Healthy gums should be firm, pale pink, and tight around the teeth. Symptoms of infection, or periodontitis are swollen or puffy gums, bright red or purple gums, sore gums, gums that bleed, seeing pink or blood when you brush your teeth, bad breath, loose teeth, pain, and sometimes even puss.
How does it start? Gingivitis is the first stage of periodontal disease. Gingivitis occurs when the bacteria in plaque build-up irritate the gums and cause them to become inflamed and bleed. Gingivitis is completely reversible. However, when left untreated by not getting regular dental cleanings, gingivitis can progress to periodontitis.
Periodontitis occurs when the inner layer of the gum and bone pull away from the teeth and form pockets. The pocket then collects debris and becomes infected. This causes the body’s immune system spring to action. So, now we have the toxins from the bacteria and plaque combined with the body’s immune system. This combination starts to break down the jaw bone and ligaments that hold the teeth in place. This creates a snowball effect where the pockets continue to get deeper and more and more bone is destroyed. As more bone is lost, the teeth become loose. This process is not reversible, but it is treatable.
There are many contributing factors to periodontal disease such as poor oral hygiene, genetics, smoking, and illnesses that affect your immune system like diabetes. Some medications are also risk factors for developing gum disease.
Now the question becomes, how do we prevent it? Early prevention is easy! Brushing and flossing you teeth after meals and getting checked every 6 months at the dentist will help prevent periodontal disease. If you already have periodontal disease though, that is another story. Periodontal disease is irreversible, and once you have it, you’ll always have it. The good news is that your dentist can help you keep it in remission and under control. The only way to accomplish this is to get a deep cleaning followed by maintenance cleanings every three months called periodontal maintenance visits. Research has shown that once the bacteria is completely cleaned out of the gum pockets by a deep cleaning, it takes approximately 90 days for the bacteria to get back down in the pocket and start breaking down the jaw bone and surrounding tissue again. This is why we recommend 3 month periodontal maintenance visits. We are trying to stay ahead of the jaw destruction, and research shows we need to clean the teeth and gums 90 days in order to have the highest chance for success.
There have been many times where I have seen a patient and diagnosed gum disease and they have gotten the deep cleaning, and then they just disappear and fail to do maintenance cleanings afterwards. After being in practice for a while, I started to see those patients turn back up. They were confused as to why their gums were bleeding and inflamed again after they had gotten the deep cleaning done years ago. The periodontal maintenance visits are as important as the original deep cleaning. Without them, the disease cannot be kept in remission.
I hope this helps you to understand! In a quick rundown, gum problems start with reversible gingivitis and if left untreated progress to periodontal disease which is an irreversible disease that must be treated every 3 months to avoid future problems. Now go brush and floss your teeth! :)
Ariana Clayton, DMD