Have you seen a bit of blood in your sink when you brush your teeth lately? That bleeding can be one of the first warning signs ofgum disease.
The mild variety is called gingivitis. When you have that, only your gums are infected. If you don’t treat it, the infection can travel below your gumline and into your bone. Then it becomes a more serious form of gum disease called periodontitis.
Both gingivitis and periodontitis have been shown to raise your risk of things likediabetes,heart disease, osteoporosis, pneumonia, andcancer. Early detection is your best bet.
There are a variety of treatments forgum disease, depending on the stage of your disease, how you’ve responded to earlier treatments, and your overall health.
Treatments range from nonsurgical therapies that control bacterial growth to surgery that restores supportive tissues.
Symptoms of Gum Disease
You can find and treat the problem before it gets serious, if you know what to look for. Take note if you notice:
Red,swollen gums:That’s one of the first signs your gums need attention. “Gum diseases typically start with inflammation along the gumline,” says Erik Sahl, DDS, an assistant professor of periodontics at Loma Linda University. They may also feel tender or painful and bleed easily when you floss or brush.
Bad breath:Your mouth is a nice, warm, and wet home for millions of bacteria. They feed on plaque, so the more of that you have, the bigger the buffet. “Bacteria release toxins that can irritate the gums and teeth and have a foul smell,” Sahl says.
It can also be a symptom of serious gum disease. Your breath usually doesn’t change much if you’ve got gingivitis.
Gums that get smaller:If your teeth look longer than they used to, chances are your gums are shrinking.
“[When] bone starts to break down, the gums start separating from the tooth, creating a pocket,” Sahl says. This pulling away is calledreceding gums.
Sensitive teeth:If a sip of a cold drink makes you wince, your teeth may be telling you something. That’s a symptom of gum disease that often goes hand in hand with shrinking gums. “With receding gums, the sensitive part of the tooth is exposed – called the dentin – causing sensitive teeth when exposed to cold water and air,” Sahl says.
Wiggly or shifting teeth:Does your smile look a little different lately? Gum disease can attack the bones that hold your teeth in place, making them loosen or move. Periodontitis is the main cause, and it can even change the way your teeth fit together when you bite.
Treatments for Gum Disease
There are a variety of treatments for gum disease, depending on the stage of the disease, how you’ve responded to past treatments, and your overall health.
Nonsurgical treatments. Some treatments that don't involve surgery include:
- Professional dental cleaning. During a typical checkup, your dentist or dental hygienist will remove the plaque and tartar (plaque that builds up and hardens on the tooth surface and can only be removed with professional cleaning) from above and below the gumline of your teeth. If you have signs of gum disease, your dentist may recommend professional dental cleaning more than twice a year. These cleanings aren’t treatments for active gum disease. But they’re important preventive measures.
- Scaling and root planing. This deep cleaning is done under a local anesthetic. In this procedure, your plaque and tartar from above and below your gumline are scraped away (scaling) and rough spots on your tooth roots are made smooth (planing). Smoothing these rough spots removes bacteria and provides a clean surface for your gums to reattach to your teeth. Scaling and root planing is done if your dentist or periodontist finds you have plaque and calculus (hardened plaque, also called tartar) under your gums that need to be removed.
- Medications. There’s no magic pill or cream that can cure gum disease, Sahl says. Still, your dentist may prescribe medication as part of your treatment. Some options include:
- Antiseptic chip or antibiotic microspheres: You insert these tiny gels or particles into pockets in your gum, and they release medication slowly over time to help reduce the size of the pocket and get rid of bacteria.
- Antibiotic gel: You spread this on gum pockets after a deep cleaning to help control infection.
- Enzyme suppressant: You take this tablet after a deep cleaning to block certain enzymes in your mouth from breaking down gum tissue.
Surgical treatments. You might need surgery if the tissue around your teeth is unhealthy and can’t be repaired with nonsurgical options. If your gum disease requires surgery, some types are:
- Flap surgery/pocket reduction surgery. During this procedure, your gums are lifted back and tartar is removed. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. Your gums are then placed so that tissue fits snugly around your tooth. This reduces the space between your gum and tooth. It also decreases areas where harmful bacteria can grow and lessens your chance of serious health problems caused by gum disease.
- Bone grafts. These use fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by your gum disease. Grafts serve as a platform for the regrowth of bone, which restores stability to your teeth. New technology, called tissue engineering, encourages your body to regenerate bone and tissue at a faster rate.
- Soft tissue grafts. These can reinforce thin gums or fill in places where your gums have receded. Grafted tissue, most often taken from the roof of your mouth, is stitched into place. That adds tissue to your affected area.
- Guided tissue regeneration. Performed when the bone supporting your teeth has been destroyed, this procedure causes your bone and gum tissue to grow. Done along with flap surgery, a small piece of mesh-like fabric is inserted between your bone and gum tissue. This keeps your gum tissue from growing into the area where your bone should be. That allows your bone and connective tissue to regrow and better support your teeth.
- Bone surgery. This can smooth out shallow craters in your bone due to moderate or advanced bone loss. After flap surgery, the bone around your tooth is reshaped so that it’s harder for bacteria to collect and grow.
Drugs Used to Treat Gum Disease
Antibiotics can be used along with surgery and other therapies, or alone, to reduce or temporarily get rid of bacteria linked to gum disease. They can also help suppress destruction of your tooth's attachment to your bone.
Chlorhexidine (Peridex, PerioChip,PerioGard) is an antimicrobial used to control plaque and gingivitis in yourmouth or in periodontal pockets. Thismedication is available as amouth rinse, or as a gelatin-filled chip that’s placed in pockets after root planing. It releases the medication over 7 days or so. Otherantibiotics, includingdoxycycline,tetracycline, andminocycline (Arestin), may also be used to treat gum disease. Your dentist will know if you need meds and which ones are best for you.
Other options for preventing and treating gum disease may include:
Toothpaste. Some toothpastes marked as antibacterial may contain fluoride and an antibiotic called triclosan to help reduce your plaque and gingivitis. These toothpastes are sold over the counter.
Antimicrobial mouthwash.Your dentist may also recommend antimicrobial mouthwash You swish this in your mouth as part of your daily brushing routine to help control bacteria. It’s available both by prescription and over the counter.
Lasers. Check the Academy of Laser Dentistry for more information.
How Do I Prepare for Gum Disease Treatment?
Your dentist or periodontist can do most procedures for gum disease in their office. The time needed to perform the procedure, your degree of discomfort, and time needed to heal will vary from person to person. They may depend on the type and extent of the procedure you have, and your overall health. You may have local anesthesia to numb the treatment area. If necessary, your dentist might give you meds to help you relax.
