GUM DISEASE – GINGIVITIS, BLEEDING GUMS

Let’s start with the good news – our dental health has improved enormously over the last twenty years and continues to do so. Nevertheless, periodontal (gum) disease is still the commonest of all diseases in the world, not just in Britain, and up to one in five adults in this country will have lost all their teeth by the time they are sixty, mainly because of this condition.

Gum disease can appear as an inflammation of the gum margins (the gingival margins). Gunge – a mixture of bacteria and food debris – collects in this crevice. Initially this may cause very mild inflammation, but sometimes it will inflame the gums sufficiently to make them sore and swollen – a condition called gingivitis. More seriously, the infection can spread beneath the gums and affect the deeper tissues which attach the tooth to the jaw-bone. It is then known as periodontitis or pyorrhoea and if it goes undetected and untreated the gums gradually recede, the bone becomes eroded and the teeth loosen and eventually fall out. Fortunately, gum disease can nearly always be prevented by good dental care and if you visit your dentist regularly, he or she will spot warning signs such as ‘pocketing’ – a gap developing between the teeth and gums. This can be measured and advice or treatment can then be given to halt the process.

Even the severest form of gum disease can be almost symptomless and surprisingly pain free, but one of the first signs that all is not well with your gums is if they look ‘spongy’ and inflamed, and bleed when you brush your teeth. Nearly everyone will experience this mild form of gingivitis from time to time and it is important to treat it promptly before it becomes more serious. Often a little extra care with your teeth-cleaning routine will do the trick.

The main cause of gum problems and tooth decay is plaque. This is a thin, colourless, sticky substance, composed mainly of bacteria, which forms almost continuously around the teeth and gum margins. If not removed by regular brushing it can build up and harden into a deposit known as tartar or calculus, which attracts further plaque. Tartar, unlike plaque, can be felt with the tongue and can only be removed by a dentist or dental hygienist using special instruments to scale the teeth.

When tartar has built up, every chew and every incorrect brushing can push the tender gums against the sandpaper- Indeed, many middle-aged and elderly people who have suffered from this process for years are said to be long in the tooth7. But this need not happen at all.

Food – particularly sugary and starchy food – interacts with plaque on the teeth and produces acid which eats away at the enamel. This acid attack can last anything from 40 minutes up to two hours after a meal or snack, so the number of times you eat during the day is important, as well as what you eat. If you must eat sweet things, try to limit them to meal times, when the other foods being eaten will ‘dilute’ the acid produced.

Eating a small piece of hard cheese at the end of a meal will help to neutralise the acid, as well as providing protective calcium. Contrary to popular belief, fruit such as apples do not clean the teeth and may only produce more acid. If you can, you should also avoid eating anything shortly before bedtime – our flow of saliva decreases when we sleep and its beneficial cleansing effects will therefore be less.

Saliva has another advantage – it contains a substance which neutralises acid. A recent study has shown that the Americans may have known a thing or two all along -chewing gum for a minimum of 20 minutes after a meal or snack increases the flow of saliva considerably, reducing the time that teeth are attacked by acid from two hours to just 20 minutes. Most people could benefit from it, including anyone who suffers from a dry mouth through taking certain medicines which can have the side-effect of drying up secretions. Any long-standing lack of saliva increases the likelihood of tooth decay, gum disease and mouth infections.

Of course, regular brushing – ideally for at least three minutes after breakfast and at bedtime – is also very important in keeping teeth and gums healthy. So too is the right toothbrush, replaced every three months. Ask your dental hygienist to advise you and show you the most effective way to clean your teeth. He or she will also show you how to use dental floss, useful for removing plaque from awkward crevices between the teeth and particularly necessary if your gums become inflamed and start to bleed.

Special ‘disclosing tablets’ which you chew and rinse around your teeth are helpful because they stain the plaque pink and enable you to see any you may have missed. Fluoride toothpaste strengthens the enamel and some toothpastes also contain an ingredient which reduces the build-up of tartar; there is also a fluoride toothpaste called Oral-B Zendium, which contains natural enzymes to help boost the mouth’s defences against plaque. Antibacterial mouthwashes are available for treating mild gingivitis.

When electric toothbrushes were first invented, I thought they were the latest useless piece of 20th century equipment. How wrong I was! They vibrate electrically while the user is able to hold the small-headed brush at just the right angle. The result is the best cleaning job you can get without visiting your dental surgeon or hygienist. I never go anywhere without mine.

What’s Available

Bocasan Mouthwash, Dettol Mouthwash, Merocet, Oraldene

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