Gums are the soft tissues covering our teeth and the supporting bone. They are intimately related to the bone and teeth, and thus their health is important for the health of teeth.

You must have encountered your friends or family members often complaining that their gums bleed while brushing or sometimes while eating. Have you ever tried to find out why this happens?

It is because of the weakening of the gums. It occurs when due to improper or neglected tooth brushing, some deposits start accumulating on the teeth near the gums. Since initially, these deposits are soft, transparent, and sometimes white, they cannot be easily seen on the tooth surface by you.

But if not cleaned, they start becoming hard and also start changing color to yellow to brown or black.

The soft deposit is called "plaque” in scientific terms. It is easy to remove by yourself with proper tooth brushing.

But once it gets hold of the tooth and starts hardening, it is difficult to remove by brushing and you have to take the service of a dental surgeon to remove them.

Plaque is a soft deposit on the teeth, which gets accumulated within 30 minutes of tooth brushing. The proteins from saliva, the bacteria normally staying in our mouth and the food what we eat contribute to its development.

If not cleaned, then within 3 days, the bacteria start decaying the food which releases the chemicals causing injury to the gums. It leads to dilatation of the blood vessels in the gum tissues and inflammatory cells start coming to the site.

It leads to bleeding and swelling of the gums; change in the shape, color, and structure of gums; and they are painful to touch.

Bad breath from the mouth also starts coming and you will notice that your friends stand at a distance from you when you are talking. With further assault, the gums keep on weakening and start losing their original shape, size and structure.

This phase is called gingivitis. It is also very commonly seen in pregnant females, and diabetic patients due to hormonal changes in tissues. Scientific studies have proved a positive link between gum disease and heart diseases. So by neglecting gums, you are making your heart prone to diseases.

This stage can be controlled by professional cleaning and thereafter, maintaining with proper tooth brushing. But if still neglected, the infection spreads to the bone in which the teeth are staying.

There, the chemicals released by bacteria and local inflammatory response of the tissues leads to damage of tooth – supporting bone. The bone gets reduced in height and strength with time.

At that time, you can see that gums are leaving the tooth and tooth is getting longer. You also start feeling sensitivity to hot, cold, sweet foods and with certain fruits like pineapple and orange.

With further progress of the disease, the tooth starts shaking due to loss of supporting bone, and ultimately you lose the teeth. This is called periodontitis.

Plaque not only leads to gum disease, but it also leads to development of cavities on the tooth surface where it gets deposited. The acids released by decaying food leads to dissolution of the calcium and protein structures of the tooth surface.

Initially, it is noticeable as "whiteness” in that area. It is called "white spot lesion”, which occurs due to subsurface demineralization, meaning that cavity has not formed as yet.

This stage can be reversed to normal enamel surface by proper cleaning and care. But once, the surface of enamel shows a frank cavity, then it can only be filled to be corrected.

Prevention

Good oral hygiene is the best way to prevent gingivitis because it removes the plaque. The teeth should be brushed at least twice daily. Some special treatment may be recommended by the dentist for patients having severe form of disease e.g. flossing; mouth washes, special toothpicks and toothbrushes, water irrigation devices etc.

In a nut shell, the gum care is very important for the health of gums and teeth, and your heart, and it takes only 10 minutes of your day to keep them healthy. So, take care of your gums yourself; visit your dentist once in 6 months for regular check up and care and KEEP SMILING.

Dr Sandeep Goyal is an
Orthodontist and Dental Surgeon
King Faisal Hospital, Kigali