Gum Disease (Gingivitis and Periodontitis)
Published: 01 June 2021
Published: 01 June 2021
Most people experience gum disease at some stage of their lives (Better Health Channel 2019a).
Ensuring that your clients maintain good oral hygiene and helping to provide oral care when required are crucial in preventing potentially irreversible damage.
Gum disease occurs when the gum (gingiva) - the mucosal tissue surrounding and protecting the teeth - becomes infected and inflamed (Wu & Oakley 2015; Healthdirect 2021).
Gum disease is usually caused by plaque, a sticky coating of bacteria that accumulates on the teeth along the gum line and causes irritation. The immune system triggers an inflammation response in order to remove this bacteria, leading to symptoms such as redness, swelling, tenderness and bleeding (Better Health Channel 2019a; QLD Health 2017).
All people naturally carry bacteria inside their mouths. These bacteria feed on the sugars in foods and drinks that are consumed. As a result, plaque is continuously being formed and providing millions of bacteria with an environment to live and multiply in (Better Health Channel 2019a; QLD Health 2017).
If plaque is not brushed off, it can harden into calculus (also known as tartar), which cannot be removed with a toothbrush alone (Healthdirect 2021).
In addition to poor oral hygiene, gum disease may also be caused by:
(Wu & Oakley 2015)
(Healthdirect 2021; Better Health Channel 2019b; Wu & Oakley 2015)
There are two main stages of gum disease:
(Healthdirect 2021)
Gingivitis is an early stage of gum disease that affects the superficial gum layers, particularly around the gum line. The deeper parts of the gum, teeth and bone are not yet affected (Better Health Channel 2019a).
Symptoms of gingivitis may include:
(Wu & Oakley 2015)
Gingivitis is reversible. Treatment involves plaque removal, which should be performed as soon as possible in order to avoid complications and prevent disease progression (Healthdirect 2019).
About 22% of children (aged 5 to 14) and 29% of adults have gingivitis (AIHW 2021).
Periodontitis is an irreversible, more serious stage of gum disease that occurs when gingivitis is left untreated (QLD Health 2017).
Periodontitis is an inflammation of the periodontium - the group of structures responsible for keeping the teeth in place. These structures include the cementum (tooth root covering), alveolar bone and periodontal ligament (fibres connecting the root of the tooth to the bone) (Better Health Channel 2019a; Katancik et al. 2016 pp. 189-202).
The periodontium is protected by the gum, which forms a seal around the neck of each tooth. However, if this seal is damaged by gum disease, periodontal pockets (spaces between the gum and the tooth roots) may form and trap bacteria. Gradually, the space between the gum and the tooth roots may increase and potentially lead to permanent bone loss (Better Health Channel 2019a).
If left untreated, this cumulative damage to the periodontium may become so severe that the teeth loosen and need to be removed (Better Health Channel 2019a).
Symptoms of periodontitis may include:
(Better Health Channel 2019a; Wu & Oakley 2015)
Periodontitis is associated with complications such as:
(Wu & Oakley 2015; Healthdirect 2019)
About 30% of adults over 14 years of age have periodontitis (AIHW 2021).
Gingivitis can be treated by removing plaque. Calculus will require removal by a dentist (Healthdirect 2019).
The patient should maintain an oral hygiene routine at home and visit the dentist regularly for monitoring (Wu & Oakley 2015).
Periodontitis may require additional treatment, including:
(Wu & Oakley 2015)
It is crucial to seek treatment as soon as possible in order to prevent further damage (Better Health Channel 2019a).
Strategies for preventing gum disease include:
(Healthdirect 2021; Better Health Channel 2019a)
Question 1 of 3
True or false: Calculus can be removed.