The Wentworth Clinic, Bournemouth

01202 428 773 01202 422 171

Harley Street Clinic, London

0203 417 3891

Patient Resources

If you have been told that you have periodontal (gum) disease, you are not alone. Many adults in the UK currently have some form of the disease. Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that supports the teeth. In advanced cases teeth are lost. Whether the gum disease is stopped, slowed or gets worse depends a great deal on how well you care for your teeth and gums everyday.

What causes gum disease?

Gum disease is caused by build-up of plaque on the teeth. Plaque is a stick colourless substance that contains bacteria, which forms when you eat and drink. Some bacteria in the plaque are harmless but some are very harmful for the health of your gums. If you do not remove the plaque from your teeth by brushing them it will build up and irritate your gums, leading to redness, swelling and bleeding.

Gingivitis

Gingivitis is the mildest form of periodontal disease. It causes the gum to become red, swollen and bleed easily. There is usually little or no discomfort at this stage, and is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral care.

Periodontitis

Untreated gingivitis can advance to periodontitis. It is also known as gum disease. It is a serious inflammatory disorder, that left untreated, can lead to tooth loss. The word periodontal literally means ‘around the tooth’. In periodontitis, gums pull away for the teeth and form spaces (called pockets) that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the bodies natural response to infection start to breakdown the bone and connective tissue that holds the teeth in place. If not treated, the bones, gum and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.

Risk factors

The main cause for periodontal disease is plaque, but often factors affect the health of your teeth.

  • Age: studies have shown that older people have the highest rates of periodontal disease.
  • Smoking: smoking is one of the most significant factors associated with the development of gum disease additionally, smoking can lower the chance for successful treatment.
  • Hormones: changes in woman: these changes can make the gums more sensitive and it’s easier for gingivitis to develop.
  • Diabetes: people with diabetes are at higher risk for developing infection including gum disease.
  • Other illnesses and their treatment: treatment such as AIDS and its treatment can also negatively affect the health of gums, as can treatment for cancer.
  • Medications: Some medications can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infection such as gum disease. Also some medications can cause abnormal over growth of the gum tissue, this can make it difficult to keep teeth and gum clean.
  • Genetic susceptibility.

How do you know that you have gum disease?

  • Bad breath that won’t go away
  • Red or swollen gums
  • Bleeding or tender gum
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Receding gums and longer appearing teeth

How is gum disease treated?

The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home, it may also suggest changing certain behaviours such as quitting smoking as a way to improve treatment outcome.

Non-surgical treatment

Deep cleaning: scaling and root planning.

Scaling and root planning is careful cleaning of the root surfaces to remove plaque and calculus (tartar) from the deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. This procedure is often followed by adjacent therapy such as a local delivery anti-microbials as needed on case by case basis.

After scaling and root planning many patients, do not require any further active treatment. However, the majority will require ongoing maintenance therapy to sustain health.

Surgical treatment

Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medication.

How to maintain healthy teeth and gum?

  • Brush your teeth twice a day with a fluoride toothpaste.
  • Floss regularly to remove plaque between teeth or use a device such as a special brush or wooden or plastic pick recommended by your dentist.
  • Visit dentist routinely for check-up and professional cleaning.
  • Do not smoke.

Can gum disease cause health problems beyond the mouth?

In some studies show that people with gum disease when compared with people without gum disease were more likely to develop heart disease or have difficulties controlling blood sugar. Other studies showed that woman with gum disease were more likely than those with healthy gums to decline pre term, low birth weight babies. But so far, it has not been determined whether gum disease is the cause of these conditions. More research is needed to clarify whether gum disease actually causes health problems beyond the mouth; and whether treating gum disease can actually help other health conditions from developing. In the meantime, it’s a fact that controlling gum disease can save your teeth - a very good reason to take care of your teeth and gums.

Burning mouth syndrome

What is burning mouth syndrome?

It is a relatively common condition that is characterised by a complaint of abnormal sensation of the lining of the mouth that more people describe as feeling like their mouth has been scalded. Usually this sensation develops in the front part of the mouth, typically affecting the inner surfaces of the lips, the roof of the mouth and the sides, and tip of the tongue. Some people may have decreased ability of altered taste sensation (bitter or salty). Other people may feel that their mouths are dry or sticky.

What causes burnt mouth syndrome?

Nobody knows for sure. Some investigations gave suggested that burning mouth may be a problem related to the nerves in the mouth. It is not related to anything serious, such as cancer or AIDS. Furthermore it is not contagious so it can’t be passed from one person to another.

How is burning mouth syndrome treated?

There is no definite cure for BMS. This is because no one knows exactly what causes it. You may feel better when you know your pain isn’t a sign of a serious disease. If you stop worrying about pain, you might stop noticing it so much. These are things you might try on your own might to improve your pain.

Things you can do it yourself

Some people find that drinking cold water or sucking ice cubes helps with the pain. Drinking more fluids might also ease the feeling of dry mouth. You might also try to avoid things that irritate your mouth, such as alcohol, tobacco products, spicy foods, carbonated beverages and food and drinks that are high in acid such as tomatoes and fruit juice. Some people use painkilling mouthwash called benzydamine

How long will the burning sensation last?

Research shows that about half of all people with burning mouth syndrome find it improves or goes away eventually. But it takes years.

Remember the BMS is not dangerous. Although it maybe uncomfortable, it wont damage your mouth or your teeth.

Mouth ulcers

They are breakdown in continuity of the muscle living in and around the mouth. Some of the causes of mouth ulcers are known, whereas the others appear without any obvious cause. Ulcers are a result of trauma usually.

Ulcers as a result of viral infections will have periodontal symptoms prior to frank ulcers and again heal within 7-10 days.

The well known but very painful mouth ulcer with no known obvious aetiology is called Apthous ulcers. They are minor, major and herpetiform. It is important to diagnose them correctly and treatment is steroid ‘based’. The mouth ulcer with serious consequences is caused by cancer. These ulcers have varied presentation, but they do not Heal.

Causes of oral ulceration:

Infective:

  • Bacterial
  • Viral
  • Fungal

Traumatic

  • Mechanical
  • Chemical
  • Thermal
  • Fractitious injury
  • Radiation
  • Eosinophilic ulcer (traumatic granuloma)

Idiopathic

  • Recurrent aphthous stomatitus
  • Minor aphthous ulcers
  • Major aphthous ulcers
  • Herpetiform ulcers

Associated with systemic disease

  • Haematological disease
  • Gastrointestinal tract diseases
  • Behcet syndrome
  • HIV infection
  • Other diseases

Associated with dermatological diseases

  • Lichen planus
  • Chronic discoid lupus erythematosus
  • Vesiculobullous diseases

Neoplastic

  • Squamous cell carcinoma
  • Other malignant neoplasms

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