A Guide on How to Manage and Prevent Gum Disease
Step 1: Identify the type
While you most likely need a dental professional to assist you, there are really only 2 types of Gingival inflammation: Gingivitis and Periodontitis (or Periodontal Disease).
How do you measure periodontal disease and can you reverse it?
This will require a dental professional.
Dental professionals use 2 things to determine whether or not you have periodontal disease:
- Dental X-Rays to see the amount of bone loss.
- Periodontal Probing which is a small measuring stick used below the gum line a six different places around each tooth.
A healthy pocket depth – approximately 1 to 3 millimeters.
Higher number of 4 to 5 millimeters – inflammation or slight bone loss.
6 millimeters and above will indicate the need for more invasive procedures to prevent mobility of tooth substructure or tooth loss.
Gingivitis
The determining factor in whether or not you have Gingivitis or true Pyorrhea of the gums, or Periodontal disease, is if there is BONE LOSS.
You have gingivitis if it is limited to inflammation and increases the pocket depth WITHOUT BONE LOSS on dental x-rays.
Periodontal Disease
Periodontal Disease was referred to as Pyorrhea of the gums, due to large amounts of pus that accumulated beneath the gum line. Fortunately, most gum issues are avoided in the United States if patients are seen every 6 to 12 months.
However, differing biology in each individual and genetics play a role in the level of calculus, or tartar build up that can occur in only a short amount of time. Therefore, dental x-rays are crucial in determining whether calculus has caused bone loss to occur.
Step 2: Identify the cause
Pregnancy
In women who are pregnant, the most common cause will be a change in hormone levels that can affect the gums during AND after the labor and delivery of the child for months.
You may need a medical clearance for any dental treatment that was not completed before conception, as OB/GYN differ on their criteria for dental work.
The ideal time for treatment is the second trimester.
The first trimester is limited due to major development of the fetus and the third trimester for stress on the mother during dental treatment if she is laid back in the dental chair for too long.
It is possible to keep swollen gums to a minimum by discussing oral hygiene strategies with your dental healthcare professional and monitoring dietary intake of foods that may cause gum irritation. These may include: spicy or extremely acidic foods causing ulcerations.
Diligent flossing and brushing is recommended during pregnancy to avoid cavities and dental work postpartum.
Some mothers-to-be experience their very first cavity after giving birth and are surprised to find out this was due to something that could most likely have been remedied.
Irritants to Your Gums Play a Part
Many foods contain physical components that make them difficult for your oral tissues to handle (sharp edges, acidic like in fruits, or think pizza burn).
Foods containing chemical dyes and chemical compounds that your mouth have not been exposed to for a long time or for very long in the past.
With such a wide range of foods that you have access to, the human mouth has not adapted as quickly and can therefore develop swelling or ulcerations throughout the mouth.
One of the top considerations is a change in toothpastes or any other dental product. If you have had a change or mouth rinse or floss, it may take a while for your mouth to adapt. Or, you may want to revert back to what you used that kept your mouth swelling-free in the past. The best determination for this is if it takes place throughout the entire mouth.
Localized causes include chewing tobacco, or “dip”, and chewing gum. These contain numerous compounds and most favor a specific side to use of their mouth.
If you look in the mirror and notice irritation of the gums on only one side, this may be a good indication of a dental irritant.
One good and cheap solution is to use a salt water rinse. If in 24 to 48 hours, the irritant has cleared up, there is a good chance that avoiding that brand in the future could help.
Whitening or Orthodontic Trays
If you are using anything fabricated at a dental lab, it could also be a culprit.
Many patients use trays to whiten and with the rise of clear invisible orthodontic alignment trays, many patients may find that when trays extend beyond the junction of the tooth and the gums, irritate and swelling of the gums may occur.
Trimming of the appliance or remaking it altogether (cost is a factor) may help if irritation is too painful once appliance is inserted.
This includes patients wearing dental partials or full dentures, as well. Metal allergies from a recently made partial may be to blame. The hooks on partials need adjustment from time to time as they may shift the anchoring teeth.
Please consult with your dental professional.
Are you too good of a brusher?
With the advent of electric toothbrushes and toothpastes that have even more abrasive additives to encourage whiter teeth and keep up in the marketplace for your whitening dollar, you may have discovered the con with the latest in dental technology: Gum Swelling and Recession.
Periodontal recession or swelling can occur with the trifecta of:
1. Abrasive toothpaste
2. Electric toothbrush
3. Hard bristles
How to Treat Your Swollen Gums
An ounce of prevention is worth a pound of cure when it comes to keeping yourself from bone loss and potential dentures years down the road. After consulting with your dentist, consider the following remedies:
- Listerine Zero – No alcohol means not drying out your mouth at night, which is a very good thing. The active ingredients are also a plus. Consider this if warm salt water rinses are not helping.
- Continue your twice-daily routine – Have you taken a trip and forgotten to floss for a while? Jump back on the nightly routine for at least 10 days to see if this has solved the problem. It may only be gingivitis.
- Can’t get in to see a professional this week? – Consider numbing gels or ointments like Oragel can alleviate gum pain from swelling, but rarely do they address the concern.
How to reverse gum disease damage?
While there are two types of gum disease, both have very different outcomes:
- Gingivitis is completely reversible with proper oral hygiene at home and six month dental cleanings. This removes plaque and tartar, along with irritants.
Once true bone loss has occured, most dental professionals agree that PERIODONTAL MAINTENANCE is necessary.
It is recommended every 3 to 4 months to maintain what bone is left and prevent further gum surgeries and mobility of teeth.
You may want to ask about modern techniques such as laser assisted new attachment procedure (LANAP).
These have been indicated with some clinical trials leading to new attachment of the gums to the teeth.
Source NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046393/
Other practical methods include less frequency of eating sessions in a day and fewer refined sugars that are not so easily converted to plaque and tartar.
We are a family dentist located in Celina, Texas (TX), serving patients of all ages from Prosper, Gunter, Aubrey Frisco, Anna, and the surrounding areas. Book online or call us at (972) 885-9670. We look forward to hearing from you!