Nowadays it is not uncommon to visit the dentist with a continuously repeated query: “Sometimes my gums bleed, is that normal?”. But our patients should ask themselves the following questions: have your gums ever bled, do they bleed when you brush, when you take a bite of an apple, when you wake up at night, has anyone in your family had a history of gum problems or a lot of tooth loss?
The gingiva performs a sealing function, protecting our organism from bacterial, physical and chemical aggressions. In healthy conditions, the gum adapts to the teeth and its color is coral pink, with a superficial texture similar to orange peel, and it does not bleed.
The clearest manifestation of gingival inflammation is bleeding. This is the earliest sign of detection of gingival disease (gingivitis).
Periodontics is the branch of dentistry that studies the supporting tissues of the tooth (gum and bone). And the periodontist is the specialist dentist in charge of this.
There is no point in having teeth that appear to be in perfect condition if the supporting tissues are not healthy and stable, just as there is no point in having a luxury house built on quicksand.
8 out of 10 people over the age of 35 have some kind of problem with their gums. Periodontal diseases are among the most common diseases in humans. However, they are among the least known.
In Spain, according to the National Health Survey, between 85-90% of the population suffers from these pathologies to some degree, mainly gingivitis (gum inflammation). The most destructive manifestation of gingivitis or periodontitis (commonly called pyorrhea) affects 30-38% of adults over 35 years of age. Bleeding will be seen in both situations but the difference between the two will require assessment by a specialist.
How do I know if my gums are diseased?
One of the main and most dangerous characteristics of the appearance and progression of periodontal disease is that, except on rare occasions, it is painless. Certain oral symptoms of acute pain such as the eruption of a wisdom tooth or a deep caries are easy for the patient to recognize because once treated, the discomfort disappears. However, in the case of periodontal diseases, the process progresses stealthily and, in most cases, is diagnosed late. For this reason, it is of utmost importance that the problem is diagnosed early, since gingivitis treated in time can be reversed, but otherwise, the problem evolves being irreversible and chronic and with the possible loss of teeth and bone, in a variable period of time.
The main cause is bacterial plaque. Bacterial plaque is composed of 70-80% of bacteria from the oral cavity and 20-30% of food remains, components of the metabolism of these bacteria, remains of cells of the oral mucosa and components of saliva.
However, bacteria do not affect all individuals equally, and not all people are susceptible to developing the disease. All this will also depend on a series of factors: genetic (which we inherit) and environmental (habits of the patient). Dental malposition, stress and smoking (a patient who smokes is 6 times more likely to develop periodontal problems) are other risk factors for the development and/or progression of the disease.
Contrary to common belief, periodontal diseases are not more frequent in women, but hormonal changes such as those that occur in adolescent women, pregnancy or menopause may accentuate the symptoms or may produce temporary alterations, requiring specialized treatment.
In the case of pregnant women, it is important that they have a control from the first trimester of pregnancy, because, due to their condition, there is a high hormonal influence in their organism that can alter their gums. Poor control of periodontal disease in pregnant women is also associated with an increased risk of premature birth in 18% of pregnant women.
Edentulism (tooth loss) is one of the consequences of this disease, as the problem progresses and the disease is not treated. The consequences of losing teeth are not only functional, preventing us from chewing well, but also aesthetic, social and psychological for the people who suffer from it.
Another of the most common problems associated with these conditions is halitosis or bad breath. This is caused by substances released by bacteria or pus accumulated in localized areas of the gums.
In Spain, the percentage of partially edentulous people is 52% at 40 years of age and the percentage of total edentulous people (loss of all teeth) is 41% at 60 years of age. The economic cost of replacing lost teeth represents a cost that is difficult to assume for many private economies, which causes a major problem of accessibility to such a fundamental right as health.
Detection of the problem
Go to the specialist in the presence of bleeding, however slight it may be, whether it is spontaneous or due to brushing. The appearance of pus in the gum, bad taste or odor in the mouth, redness, gum recession, change of position of the teeth, thermal sensitivity, pain and even mobility of the teeth are signs that require immediate treatment.
Prevention of the disease
Good hygiene and regular visits to the dental office will help to identify cases in early stages, preventing the evolution of the disease or stopping it in time. Hygiene is the most important pillar but not the only one. It will also significantly reduce the occurrence of new caries by detecting incipient caries.
Recent studies show that, since it is a bacterial disease, there is contagion between stable couples and children, the vehicle of transmission being saliva. The way to avoid contagion is to have a good dental hygiene and control along with periodical check-ups by the periodontist.
In addition, today we know the direct relationship between some systemic pathologies (such as cardiovascular diseases and diabetes) and periodontal disease. Due to the chronic inflammation of the gums and other factors, a patient with periodontal problems has a higher risk of developing these pathologies and vice versa, and in the case of those who already suffer from them, of aggravating them.
Gingival disease can also manifest itself in the form of recession, i.e. a recession of the gum of the teeth, exposing the root of the teeth. In anterior areas where gum or bone loss is very evident and has an undesirable esthetic effect, esthetic corrections can be made to correct the alterations in the quality and quantity of gum.
In our dental clinic, Alberto Fernandez & Ayora, we have an area of periodontics for prevention and detection of these diseases, study, maintenance and monitoring of patients, to subsequently rehabilitate their oral situations if required, depending on the case, bone loss and the demand for aesthetic requirements of the patient.