Severe gum disease (periodontitis) occurs in almost 20% of all adults world wide. This means that right now more than 1 billion people are suffering from unhealthy gums according to the World Health Organisation . You gums form the basis of your mouth. They are the structures that protect your jaws and are the foundation that secure your teeth. Healthy gums are in a sense even more important than healthy teeth. Without healthy gums, your teeth would just fall out. Therefore for you to have good oral health, you must first have good gum health.
Before you can understand how to keep your gums healthy, it is important to understand what makes them unhealthy. Your gums form a protective skin layer around your teeth, the junction at which the gums meet the enamel is called the ‘sulcus’. This sulcus is a crevice at the junction between your teeth and gums which surrounds the tooth all the way around.
When plaque builds up on the surfaces of teeth (due to bad oral hygiene or diet), it tends to build along the margins of your gums. Bacteria love crevices where they can hide and grow. Slowly this plaque will grow into your sulcus where they will harden over time. Eventually becoming so hard that they cannot be removed by brushing (called calculus or tartar).
This calculus will slowly start irritating your gums, which will result in inflammation. Early gum inflammation is called gingivitis, which is very common and easily manageable. However, if this calculus is left unchecked, it can cause so much inflammation in your gums that the condition proceeds from gingivitis to periodontitis (gum disease).
Periodontitis is an irreversible life long disease, however it can be managed with routine treatment. With unmanaged periodontitis, the bone supporting your gums will slowly recede. This will lead to receding gums and eventually tooth loss.
Certain groups are often more susceptible to gum disease.
Elderly people people experience the disease at a much higher rate.
People with diabetes are at higher risk
People who are overweight
People with genetic predisposition toward inflammation
Being able to differentiate between health and disease is the starting point for treating a problem. Healthy gums have certain characteristics that set them apart from unhealthy gums. Here are some indicators to look out for:
Healthy gums will be very tightly bound to the underlying bone.
The margins of the gums are sharp and well contoured around the teeth
They gums do not appear overly red
The gums are firm and thin
There should be no signs of plaque being pushed out of the gums when pressed
Healthy gums can vary depending on your skin tone. This is because melanin can alter the pigmentation of your gums. Therefore not all healthy gums look pink, sometimes they can be purple. When trying to determine whether your gums have a healthy colour, compare the colour of the gums to the surrounding tissues in your mouth. Anything that looks like a deep red in colour is an indication of inflammation, and might mean you have gingivitis or gum disease.
When comparing the differences between healthy and unhealthy gums, are 5 things you should be aware of:
Colour, like discussed above, healthy gums should be a light pink/purple colour (depending on the colour of your mouth). Any colouration of deep red indicates unhealthy gums.
Contour, your gums should contour around your teeth well with sharp margins. If the contour of your gums are swollen and bulbous then they may be inflamed.
Consistency, healthy gums should be firm and tight on touch. Any spongy consistency is a sign of unhealthy gums.
Texture, the surface of your gums should be smooth matte or stippled if they are healthy. If they are inflamed they may appear rubbery or glossy.
Exudate, if there are any signs of white exudate or plaque coming out of the pockets of your gums, then your gums are probably unhealthy. Healthy gums should be free of plaque and exudate.
If you are at all concerned about the health of your gums be sure to consult your dentist and get a professional assessment. They are the best to diagnose and treat any of your dental concerns.
Brushing techniques can be very effective at reducing plaque build up and keeping your gums healthy. The idea is to brush the gum line along with other surfaces of your teeth. The modified Bass technique is perfect for achieving this goal. The brushing technique gives importance to all areas of the mouth but provides a key mechanism to clean plaque that may be growing under your gum line.
Steps to follow for the modified Bass technique:
Split each jaw into 3 sections (back left, middle, back right).
Starting at your upper back right teeth, clean the outside surface.
Use gentle back and forth strokes
Make sure to brush the gum line by angling the brush head
Every few strokes flick the brush away from the gum line
Flick down for upper teeth, flick up for lower teeth
Continue and brush 2 other outside sections of the jaw
Then brush the tops of each section of teeth
The brush the backsides of each section of teeth
Follow 2a - 2c
Repeat the steps for the lower jaw
Although having a great brushing technique can make huge improvements to your oral hygiene, brushing gums alone will not get you healthy gums. To keep your gums healthy, you need to incorporate regular flossing into your oral hygiene routine. Flossing is required to clean between the teeth (an area where brushes cannot reach). If left uncleaned the gums between the teeth will recede resulting in gaps.
To floss these areas effectively make sure to take the floss with two hands and push it into the spaces of your teeth. Wrap the floss around the tooth, moving it up and down as well as left and right to dislodge any buildup. Once done repeat the process for the opposite tooth in the same space, then all the spaces in your mouth.
If you find it difficult to clean these spaces with regular floss, there are many other options that may be better suited for your needs.
Flossing aids - A small piece of floss strung between a plastic head, with a handle. Floss aids can make flossing much easier.
Interdental brushes - Small bristle brushes with handles. They are great options for people with slightly receded gums and more gaps between their teeth.
Water floss - An automated water syringe that shoots water into your gums to clean them. A very quick and effective way to floss your teeth.
Mouthwash can be a very effective way of reducing the amount of bad bacteria in your mouth. In many cases, mouthwashes contain antibacterial agents within them that inhibit the growth of bacteria. When incorporated into your oral hygiene routine, it can greatly defend your mouth from plaque build up. There are many different mouthwash products you can use to reduce plaque, however products containing chlorhexidine (such as curasept) have been shown to be the most effective.
When using chlorhexidine mouthwashes be sure to follow these instructions:
Separate brushing teeth and mouth washing by at least 30 minutes
Fluoride in toothpaste and chlorhexidine will chemically negate each other if used together.
Switch the mouthwash around for at least 1 minute
This will allow it to get into all the pockets of your gums and kill any bacteria.
Only use the mouthwash for the first week of every month
Chlorhexidine is a very good antibacterial, however it can stain your mouth if you use it for more than 2 weeks in a row. Thus it is recommended to only use it one week every month.
When using regular mouthwashes without chlorhexidine (such as listerine), feel free to use them everyday during your oral hygiene routine.
Gum disease is an inflammatory disease, therefore a good balanced diet can help greatly at preventing its onset. Try to avoid high fatty foods because there is a strong association between build up adipose tissue (fat storage in a person) and gum disease. Adipose tissue is known to promote inflammation. Thus, a highly fatty diet will encourage the formation of more adipose tissue and increase the risk of gum disease.
Try to stay away from foods with lots of high free sugars. Diets consisting of many snacks or sugary foods are known to promote the formation of plaque. This plaque can often be so rampant due to the diet that even good oral hygiene is not enough to stop the formation of decay and gum disease. Along with this, consistent high sugar diets can put you at risk of developing diabetes. Diabetes is a known risk for immune related diseases such as periodontitis.
High protein diets can greatly increase the vascularity (blood flow) around your body. Normally this is a good thing, well distributed blood flow can greatly increase tissue maintenance and repair. However, increased vascularity can lead to higher susceptibility to inflammation possibly leading to gum disease.
Thus having a balanced diet is the best way to increase the health of your gums.
Stress can be a leading risk factor for infections and disease. When stressed, a hormone in the body called cortisol is released. Cortisol has many effects on the body, one of which is increasing immune system activity. Therefore while you are stressed you enter a state of increased immune function, making you more susceptible to inflammatory diseases like periodontitis.
On top of this stress can increase the risk of gum infections, such conditions can be very painful and difficult to clean. If left unchecked, these gum infections can develop into oral and facial gangrene. If at any moment you believe you may be suffering from a gum infection, be sure to see your dentist.
Stress is thus a very important factor in gum health. Being able to manage stress in an effective way can go a long way to decrease your risk of developing disease, therefore giving you healthy gums for longer.
It is important to note like many aspects relating to the body, genetics often plays a silent role. Due to the genetic variance in people, some are often more susceptible to certain diseases than others. The same is true for healthy gums and gum disease. People who are genetically less predisposed to inflammation will likely have healthy gums. While those who have mutations in inflammatory proteins may be at higher risk for gum disease.
Certain genetic mutations such as interleukin-1 polymorphisms is a mutation in an inflammatory protein. This mutation makes the protein more potent in creating inflammation, thus greatly exaggerating an immune response. People with this or similar mutations may experience gum disease even though their oral hygiene is good. If you are concerned about your risk for gum disease consult with your dentist for further testing.
Regular dental checkups are easily the most important part of your dental care. Seeing your dentist or hygienist regularly for check ups and cleans will inform you of any issues that may be going on in your mouth. They will be able to tell you how effective your oral hygiene is, and whether or not you have healthy gums.
However, the most important part about routine dental check-ups is that they provide an opportunity for preventative care. The dentist will be able to spot any early signs of gum disease before the periodontitis progresses. This allows for preventative care such as scaling and oral hygiene instruction to take full effect, stopping the periodontitis and making your gums healthy again. After you have been treated for your gum health, your dentist may suggest treatment for rotten teeth or aesthetic concerns (placement of composite veneers ).
Another key problem about gum disease is that once the calculus has established itself in the pockets of your gums, it can no longer be removed by normal hygiene. Established calculus will need to be removed with professional scaling at the dentist. Thus by attending regular dental check-ups you are receiving the required care for your gums.
Here are some habits to avoid if you want to have healthy gums.
Quit smoking - Smoking is a huge risk factor for many diseases, periodontitis included. Smoking can often mask the symptoms of gum disease making it hard to detect, while making the disease progression much more destructive.
Tooth picks - Do not use toothpicks to remove food from your mouth. They are very destructive to your gums and cause permanent gum recession.
Brushing too hard - Do not use too much force while brushing your teeth, you may cause trauma to your gums which can result in permanent gum recession.
Alcohol - Drinking too much alcohol is associated with more severe periodontitis.
Not using fluoride toothpaste - Fluoride is a very effective antibacterial element, toothpastes without fluoride and ‘natural alternatives’ are clinically unproven to defend against plaque.
Hopefully you have acquired a better understanding of what healthy gums are, and how to prevent and treat gum disease. Try to implement the suggestions within this article into your life and hopefully you will notice a huge improvement in your gum health. If you believe you may be suffering from gum disease or you are concerned about your gums, we recommend you visit a dentist and discuss your concerts.