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Oral Health

Gum Treatment

Gum disease describes swelling, soreness or infection of the tissues supporting the teeth. This can be inflammation of the gums (gingivitis) or a more severe form (periodontal disease).

Q & A

What is periodontal disease?

Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out. In fact, more teeth are lost through periodontal disease than through tooth decay.

Am I likely to suffer from gum disease?

Probably. Most people suffer from some form of gum disease, and it is the major cause of tooth loss in adults. However, the disease develops very slowly in most people, and it can be slowed down to a rate that should allow you to keep most of your teeth for life.

What is the cause of gum disease?

All gum disease is caused by plaque. Plaque is a film of bacteria which forms on the surface of the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day. This is done by brushing and flossing.

How will smoking affect my gums and teeth?

Smoking can also lead to gum disease. Patients who smoke are more likely to produce bacterial plaque, which leads to gum disease. The gums are affected because smoking causes a lack of oxygen in the bloodstream, so the infected gums fail to heal. Smoking causes people to have more dental plaque and for gum disease to progress more rapidly than in non-smokers. Gum disease still remains the most common cause of tooth loss in adults.

What happens if gum disease is not treated?

Unfortunately, gum disease progresses painlessly on the whole so that you do notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can become more difficult.

How do I know if I have gum disease?

The first sign is blood on the toothbrush or in the rinsing water when you clean your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant.

What do I do if I think I have gum disease?

The first thing to do is visit your dentist for a thorough check-up of your teeth and gums. The dentist can measure the 'cuff' of gum around each tooth to see if there is any sign that periodontal disease has started. X-rays may also be needed to see the amount of bone that has been lost. This assessment is very important, so the correct treatment can be prescribed for you.

What treatments are needed?

Your dentist will usually give your teeth a thorough clean. You'll also be shown how to remove plaque successfully yourself, cleaning all surfaces of your teeth thoroughly and effectively. This may take a number of sessions with the dentist or hygienist.

What else may be needed?

Once your teeth are clean, your dentist may decide to carry out further cleaning of the roots of the teeth, to make sure that the last pockets of bacteria are removed. This is known as root planing. You'll probably need the treatment area to be numbered before anything is done. Afterwards, you may feel some discomfort for up to 48 hours.

Once I have had periodontal disease, can I get it again?

The disease can recur in the absence of oral hygiene, but as long as you keep up the home care you have been taught, any further loss of bone will be very slow and it may stop altogether. However, you must make sure you remove plaque every day, and go for regular check ups by the dentist.




Bad Breath

Bad breath is a very common problem and there are many different causes. Persistent bad breath is usually caused by the smelly gases released by the bacteria that coat your teeth and gums. However, strong foods like garlic and onions can add to the problem. Smoking is also one of the main causes of bad breath, along with certain illnesses such as nasal and stomach conditions. Bits of food that get caught between the teeth and on the tongue will rot and can sometimes cause an unpleasant smell. So correct and regular brushing is very important to keep your breath smelling fresh.

The bacteria on our teeth and gums (plaque) also cause gum disease and dental decay. If you see your dentist regularly this will not only help prevent bad breath but will also let the dentist look for and treat these problems.

Smoking can cause short term bad breath.

Q & A

How can I tell if I have bad breath?

Lots of small signals can show that you have bad breath. Have you noticed people stepping away when you start to talk? Do people turn their cheek when you kiss them goodbye? If you think you might have bad breath, there is a simple test that you can do. Simply lick the inside of your wrist and sniff - if the smell is bad, you can be pretty sure that your breath is too. Or, ask a very good friend to be absolutely honest, but do make sure they are a true friend.

How can my dentist help?

If you do have bad breath, you will need to start a routine for keeping your mouth clean and fresh. Regular check-ups will allow your dentist to watch out for any areas where plaque is caught between your teeth. Your dentist or hygienist will be able to clean all those areas that are difficult to reach. They will also be able to show you the best way to clean your teeth and gums, and show you any areas you may be missing, including your tongue. One of the warning signs of gum disease is that you always have bad breath or a bad taste in your mouth. Again, your dentist or hygienist will be able to see and treat the problem during your regular check-ups. The earlier the problems are found, the more effective the treatment will be.

Can I prevent bad breath?

To keep your breath fresh, you must get rid of any gum disease, and keep your mouth clean and fresh. If you do have bad breath, try keeping a diary of all the foods you eat and list any medicines you are taking. Take this diary to your dentist who may be able to suggest ways to solve the problem. Brush your teeth and gums twice a day with a fluoride toothpaste. Don't forget to brush your tongue as well. Use dental floss once a day for cleaning between your teeth. There are other products you can buy to clean between your teeth (they are called 'interdental cleaners'). If you wear dentures, take them out at night to give your mouth chance to rest. Do not clean them with toothpaste as it will scratch the surface and more stains will build up. They will also lose their shine. Hold them over a bowl of water or a towel in case you drop them. Clean them thoroughly with soap and lukewarm water, a denture cream or a denture cleaning tablet. Use a denture brush kept just for the purpose. Remember to clean the surfaces that fit against your gums and palate. This will make sure your dentures are always fresh and clean, and avoid the plaque build-up on the denture that may cause bad breath. For more information see our brochure 'Tell me about dentures'.

What products are available?

There are several types of toothpastes you can use, from total care toothpastes to those especially for sensitive teeth. Look for the toothpaste that will suit your needs. If you know that you often get food stuck between your teeth, you may need to brush after every meal. So carry a brush and interdental cleaner with you. Most mouthwashes only disguise bad breath for a short time. So if you find that you are using a mouthwash all the time, talk to your dentist, because they may be able to recommend an antibacterial or chlorhexidine mouthwash for you to use. Some mouthwashes that are recommended for gum disease can cause tooth staining if you use them for a long time. It is important to read the manufacturer's instructions or ask your dentist about how and when to use them. Look for products carrying the British Dental Health Foundation 'Approved' symbol. These products have been clinically and scientifically tested, and a panel of dental experts have decided whether the packaging claims are correct before giving theiraccreditation badge. See the BDHF web site for more details.

What else causes bad breath?

Bad breath can also be caused by some medical problems. Dry mouth (xerostomia) is a condition that affects the flow of saliva. This causes bacteria to build up in the mouth and this leads to bad breath. Dry mouth may be caused by some medicines, salivary gland problems or by continually breathing through the mouth instead of the nose. Older people may produce less saliva, causing further problems. If you suffer from dry mouth, your dentist may be able to recommend or prescribe an artificial saliva product. Or your dentist may be able to suggest other ways of dealing with the problem. Other medical conditions that cause bad breath include infections in the throat, nose or lungs; sinusitis; bronchitis; diabetes; or liver or kidney problems. If your dentist finds that your mouth is healthy, you may be referred to your family GP or a specialist to find out the cause of your bad breath. Tobacco also causes its own form of bad breath. The only solution in this case is to stop smoking. As well as making your breath smell, smoking causes staining, causes loss of taste and irritates the gums. People who smoke are more likely to suffer from gum disease and also have a greater risk of developing cancer of the mouth, lung cancer and heart disease. Ask your dentist, pharmacist or practice nurse for help in quitting. If you do stop smoking, but still have bad breath, then you need to see your dentist or GP for advice.

How can I tell someone they have bad breath?

The chances are, we all know someone who has bad breath, but very few people feel brave enough to discuss the problem. It is obviously a very delicate matter to tell someone they have bad breath. There is always the risk that they will be offended or embarrassed and may never speak to you again! However, it is always worth remembering that the bad breath may be the result of any number of problems. Once the person knows they have bad breath, they can deal with whatever is causing it. You could try talking to their partner or a family member, as the bad breath may be caused by a medical condition, which is already being treated. Or you could try, for instance, asking if the person has been eating garlic lately!