How is your gum health?

How is your gum health? Worldwide, the oral disease that affects the majority of adults, reaching 3 out of 4 adults, is not tooth decay, but periodontal disease. This disease is silent and begins as mild gingivitis.

In its advanced stages, it develops into periodontitis, which destroys the supporting tissues of the teeth and can cause total or partial tooth loss. The leading cause of tooth loss in adults is periodontitis.

This disease can also harm overall health through toxins produced by bacteria that destroy supporting tissues. Learn to recognize some signs related to gum health.

How can I tell if my gums are healthy?

1. Color: The normal color of healthy gums ranges from light pink to reddish-pink, depending on individual pigmentation. It is important to observe whether there is a uniform color throughout the gums.

2. Texture: Healthy gums generally have a firm and resilient texture. They should be smooth and firmly attached to the teeth, without swelling, recession, or painful spots.

3. Contour: The contour of healthy gums follows a uniform line around each tooth. The gingival margins should be consistent and symmetrical, without areas of irregularity.

4. Absence of bleeding: When brushing your teeth or flossing, healthy gums should not bleed. Bleeding can be a sign of gum inflammation, such as gingivitis.

5. Absence of pain: Healthy gums generally do not cause pain or discomfort. If you feel pain or sensitivity in your gums, it may be a sign of an underlying problem, such as infection or periodontal disease. Therefore, don't fall for the line that "it's normal"!

6. Firmness: Healthy gums are firm to the touch. When pressed lightly with a finger, they should quickly return to their original shape.

7. Absence of swelling: Healthy gums do not show swelling or edema. If you notice a swollen or "puffy" area on your gums, it may be a sign of inflammation or infection. For example, this video That's very enlightening.

8. Minimal gingival recession: Healthy gums adequately cover the tooth root without showing significant recession. Root exposure is called gingival recession and can be caused by brushing too hard over the years, combined with anatomical gum problems that exacerbate this phenomenon. However, it can also be a sign of periodontal disease.

How is your gum health?

Smoker's Gums

One way to identify the presence of periodontitis is the existence of areas where the gums bleed easily. Often, people seek dental help when they notice this bleeding. If you smoke, the blood supply to the gums decreases significantly, reducing the intensity of this symptom.

Reduced blood flow to the gums can mask periodontal disease. You become slightly more prone to developing periodontal disease without experiencing bleeding symptoms.

 The simplest and most accurate way to diagnose gingivitis and periodontitis is through periodontal probing. In this simple examination, the professional pays attention to the areas where the gums bleed easily.

It is important to emphasize that a complete assessment of gum health should be performed by an oral health professional, such as a general dentist or a periodontist. These professionals can identify early gum problems and provide appropriate treatment.

How is your gum health?

What are the signs of diseased gums?

Diseased gums can present with various signs and symptoms. Here are some of the most common signs of periodontal disease, a condition that affects the gums and supporting structures of the teeth:

1. Bleeding: Healthy gums do not bleed during brushing or flossing. If you notice bleeding while brushing or flossing, it may be a sign of periodontal disease.

2. Swelling: Inflamed or swollen gums are an indicator of possible gum disease. They may appear red or purple instead of their healthy pink color.

3. Sensitivity: Diseased gums can become sensitive and painful. This can occur when eating, drinking, or touching the gums.

4. Persistent bad breath: Periodontal disease can cause chronic bad breath that doesn't go away even after brushing your teeth.

5. Gingival recession: As periodontal disease progresses, the gums may recede, exposing the roots of the teeth. This can lead to increased sensitivity to hot or cold foods.

6. Pus between the teeth and gums: In more advanced cases of periodontal disease, pus or debris may accumulate between the teeth and gums. This is a sign of infection and requires immediate dental attention.

It's important to note that these signs are not exclusive to periodontal disease and may be associated with other conditions. If you are concerned about the health of your gums, it is advisable to schedule an appointment with a dentist, who can make a proper assessment and recommend the appropriate treatment.

Are there other problems that can affect the gums?

Well, as you can imagine, it's not just periodontal disease that causes damage to the gums. There are other pathological conditions as well.

How is your gum health?

Gingivo-Herpetic Stomatitis (Primary)

Primary Herpetic Gingivostomatitis or HPG is an acute inflammation of the oral mucosa, which manifests as clusters of vesicles on a reddish base.

Its origin is associated with the Herpes Simplex Virus, which, at certain times, triggers a new inflammatory cycle in subclinical conditions.

Symptoms include irritability, loss of appetite due to pain, and enlarged lymph nodes in the submandibular region. Within 48 to 72 hours, numerous vesicles develop on a reddish base, affecting the mucous membranes, lips, tongue, gums, and palate. Subsequently, these vesicles rupture, exposing nerve endings and tissue beneath the epidermis, resulting in sensitivity in the affected areas. Although this condition can be very uncomfortable, it is transient and not serious.

PERICORONAL ABSCESS

More popularly known as pericoronitis, it is an inflammatory condition that occurs in the hood covering partially erupted teeth, frequently affecting the lower third molars. This condition can become dangerous, making antibiotic therapy essential as a protective measure.

The diagnosis is established through clinical evaluation. These abscesses are triggered by teeth that fail to fully emerge, especially those near the ascending ramus of the mandible, or due to the existence of an excessively deep distal sulcus. Furthermore, mechanical trauma from the opposing tooth can also be a contributing factor.

Finally, the signs and symptoms include a red and shiny area, varying degrees of swelling, involvement of the floor of the mouth and pharynx, deepened sulcus, trismus, enlarged lymph nodes, as well as fever and a feeling of malaise.

Thus, the associated risks and complications involve the spread of inflammation to adjacent tissues, which, due to their flaccid nature, can allow easy diffusion, potentially culminating in a dangerous condition known as Ludwig's angina, which can be fatal in extreme cases. Given that there is a potential risk of death associated with this condition, prompt medical intervention, which often includes antibiotic therapy, is crucial to prevent more severe complications and protect the patient's health. So don't let it get worse.

How is your gum health?

Necrotizing Ulcerative Gingivitis

Necrotizing Ulcerative Gingivitis (NUG or NAUG) is a condition that was first identified during World War I, gaining notoriety for being associated with poor hygiene, smoking, and stress, and is popularly known as "trench mouth".

Pioneers Plaut (1890) and Vincent (1892) were the first to detail the role of bacteria in this condition. The disease tends to affect young adults, predominantly males, between the ages of 17 and 30. Factors such as smoking and stress are usually present, often arising from pre-existing gingivitis.

The etiopathogenesis of the condition involves the complex interaction of several factors:

1. Microorganisms: Spirochete bacteria and Gram-negative bacilli are pathognomonic for Necrotizing Ulcerative Gingivitis.

2. Smoking: Promotes peripheral vasoconstriction and decreases chemotaxis, contributing to disease progression.

3. Poor Hygiene: Inadequate oral hygiene, including plaque, materia alba, and calculus, plays a significant role.

4. Physical trauma: Trauma to the gums can worsen the situation.

5. Systemic Factors: Emotional stress, smoking, immunological factors, and alterations in chemotaxis also contribute to the development of the condition.

The condition is characterized by pain in response to physical, chemical, and thermal stimuli, due to the exposure of connective tissue resulting from necrosis. The pain may be localized or generalized.

How is your gum health?

Related Systemic Factors

The stress response can lead to the release of epinephrine by the adrenal glands, causing peripheral vasoconstriction and increased circulating corticosteroids, which inhibits lymphocyte activity and decreases chemotaxis. Cigarette smoking, in turn, also produces peripheral vasoconstriction and affects chemotaxis.

It is important to note that the emergence of AIDS has contributed to an increase in the incidence of Necrotizing Ulcerative Gingivitis, and treatment may be less effective in these cases.

Pain in response to physical, chemical, and thermal stimuli – in other words, various stimuli. In this sense, in terms of diagnosis, intense pain is a key symptom. After all, the destruction of the epithelial layer, resulting from necrosis, exposes the underlying connective tissue. However, this can be localized or generalized in the gingival tissue.

Oral Cancer

Above all, the risk of oral cancer related to the use of poorly fitting prostheses such as dentures or removable partial dentures and other irritants cannot be underestimated. Furthermore, excessive friction and pressure on the oral mucosa, resulting in chronic wounds or ulcers, can potentially trigger the development of cancer.

Similarly, the presence of irritants such as tobacco and alcohol, combined with the chronic trauma of poorly fitting dentures, can create a favorable environment for cell mutation and the growth of cancerous cells. Therefore, early detection is crucial in the prevention and effective treatment of oral cancer.

Removable dentures have an "expiration date"—it is recommended to replace them with new dentures every 5 years. However, there are cases, and they are not uncommon, of people who keep the same denture for 30 years. This is strongly discouraged. Furthermore, adopting proper hygiene practices for dentures is also a preventative measure against cancer. So, take care of cleaning your dentures as well.

How is your gum health?

When does the yellow light come on?

Finally, be alert to spontaneous gum bleeding and wounds that do not heal for more than 2 weeks. Additionally, look for any increase in keratinization that causes white spots on the mucosa.

Above all, the best way to prevent the onset and progression of periodontal disease is Bass Brushing Technique and the Use of Dental floss. Therefore, learn how to perform these tasks efficiently.

Seek help.

Author: Nivaldo Pinho Gonçalves, Periodontist, CROSC 9696.

Refer to JAN, Lindhe; LANG, Niklaus P.. Treatise on clinical periodontics and oral implantology. 6. Rio de Janeiro: Guanabara Koogan, 2018, 1292 p.