How Gum Disease Forms – Dental Terms Made Easy

Posted on Jan 15, 2016 by William J. Claiborne, DDS MS

A friend who recently acquired a sail boat loves to talk about his new passion. Unfortunately, as he casually throws out terms such as halyard, fife rail, and jibe when describing his outings, I become “lost at sea” (pun intended!). Rather than stop his conversation at each unfamiliar term for an explanation, I tend to try to absorb what I can. More than not, I fail to truly grasp the actual picture of what he is sharing.

As a Periodontal Specialist, I have to continually remind myself that some dental terminology that’s second nature to me isn’t as clear to the patients with whom I’m communicating. Just as jibe means very little to me, terms like osseointegration and mandibular are not familiar ones, often leaving the patient drifting as the conversation begins to fall apart.

Although dental implant placement and gum recontouring are regular treatments our office provides, gum disease is the most frequent problem we treat. Gum disease in the U.S. affects over 70% of adults at some level. It is the leading cause of tooth loss and has been linked to heart disease, high blood pressure, stroke, memory loss, arthritis, diabetes, preterm babies and impotency.

Because gum disease (also known as periodontal disease), begins without obvious symptoms, people often ignore the warning signs, which merely allows the disease to progress further. In order to help people have a clear, concise picture of how gum disease forms, I’ve broken the stages down in language that removes dental jargon.

• Oral bacteria – We all have bacteria in our mouths. That’s normal. However, it’s the excess of bacteria that is at the root of the problem. When oral bacteria are not brushed, flossed or rinsed from the mouth properly and on a daily basis, they band together and form plaque.

• Plaque – This is a sticky film that coats teeth. It also covers the gums and tongue but is not as obvious as what can be felt by running the tongue over teeth. The presence of plaque means the mouth contains more bacteria than saliva flow can handle. When plaque is not removed, oral bacteria continue to reproduce, thrive and form calculus.

• Calculus – Also known as tartar, this is actually a hardened form of bacteria that emerges from plaque. As a condensed colony of bacteria, calculus attaches to teeth and can only be removed with special instruments used by dental professionals. This is why your 6-month check-ups and cleanings are so important. By scraping away buildup on a regular basis, you can halt damage to gums and enamel.

• Gingivitis – This is actually the first stage of gum disease. In this stage, oral bacteria are attacking gum tissues and tooth enamel as they reproduce at a rapid rate. Signs of gingivitis are gums that bleed when brushing, sore spots and frequent bad breath. It is this stage, however, that can be self-treated. That is to say that an immediate response with proper measures can combat the problem before it worsens. This includes a minimum of twice daily brushing (at least two minutes each time) with a soft to medium bristle tooth brush and flouridated tooth paste. Daily flossing is also needed to remove food particles and bacteria between teeth. Tongue scraping is advised, also. This removes oral bacteria that is embedded in the grooves of the tongue. When a tongue scraper is not available, brush the tongue with your tooth brush after brushing teeth. Be sure to get to the back of the tongue where the greatest concentration of bacteria live. Drink lots of water and swish daily with an oral rinse that kills bacteria and provides added protection to enamel.

• Periodontal (Gum) Disease – When gingivitis is not resolved, the next stage you can expect will be periodontal disease. This is when the bacteria have moved down into the gum tissues and are eating away at gums and tooth enamel at a rigorous rate. Typical symptoms are red and swollen gums, gums that bleed easily when brushing, gums that pull away or loosen from teeth, exposing sensitive tooth root areas. Persistent bad breath is another symptom, which occurs even after brushing or chewing gum.

• Periodontitis – At this stage, gum disease is running rampant in your mouth. Gums are red and tender all the time. Pus pockets form at the base of some teeth. Some teeth will begin to loosen as bacteria eat away at the structures that support tooth roots. Eventually, some (or all) of your natural teeth will need to be removed.

I believe if the general population were more aware of the sequence that leads to full-blown gum disease, we’d have far less adults walking around with bacteria that causes internal inflammation. When oral bacteria enter the bloodstream through tears in diseased gum tissue, it can trigger inflammatory reactions that are the foundation of the severe health problems mentioned prior (heart disease, arthritis, etc.). We’d also have fewer adults dealing with the ordeals surrounding tooth loss.

I hope I’ve provided a helpful explanation of how oral bacteria progresses and how it effects your oral and overall health. For an examination to determine the health of your gums, along with recommended treatment options, call 828-274-9440 to request an appointment.

Remember, if you are having any symptoms, these will only worsen when treatment is delayed. This typically means more treatment time and greater expense.