Preventing Gum Disease
Visiting the dentist
If you have never had gum disease and have good oral health, you may only need to visit your dentist every one to two years for a check-up. It is very important that you attend your dental appointments so that any problems with your teeth and gums can be detected and treated early.
If you have had problems with gum disease or periodontitis in the past, you may need to visit your dentist more frequently. At each dental appointment, your dentist will discuss with you when you need to return for your next appointment.
If you are more at risk of developing problems with your gums, for example if you smoke or have diabetes (a long-term condition caused by too much glucose in the blood), you may be advised to visit your dentist more frequently. This is so that your teeth and gums can be closely monitored.
One of the best ways to treat all kinds of gum disease (gingivitis), including periodontitis and acute necrotising ulcerative gingivitis (ANUG), is to practise good oral hygiene. Leaving gum disease or periodontitis untreated can lead to tooth loss.
Good oral hygiene
Good oral hygiene involves:
- brushing your teeth for 2-3 minutes twice a day (in the morning and last thing at night)
- using an electric toothbrush if possible (unless you have ANUG, see below)
- using a toothpaste that contains fluoride (fluoride is a natural mineral that helps to protect against tooth decay)
- flossing your teeth at least three times a week
- avoiding smoking
- seeing your dentist regularly (at least once every one to two years, but more frequently if necessary)
Treatment of gum disease and periodontitis
Antiseptic mouthwashes that contain chlorhexidine or hexetidine are available over-the-counter (OTC) from pharmacies. There is some debate about whether these are necessary for people with healthy gums.
Your dentist may recommend that you use a mouthwash if it helps control the build-up of plaque (the soft, sticky substance that forms when bacteria collect on the surface of your teeth). Your dentist will tell you which type of mouthwash is most suitable and how to use it.
Chlorhexidine mouthwash is not suitable for women who are pregnant or breastfeeding. It can also stain your teeth brown if used regularly. Rinse your mouth thoroughly in between brushing your teeth and using a chlorhexidine mouthwash because some ingredients in toothpaste can prevent the mouthwash from working.
Acute necrotising ulcerative gingivitis (ANUG)
Acute necrotising ulcerative gingivitis (ANUG) should always be treated by a dentist. However, if you see your GP before visiting a dentist, they may provide you with some treatment while you wait to see your dentist. Always read the instructions before using mouthwash because some types may need to be diluted in water before they are taken. They are usually used two or three times a day.
As with gum disease and periodontitis, if you have ANUG, continue to practise good oral hygiene as described above. However, because ANUG can cause painful ulcers, brush your teeth with a very soft toothbrush and avoid using an electric brush.
If your GP refers you to a dentist, they may recommend the following treatments:
- scale and polish
- root planing
These are described in more detail below and can be used for gum disease, periodontitis and ANUG.
Scale and polish
To remove plaque and tartar (hardened plaque) that can build up on your teeth, your dentist may suggest that you have your teeth scaled and polished. A scale and polish is a type of ‘professional clean’ that is usually carried out at your dental surgery by a dental hygienist.
A scale and polish involves having the plaque and tartar scraped away from your teeth with a special instrument, before your teeth are polished to remove any marks or stains. If a lot of plaque or tartar has built up on your teeth, you may need to have more than one scale and polish.
The price of scale and polish treatments can vary depending on what exactly is being carried out, so ask your dental hygienist how much the treatment will cost beforehand. Treatment on the NHS should cost £17.50 for basic treatment, or £48.00 for more advanced treatment.
In some cases of gum disease or periodontitis, root planing may be required. Root planing is a cleaning procedure to clean bacteria from the roots of your teeth. Before having the treatment, you may need to have an anaesthetic (painkilling medication) to numb the area. You may feel some discomfort for up to 48 hours after having root planing.
If you have severe gum disease or periodontitis, you may need further treatment, such as surgery. Your dentist can tell you about the procedure that is required and how it is carried out.
If you are having surgery or root planing, you may be given antibiotics (medication to treat infections). Your dentist will tell you whether these are necessary.
Your dentist may advise a referral to a gum specialist called a periodontist. The periodontist speacialises in the treatment of gum conditions and can improve your chances of successfully managing the problem and saving your teeth.