Understanding Gum Disease

Periodontal disease, commonly known as gum disease, is a bacterial infection that affects the gums and supporting structures of the teeth. It is one of the most common dental problems, and if left untreated, it can lead to tooth loss and other serious health complications. There are three main stages of gum disease: gingivitis, periodontitis and advanced periodontitis.

Stage 1: Gingivitis

• Gingivitis is the mildest form of gum disease and is caused by the buildup of plaque, a sticky film of bacteria that forms on the teeth. Symptoms include red, swollen, and bleeding gums. However, gingivitis can be reversed with good oral hygiene practices including regular brushing, flossing, and professional dental cleanings.

Stage 2: Periodontitis

• If gingivitis is left untreated, it can progress to periodontitis, a more severe form of gum disease. This occurs when the infection spreads to the supporting structures of the teeth, including the bone.

Stage 3: Advanced Periodontitis

• This is the most severe stage of gum disease, characterised by significant damage to the gums, bone, and other supporting structures of the teeth. In this stage, the infection and inflammation progressed to the point where there may be deep pockets between the teeth and gums, severe gum recession, loose teeth, and even tooth loss.

Causes and Risk Factors

Gum disease is caused by oral bacteria infecting the tissue around teeth. Bacteria that remain on teeth for an extended period of time produce a film known as plaque, which hardens into tartar. Tartar build-up may spread below the gum line, making the teeth harder to clean.

Other factors that may increase the risk of gum disease include:

• Inadequate tooth brushing and flossing leading to poor oral hygiene
• Smoking
• Poor nutrition
• Hormonal changes during pregnancy or puberty
• Medical conditions such as diabetes
• Taking certain medications, particularly those that cause a dry mouth

Symptoms

• Redness and swelling of the gum
• Gum bleeding during tooth brushing
• Bad breath
• Loose or shifting teeth
• Gums that pull away from the teeth, making them appear longer

Diagnosis

During an appointment, a dentist or dental hygienist will do examinations to identify periodontal disease:

• Gum Examination: Dentists visually inspect your gums for signs of inflammation, bleeding, and use a periodontal probe to measure the depth of the pockets between your teeth and gums. Deeper pockets indicate more advanced gum disease.
• X-rays: This can show the extent of damage to the supporting structures of your teeth, such as bone loss. This helps in determining the stage of gum disease and planning treatment.

The Impact of Gum Disease

Gum disease destroys the supporting structures of the teeth, which can cause them to become loose. Receding gums exposes the tooth roots, increasing risk of tooth decay. Gum abscesses and bad breath can occur as a result of infection. Changes in bite and sensitivity may also develop.

Gum disease is also linked to systemic health conditions. It may contribute to heart disease and stroke due to inflammation and an increase in cholesterol levels. Diabetes and gum disease have a two-way relationship, which may impact blood sugar control. Respiratory problems, pregnancy complications, and other conditions, such as arthritis and Alzheimer's, are also linked to gum disease.

Periodontal Treatments in Singapore

Non-Surgical Treatments

• Scaling and Root Planing: This deep cleaning procedure removes plaque and tartar from the teeth and root surfaces, smoothing the root surfaces to prevent bacteria from reattaching.
• Antibiotics: In some cases, antibiotics may be prescribed to help control bacterial infection and inflammation in the gums.
• Professional Dental Cleaning (Dental prophylaxis): This is a standard procedure where a dental professional thoroughly cleans the teeth. The process involves removing plaque and tartar from the surfaces of the teeth.

Surgical Treatments

• Flap Surgery: This procedure involves lifting the gums to remove tartar deposits and reduce pocket depths, making it easier to clean the teeth and gums.
• Bone Grafting: This repairs gum disease-damaged areas by using the patient’s bone, bone from donors, or a synthetic bone. The graft functions as a scaffolding, holding space until the bone can grow back in the body.
• Gum Grafts: During gum grafting surgery, the periodontist surgically places a tissue graft in areas where gum recession has occurred, securing it with stitches. If autologous tissue is used, the graft is typically harvested from the palate (roof of the mouth).

Latest Advances

• Laser Therapy: This advanced technique uses a tiny laser to remove diseased tissue and bacteria from the gums. It is minimally invasive, promoting faster healing compared to traditional methods. Specific areas can be targeted with precision to help reduce discomfort. Anaesthesia may not be required in certain cases.

Preventing Gum Disease

To prevent periodontal disease, it is important to practise good oral hygiene by brushing the teeth with a fluoride toothpaste, flossing daily to remove plaque and food particles, and using an antiseptic mouthwash to reduce bacteria and prevent plaque buildup. Regular dental check-ups are essential, with visits recommended every six months for dentists to assess gum health and provide necessary treatments.

Periodontic Care in Singapore

Finding a qualified periodontist in Singapore involves multiple steps. Start by asking for recommendations from friends or family members. Additionally, conduct online research to identify periodontists with positive reviews and extensive experience in treating periodontal diseases. Check their qualifications and board certification to ensure they meet professional standards. Consideration for insurance coverage is essential. Patients should verify with insurance providers if periodontal treatments are covered under the policy and if there are any specific clinics or specialists within their network.