Experts advise that for one to avoid dental problems, it’s ideal to maintain oral hygiene, with regular check-ups from dentists.

Failure to do so results in many health problems and diseases. One of the most common infections, they say, is gum disease.

Dr Epimak Kayiranda at University Teaching Hospital Kigali (CHUK) says that as a dentist, he attends to many patients with periodontal diseases — infections of the structures around the teeth, which include the gums.

Periodontitis is common but fairly preventable. The cause is usually poor oral hygiene. It can lead to tooth loss and is a risk factor for heart and lung diseases.

HOW DOES IT COME ABOUT?

He says that periodontal diseases range from simple gum inflammation to serious diseases that could result in damage to the soft tissue and bone that support the teeth.

 "There are cases where the teeth are affected because of this, and this, in most cases, stems from oral neglect. However, the disease can be treated, or, it can get worse,” he says.

Kayiranga explains that gum disease occurs because of the bacteria that is inside the mouth. This bacteria, along with mucus and other particles, constantly form a sticky, colourless "plaque” on the teeth.

He notes that knowing how to brush and floss the teeth is important as it helps   get rid of plaque.

In cases where plague is not well removed, he says that with time, it hardens and forms tartar, of which even if one brushes the teeth, it can’t be removed.

Poor dental hygiene can also lead to gingivitis, a non-destructive disease that causes inflammation of the gums, and usually precedes periodontitis, says Dr Gonzalue Niyigaba, a dentist at CHUK.

He says that the longer plaque is on teeth, the more harmful it becomes; explaining that the bacteria can cause the inflammation of the gums.

"With gingivitis, the gums become red, swollen and bleed easily. However, this kind of condition can be dealt with if one maintains daily dental hygiene,” he says.

Niyigaba notes that gingivitis does not include loss of bone and tissue that hold the teeth in place, but when gingivitis is not treated, it can advance to periodontitis, which can lead to loss of teeth.

"In periodontitis, gums pull away from the teeth and form spaces normally known as pockets that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line,” he explains.

He adds that at this point, the bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold the teeth in place.

Dr Pacific Habimana, a dentist at Oshen King Faisal Hospital, says if this is not treated, the bones, gums, and tissue that support the teeth can be later destroyed.

He says the teeth may eventually become loose leaving a dentist with no option but to do away with that particular tooth or teeth.

A dental surgeon at Legacy Clinic checks a child’s teeth. /File 

RISK FACTORS

Kayiranga says that one of the risk factors that can expose one to gum disease is smoking.

He notes that this is one of the most significant risk factors associated with the development of gum disease. The worst part, however, when it comes to smoking, it can lower the chances of successful treatment.

Another factor, he says, is hormonal changes in girls or women.

"These changes can make gums more sensitive and make it easier for gingivitis to develop. Proper cleaning and flossing is important as well as regular check-ups from dentists,” he says.

Habimana notes that people with diabetes are prone to gum diseases.

He explains that diabetic people are at higher risk of developing infections, including gum disease.

ILLNESSES AND MEDICATION

Niyigaba says that diseases like HIV/AIDS and its treatment can negatively affect the health of the gums, as can treatments for cancer.

Also, he says some medication can lead to gum problems.

"There are prescriptions and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth,” he says.

He adds that this is so because without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue.

Niyigaba says that this can make it difficult to keep teeth and gums clean, however much they are cleaned.

RISKS

Francis Kazungu, a general practitioner in Kigali, say it’s rare for one to show signs of gum disease, usually until they are in their 30s or 40s.

He says that men are more likely to have gum disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder condition.

"Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line and to know this, there are always signs and symptoms,” he says.

He says that symptoms of gum disease include bad breath that won’t go away, red or swollen gums, tender or bleeding gums, painful chewing, loose teeth, among many others.

Kazungu notes that receding gums or longer appearing teeth are also symptoms of gum disease, and that these may be a sign of a more serious problem.

TREATMENT

When it comes to treatment, if one has gum disease, Kayiranga says it’s ideal for a dentist to check the patient’s medical history.

This, he notes, helps to identify underlying conditions or risk factors that may contribute to gum disease.

He adds that patients should as well be examined to find out any signs of inflammation.

"The main goal of gum treatment is to control the infection. The number and types of treatment vary depending on the extent of the disease. Any type of treatment requires that the patient maintains good dental care at home,” he says.

Kayiranga points out that a dentist may as well suggest deep cleaning (scaling and root planing, also known as conventional periodontal therapy).

He explains that scaling simply means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the teeth’s roots where the germs gather, and helps remove bacteria that contributes to the disease.

In some cases for gum treatment, he says, a laser may be used to remove plaque, adding that this procedure can result in less bleeding, swelling, and discomfort, compared to traditional deep cleaning methods.

Also, Kazungu says that medications may be used with treatment that includes scaling and root planing when it comes to dealing with gum disease.

However, he adds that depending on how the disease has progressed, an expert may suggest surgical treatment.

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