Normal gums are pink in colour and have a sharp outline. They generally do not bleed on brushing.
Gum disease can be divided into two stages:
Gingivitis
Periodontitis
Gingivitis is a superficial infection of the gums. Some or all of the following signs may be present:
Redness
Bleeding gums
Bad odour
This picture shows red swollen gums.
Periodontitis is an infection of the underlying bone. Some of the signs may be:
Spacing between teeth
Mobility of teeth
Receding gums
Pain or other discomfort
This picture shows swollen gums which have overgrown and covered part of the teeth.
Gum disease is the most common cause of tooth loss. It is a slowly progressing infection and is mostly painless in the early stages, and hence most people do not pay any attention to it till it is too late. But it is a totally preventable disease, and can be treated if caught early.
The Cause
The food we eat combines with the saliva and bacteria present in the mouth to form a sticky coating called plaque. The bacteria present in the plaque cause the gum infection. If this plaque is not removed on a daily basis, it will get mineralized to form a stony crust called calculus or tartar. It is not possible for you to remove this calculus - your dentist will use a special instrument called a scaler to remove it.
The bacteria in the plaque produce toxins, which lead to swelling of the gums and bone destruction. When sufficient bone has been lost, the tooth will become mobile. The progress of the disease depends on individual health and resistance to disease. There may be no activity for years, and then when resistance decreases temporarily, gum disease appears or flares-up.
Stages of Gum Disease
These pictures are showing a cross-section. Normal healthy gums will not allow an instrument to penetrate between the gums and the teeth.
Gingivitis - the gums are swollen and the instrument penetrates a few mm between the gums and the teeth.
Periodontitis - there is destruction of the supporting bone. The gums may recede from the teeth. The instrument penetrates a few more mm. Plaque and tartar are seen on the root surfaces of the teeth.
Advanced Periodontits - more destruction of the surrounding bone. Teeth may be mobile. Pain and pus discharge are possible. The instrument now penetrates upto the full depth.
Prevention
It is very important to not allow calculus to form on your teeth, simply by brushing the plaque off on a daily basis. Floss can be used to remove plaque that forms in-between teeth.
The only way you can detect gum disease is by going for regular dental check-ups. Your dentist will check for disease signs with a probe as well as with x-rays. Only a professional can diagnose gum disease in it's early stages, when it is easiest to treat. Prevention and treatment of gum disease involves the combined efforts of your dentist and yourself. Your dentist will remove the calculus present on your teeth. He will also check for other contributing factors - defective fillings, crowns, bite problems, etc. He will explain the correct method of brushing and flossing, and will provide maintenance care after the initial treatment. You are required to put in your efforts towards daily brushing and flossing, and following other instructions. Only then can you expect your teeth to last a lifetime!
An Example of swollen gums and heavy tartar formation showing before and after pictures
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