Wake Up People: "Death Creeps In Through The Gums!"

Recently I heard an interview with comedian Sarah Silverman, where she was talking about her passion for oral hygiene, and how it affects your health.  Memorably, she said “Death creeps in through the gums!” It was a stunning image, and sadly it’s true. Studies have shown that people who brush and floss regularly live on average 6 years longer!

GUM DISEASE, GENERALLY

Gum disease is the generic term used to describe the presence of inflammation, infection, change of color and active disease conditions in the gums that surround the teeth. This condition is due to the body’s immune response to plaque biofilm and bacteria in areas that have not been efficiently cleaned on a routine basis such as through daily flossing or proper brushing.

Gum disease is known by several other names such as “Periodontal disease,” “Gingivitis,” “Pyorrhea,” “Periodontitis,” and “Trench mouth.”

THE CAUSE OF GUM DISEASE

Do you know what causes gum disease? In order to understand the etiology and factors that contribute to gum disease, it is important to first understand the anatomy of the tooth, and how the gums relate to it.

Tooth Anatomy

Each of your teeth is designed to have a natural, shallow gum pocket surrounding it. This area is called the sulcus – pocket – or if disease is present a periodontal pocket. At the base of this pocket lies connective tissue including ligaments and bone. These structures adhere to the tooth, holding it into the socket. A healthy pocket will be no deeper than three millimeters.

The Invasion Of Bacteria

Plaque biofilm is a byproduct naturally produced by our bodies. As we consume food, that food mixes with our saliva and breaks down into smaller particles. Biofilm then begins to develop and deposit itself onto the surfaces of teeth, and along the gumlines. Plaque biofilm enters into the gum pocket during chewing or by accumulation in the absence of good oral hygiene.

The Destruction Of Gum Attachment And Bone Structure

When plaque is not removed efficiently through careful flossing or brushing, your body’s own immune system begins to attack the bacteria. As the blood supply brings antibodies to attack the biofilm under your gumlines, it destroys the attached gum around the tooth in order to access the area of infection. As this attachment is lost it causes your gum pocket to deepen, destroying bone along with it. After a certain point these pockets become too deep for you to efficiently care for them through normal brushing and flossing.

Heightened Risk Factors

Certain risk factors and health conditions can also contribute to the development and severity of your gum disease.2 3 Some of these risk factors may include:

• Age
• Family history
• Tobacco use
• Diabetes
• Stress
• Osteoporosis
• Cardiovascular disease

THE EFFECTS OF GUM DISEASE

As bacteria invade the areas just under the gumlines, it causes the loss of attached support tissue. This condition ultimately leads to bone loss and tooth mobility. Gum disease is the most common cause of tooth loss, so early diagnosis and intervention is key for effective treatment.

Diagnosis

How do you know if you have gum disease? What does gum disease look like? While your dentist or hygienist can easily screen for the condition, it is also possible to identify it for yourself. Early stages of gum disease begin in the simple form of gingivitis, with more advanced stages leading to severe periodontal disease and tooth loss.

It is estimated that upwards of 90% of adults in the U.S. have gingivitis. The CDC finds that approximately 50% of adults have some form of periodontitis.

SIGNS AND SYMPTOMS

A combination of signs and symptoms may be present, depending on what severity of gum disease you may have. Typically the early signs of gingivitis involve minor irritation such as bleeding or swelling of your gums.

• Bleeding – Healthy gums should not bleed. If you floss regularly and brush along the gumlines, bleeding is not normal. However, infrequent flossing may always result in your gums bleeding due to the development of gingivitis.
• Swollen, Red Gums – Gums that are red, puffy or swollen are a sign of infection. Just as if you had another area on your body that was infected, swelling and redness would occur, alerting you to the condition.
• Bad Breath – A bad taste in your mouth or bad breath may be a sign that there is biofilm or food lodged deep under your gums.
• Gum Recession – The loss of your gum attachment causes the gums to creep slowly down the root of the teeth.
• Tooth Mobility – As gum and bone loss occurs, your tooth has less stability. This may cause your teeth to shift into other positions or make them mobile.
• Sore Teeth – When limited support structures are all that is holding your teeth into place, the delicate ligaments around your teeth can become strained.
• Pus – Clear, white or yellow pus may begin to drain between your teeth and along the gumlines.

DANGERS AND HEALTH RISKS

Having gum disease doesn’t just affect the way your teeth look or feel, but it can also make you more likely to suffer from severe health conditions in other parts of your body. Research shows a direct correlation in the severity of your gum disease and the severity of other health conditions.

Health concerns that are associated with gum disease include:

• Heart attack
• Stroke
• Cardiovascular diseases
• Diabetes
• Erectile dysfunction
• Obesity
• Premature labor
• Low birth weight

If you suffer from any of these conditions along with gum disease, it places a strain on the body’s immune system and makes it difficult to battle a combination of conditions. Bacterial plaque from the mouth can enter into the blood vessels when gum disease is present, spreading to other areas of the body. These bacteria within your bloodstream can increase the likelihood of occurrences such as a heart attack.

HOW TO PREVENT GUM DISEASE

Gum disease is a preventable disease condition, but at times you may still find that even with proper care there may be areas in your mouth that are more prone to persistent problems than others. The most effective way to prevent gum disease is to have absolutely impeccable oral hygiene habits.

Brush Your Teeth

Brushing is something we all do, but do you do it the correct way? Using a soft-bristled brush isn’t always someone’s first method of choice, but it is the gentlest, safest way to remove plaque deposits from along the gumlines without causing tooth abrasion or gum recession.  Gently angle the toothbrush 45 degrees toward the gumlines, making short back and forth motions. You should focus on only two or three teeth at a time and apply just enough pressure that the tissue blanches, no more.

High-quality electric toothbrushes can remove plaque more efficiently from your teeth than manual brushes. Because the bristles vibrate thousands of times per second they disrupt the plaque better than a few strokes back and forth with a manual toothbrush. These brushes work best when you hold the toothbrush in place on just two or three teeth at a time, allowing the brush to do the work for you.

Although conventional wisdom may tell you to use commercial toothpastes filled with fluoride and other chemicals, you may be surprised to learn of the potential dangers that go along with these substances. Click here to learn about the dangers in your toothpaste. It’s best to use toothpaste with natural botanical ingredients that will help destroy the bad bacteria on an ongoing basis

It’s better to use toothpaste with natural ingredients that help destroy bad bacteria on a daily basis. 

Floss Daily

Brushing does not remove plaque deep below the gums or between the teeth. If you do not clean these areas, you are placing your oral health at risk for an increased chance to develop tooth decay and gum disease.

To floss properly you should:

• Use approximately 18 inches of floss, wrapped around the fingers or tied in a circle, allowing you to move to a “clean” portion as you go along
• Wrap the floss in a “C” shape around each tooth
• Glide gently up and down against your tooth, sliding under the gumlines
• Allow the floss to slide down under the gums as deep as it will go, making three to four strokes against the side of the tooth
• Come up over the gums before wrapping the floss against the adjacent tooth to prevent gum trauma

Gums that have gingivitis or periodontal disease will almost always bleed when flossed (an exception is in smokers, who almost always have no bleeding). If your gums bleed, continue daily flossing for approximately two weeks before expecting to see the bleeding stop.

Get Routine Preventive Screenings And Cleanings

Seeing your dentist and hygienist regularly can help identify areas of gum disease that you might have otherwise been unaware of, allowing for early intervention. By having your hygienist clean your teeth regularly, she is able to remove the calcified plaque deposits from your teeth (tartar) that contribute to the advancement of gum disease.

Even people with exceptional oral hygiene will usually still develop small areas of plaque calcification. These tartar deposits cannot be removed on your own and require special instrumentation and training. When tartar is removed from the tooth, it creates a healthy gum environment that helps prevent the loss of bone support. Otherwise, the tartar accumulates and harbors bacteria that contribute to gum detachment.

By seeing your dentist and hygienist regularly, you can stay on top of your oral health, and guard against your overall health and early death.

If you think you might have gum disease, at the dental offices of Dr. Elzbieta W. Basil, DMD (offices in West Hartford Center and New Britain, CT) there are many things we can do to stop it, and reverse it, including deep cleaning, scaling, and antibiotic therapy. If you don’t have gum disease, Dr. Basil can make sure you don’t get it.  To schedule an appointment, contact us online, or call us at 860-561-2121.

Keep smiling

Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and  New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121