Gum disease

Gum disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Mouth Gum disease Gum disease About gum disease Symptoms of gum disease Causes of gum disease Treating gum disease Complications of gum disease About gum disease If you have a dental problem you should, in the first instance always phone the dental practice that you normally attend . If you are not registered with any dental practice thenyou should read our advice on dental emergencies . Gum disease is a very common condition where the gums become swollen, sore or infected. Most adults in theUK have gum disease to some degree andmost people experience it at least once. Its much less common in children. If you have gum disease, yourgums may bleed whenyou brush your teeth and you may have bad breath. This early stage of gum disease is known as gingivitis. If gingivitis isnt treated, a condition called periodontitis can develop. This affects more tissues that support teeth andhold them in place. Ifperiodontitisisnt treated, the bone in your jawmay be damaged and small spaces can open upbetween the gum and teeth.Your teeth can become loose and may eventually fall out. Read more about the symptoms of gum disease . What causes gum disease? Gum disease is caused by a build-up of plaque on the teeth. Plaque is a sticky substance that contains bacteria. Some bacteria in plaqueare harmless, but some are harmful for the health of your gums. If you dont remove plaque from your teeth by brushing them, itbuilds up and irritates your gums. This can lead to redness with bleeding, swelling and soreness. Read more about the causes of gum disease. Seeing your dentist You should make an appointment to see your dentist if your gums are painful,swollenor if they bleed when you brush your teeth. Find a dentist near you . Your dentistcan carry out a thorough dental examination to check the health of your gums, which may involve inserting a thinmetal stick with a bend in one end(periodontal probe) beside your teeth. In some cases, a number of X-rays may be needed to check the condition of your teeth and jaw bone. Preventing and treating gum disease Mild cases of gum disease can usually be treated by maintaining a good level of oral hygiene. This includes brushing your teeth at least twice a day and flossing regularly. You should also make sure you attend regular dental check-ups. In most cases, your dentist or dental hygienist will be able to give your teeth a thorough clean and remove any hardened plaque (tartar). Theyll also be able to show you how to clean your teeth effectively to help prevent plaque building up in the future. If you have severe gum disease, youllusually need to have further medical and dental treatment and, in some cases, surgery may need to be carried out.This will usually be performed by a specialist in gumproblems (periodontics). Read more about treating gum disease and keeping your teeth clean . Dental check-ups Its importantto have regular dentalcheck-ups so any problems with your teeth and gums can be detected and treated early. If youve never had gum disease and have good oral health, you may only need to visit your dentist every 1 to 2 years for a check-up. You may need to visit your dentist more frequently if youve had problems with gum disease in the past. At each appointment your dentist will advise when you need your next appointment. If you have an increased risk of developing gum problems for example, if you smoke or have diabetes  you may be advised to visit your dentist more often so your teeth and gums can be closely monitored. Complications of gum disease If you have untreated gum disease that develops into periodontitis, it can lead to further complications, such as: gum abscesses (painful collections of pus) receding gums loose teeth loss of teeth Read more about the complications of gum disease . Symptoms of gum disease Healthy gums should be pink, firm and keep your teeth securely in place. Your gums shouldnt bleed when you touch or brush them. Gum disease isnt alwayspainful and you may be unaware you have it. Its important to have regular dental check-ups . Early symptoms The initial symptoms of gum disease can include: red and swollengums bleeding gums after brushing or flossing your teeth This stage of gum disease is called gingivitis. Advanced symptoms Ifgingivitis is untreated, the tissues and bone that support the teeth can also become affected. This is known asperiodontitis, or periodontal disease. Symptoms of periodontitis can include: bad breath (halitosis) anunpleasanttaste in your mouth loose teeth that can make eating difficult gum abscesses (collections of pus thatdevelop under your gums orteeth) Acute necrotising ulcerative gingivitis In rare cases, a condition calledacute necrotising ulcerative gingivitis (ANUG) can develop suddenly. The symptoms of ANUG are usually more severe than those of gum disease and can include: bleeding, painful gums painful ulcers receding gums inbetween your teeth bad breath a metallic taste in your mouth excess saliva in your mouth difficulty swallowing or talking a high temperature (fever) When to see a dentist You should make an appointment to see your dentist if you think you may have gum disease or ANUG. If you dont currently have a dentist, search for a dentist near you . Read more about treating gum disease . Causes of gum disease Gum disease can be caused by a number of factors, but poor oral hygiene is the most common cause. Poor oral hygiene, such as not brushing your teeth properly or regularly, can cause plaqueto build up on your teeth. Plaque Your mouth is full of bacteria thatcombine with saliva to form a sticky film known as plaque, whichbuilds up on your teeth. When you consume food and drink high in carbohydrates (sugary or starchy foods), bacteria in plaque turn carbohydrates into the energy they need, producing acid at the same time. Over time, acid in plaque begins to break down your tooths surface and causes tooth decay. Other bacteria in plaquecan alsoirritate your gums, making them inflamed and sore. Plaque is usually easy to remove by brushingand flossingyour teeth, but it can harden and form a substance calledtartarif its not removed.Tartar sticks much more firmly to teeth than plaque and can usually only be removed by a dentist or dental hygienist. Who is most at risk? As well as poor oral hygiene,a number of things can increase your risk of developing problems with your gums. These include: smoking your age gum diseasebecomes more common as you get older a family history of gum disease diabetes a lifelong condition that causes a persons blood sugar levels to become too high a weakened immune system for example,because ofconditions such as HIV and AIDS orcertain treatments, such as chemotherapy malnutrition a condition that occurs when a persons diet does not contain the right amount of nutrients stress Treating gum disease The best way to treat gum disease is to practise good oral hygiene, although additional dental and medical treatments are sometimes necessary. Oral hygiene Good oral hygiene involves: brushing your teeth for about 2 minutes last thing at night before you go to bed and on one other occasion everydayit doesnt matter if you use an electric or manual toothbrush but some people find it easier to clean their teeth thoroughly with an electric toothbrush using toothpaste that containsthe right amount of fluoride (a natural mineral that helps protect against tooth decay ) flossing your teeth regularlypreferably daily, before brushing your teeth not smoking regularly visiting your dentist  at least once every 1 to 2 years, but more frequently if necessary See the teeth cleaning guide for more information and advice about how to keep your teeth clean. Mouthwash Antiseptic mouthwashes containing chlorhexidine or hexetidine are available over the counter from pharmacies. However,theres some debate about whether usingmouthwash isnecessary for people with healthy gums. Your dentist may recommend using mouthwash if it helps control the build-up of plaque (the sticky substance that forms when bacteria collects on the surface of your teeth). Your dentist will be able to adviseyou about which type of mouthwash is most suitable and how to use it. Chlorhexidine mouthwash can stain your teeth brown if you use itregularly. Rinse your mouth thoroughly between brushing your teeth and using a chlorhexidine mouthwash because some ingredients in toothpaste can prevent the mouthwash working. Dental treatments Some of the dental treatments described below may also be recommended if you have gum disease. Scale and polish To remove plaque and tartar (hardened plaque) that can build up on your teeth, your dentist may suggest that you have your teeth scaled and polished. This is a professional clean usually carried out at your dental surgery by a dental hygienist. The dental hygienist will scrape away plaque and tartar from your teeth using special instruments, then polish your teeth to remove marks or stains. If a lot of plaque or tartar has built up, you may need to have more than one scale and polish. The price of a scale and polish can vary depending on what needs to be carried out, so ask your dental hygienist how much it will cost beforehand. Root planing In some cases of gum disease, root planing (debridement) may be required. This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth. Before having the treatment, you may need to have a local anaesthetic (painkilling medication) to numb the area. You may experience some pain and discomfort for up to 48 hours after having root planing. Further treatment If you have severe gum disease, you may need further treatment, such as periodontal surgery. In some cases, its necessary to remove the affected tooth. Your dentist will be able to tell you about the procedure needed and how its carried out. If necessary, they can refer you to a specialist. If youre having surgery or root planing, you may be given antibiotics (medication to treat infections). Your dentist will tell you whether this is necessary. Acute necrotising ulcerative gingivitis Acute necrotising ulcerative gingivitis (ANUG) should always be treated by a dentist. However, if you see your GP before visiting a dentist, they may provide you with some treatment while you wait to see your dentist. As well as oral hygiene advice and dental treatments, treatments for ANUG may also include antibiotics, painkillers anddifferent types of mouthwash. Antibiotics Treatment with antibiotics , such as metronidazole or amoxicillin, may be recommended if you have ANUG.Youll usually have to take these for 3 days. Amoxicillin isnt suitable for people allergic to penicillin. Metronidazole can react with alcohol, causing you to feel very unwell. You shouldnt drink alcohol while youre taking metronidazole and for 48 hours after you finish the course of treatment. Other side effects of metronidazole and amoxicillin can include nausea (feeling sick), vomiting and diarrhoea . Painkillers Paracetamol and ibuprofen are the most commonly prescribed painkillers.Theyre also available over the counter from pharmacies. They may help reduce pain and discomfort. However, paracetamol and ibuprofen arent suitable for everyone, so read the manufacturers instructions before taking them. Mouthwash Mouthwash containing chlorhexidine or hydrogen peroxide may be prescribed to treat ANUG. Some chlorhexidine mouthwashes are also available over the counter, though they may not be as effective as a hydrogen peroxide mouthwash. You should always read the instructions before using mouthwash. Some types may need to be diluted in water before theyre taken. Complications of gum disease If you develop gingivitis and dont have the plaque or tartar (hardened plaque) removed from your teeth, the condition may get worse and lead to periodontitis. You may develop further complicationsif you dont treat periodontitis (where the tissue that supports teeth is affected),including: recurrent gum abscesses (painful collections of pus) increasing damage to the periodontal ligament(the tissue that connects the tooth to the socket) increasing damage to and loss of the alveolar bone (the bone in the jaw that contains the sockets of the teeth) receding gums loose teeth loss of teeth Acute necrotising ulcerative gingivitis If you have acute necrotising ulcerative gingivitis (ANUG) and itsnot treated, it can cause more severe complications. The infection can spread to all areas of your gums and the alveolar bone surrounding your teeth. This can lead to: the gums between your teeth being completely destroyed large ulcers (open sores) leaving permanent holes in your gums loose and unstable teeth If ANUG isnt properly treated the first time you have it, youre more likely to have recurring cases inthe future. This can cause persistent bad breath (halitosis) and bleeding gums, as well as gradually receding gums. In rare cases, ANUG can lead to gangrene affecting the lips and cheeks. This occurs when tissue starts to die and waste away. If you developgangrene, you may needto have the dead tissue removed. Other complications Gum disease has also been associated with an increased riskfora number of other health conditions, including: cardiovascular disease lung infections if affected during pregnancy, premature labour and having a baby with a low birth weight However, while people with gum disease may have an increased risk of these problems, there isnt currently any clear evidence that gum disease directly causes them. 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