontologist for this. There are a number of types of surgery that can help remove bacteria and repair your gums and bone. If you need more information, ask your dentist.