What is Gum Disease Exactly?

We get this question every day.  Usually, we hear it from patients that have been told in the past that they have gum disease, but sometimes it's because a patient has noticed bleeding when the brush or pain when they floss, and wants to know what the problem is.

If you have pain or bleeding from normal cleaning of your teeth with a toothbrush or floss, you have gum disease. Gum disease is a  slowly progressing infection under the gum line that starts out as inflamed gums, but eventually causes breakdown of the ligament and bone that support the teeth. Seventy percent of people have some form of gum disease, but the good news is that a full third of them having only the earliest stage of the disease.  The earliest stage (gingivitis) is when only the gums at the surface are inflamed (red, sore, or bleeding easily).  If your gums are red, sore, or bleed when brushing or flossing, that's an important warning sign, because it tells us that an infection has started, and treatment is needed before it begins permanently destroying the attachment of the teeth.  The treatment for gingivitis is simple: a combination of professional cleanings every six months, instruction for ideal techniques to clean your teeth every day in a way that addresses your personal risk factors, and often some type of medicated rinse that will fight the bacteria causing the inflammation.  

If your gum disease is treated, it can be stopped before any serious damage is done, but like most problems, if allowed to go unchecked, it gets worse and worse until teeth are lost.  The x-ray below shows a patient with advanced gum disease that has destroyed a large amount of bone.  The red line shows the current bone heights, and the green line is where they were when the teeth first came in.  As a result of the bone loss, this patient complains of loose teeth and painful abscesses when food gets trapped deep in the resulting gum pockets and the infection in that area becomes more severe.  A dental implant at the far right side of the image is replacing a tooth that became loose and was lost.  Because of the prior loss of bone and gum tissue, the implant crown is longer than usual, and its appearance  is less than ideal.  These problems could have been avoided with improved hygiene and regular professional checkups and cleanings, but like many patients, she didn't start treatment until she felt pain, at which point quite a bit of damage was already done.

Once gum disease has started to attack the bone like in this case, deep cleanings are needed, and checkup visits are needed more often.  But no matter when or how gum disease is found, it's important to treat it immediately and often to make sure that no further damage is done.  Just because there's no pain, it doesn't mean there's no infection or no destruction of the bone.  For example, the x-ray below shows a patient with gum disease so severe that his teeth have shifted, and he's going to lose all his upper teeth.  He tells us that he's never had any pain from these teeth at all!

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If you have bleeding or pain from your gums, don't delay treatment.  These are signs of an active infection,and should not be ignored. If your hands bled and hurt every time you washed them, you would hurry to the doctor to find out what was wrong!  Don't treat your mouth any differently!  Call us today at (718) 268-1561,  or request a consultation.