billy--blogBy Dr. Billy Ashaba
Resident Dental Surgeon
Neptune Dental Clinic


Healthy gums usually have a healthy pink (grey-black in some individuals) colour with a stippled outer orange peel like appearance, are firm and do not easily bleed during gentle routine tooth brushing.

This means that if you notice blood on the sink during your tooth brushing session at home, you most certainly have gum disease (gingivitis). Gingivitis is the inflammation of the gums usually as a direct result of continous gum irritation by the deposits on the teeth.

The teeth surfaces are continually covered by a sticky material called plaque which consists of food debris, and bacteria. As this plaque is left to accumulate on the teeth surfaces, it is colonized by more bacteria whose acidic products cause tooth decay and the gums to become infected, swollen and tender with bleeding on mild probing or even during tooth brushing. After about 2 weeks of plaque accumulation, the plaque is mineralised by the contents of your saliva to form an even harder deposit called tartar or Calculus. Calculus is trapped at the base of the teeth and beneath the gums and its presence makes proper toothbrushing impossible. The plaque and calculus also contribute to bad breath.

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Causes of gum disease

  • Poor dental hygiene i.e failure to brush and floss your teeth properly and regularly.
  • Teeth that are not well aligned, rough edges of fillings in teeth, ill fitting or improperly cleaned appliances in the mouth like artificial teeth (dentures, crowns and bridges) and braces.
  • Body-wide (systemic) diseases like uncontrolled Diabetes.
  • Use of certain medications like phenytoin, bismuth and birth control pills.
  • Pregnancy (hormonal changes increase the gum immune response even to the smallest quantities of plaque making the pregnant woman more prone to gum disease).
  • Vitamin C deficiencies have been associated with gum disease as seen in scurvy.

If left untreated, gum disease could progress to involve the supporting structures of the tooth (Periodontitis) causing pain on biting and in severe cases, tooth mobility and tooth loss.

Treatment of gum disease
If you have bleeding gums you should visit a dentist for treatment. The goal of treatment is to reduce the gum inflammation. It is practically impossible to remove tartar (calculus) from your teeth through home tooth brushing alone.

The dentist will carry out a professional cleaning of all the teeth to remove all the plaque and calculus trapped at the base of the teeth and below the gum line. This is what is otherwise known as scaling. After the harmful deposits are removed the teeth are polished to smoothen the surface making it easy for you to maintain good hygiene at home.

Careful oral hygiene is necessary even after professional tooth cleaning has been done. Warm salty water mouth rinses are recommended to aid gum healing. Your dentist may also recommend some anti-bacterial mouth washes.  

Bleeding and tenderness of the gums should subside within 1 to 2 weeks after professional cleaning and meticulous oral hygiene.
Professional scale and polish is recommended after every six months and this is important to remove plaque and calculus that may develop even with careful brushing and flossing. Careful dental hygiene must be maintained throughout if the gums are to stay healthy.

If the gum disease happens as a result of poorly contoured fillings in teeth, these should be corrected by the dentist. Strict oral hygiene is particularly important where a person has braces or artificial teeth. Malaligned teeth should be treated (with braces) to make them easily accessible during routine toothbrushing.

Underlying contributory disorders like diabetes should be diagnosed and treated accordingly.

Prevention of gum disease

Oral hygiene is by far the single most important factor in prevention of gum disease. Plaque control measures like tooth brushing and flossing are important in the prevention of gum disease.

Tooth brushing
You should endeavor to brush your teeth after every meal or atleast twice a day; in the morning AFTER breakfast and before bedtime at night. Toothbrushing should be done carefully to involve all the surfaces of all teeth especially the back teeth.

Dental flossing
It may not be possible to remove food debris trapped in between the teeth with toothbrushing alone. To clean in between the teeth, a dental floss is recommended. A dental floss is a special waxed string wound on the middle fingers of either hand and gripped by the thumbs to dislodge the food debris trapped in between the teeth. Dental flossing should be done every time you brush your teeth. Wooden tooth picks are to be avoided as these tend to traumatise the gums. Ask your dentist to show you how to use dental floss.

Professional cleaning
Your careful oral hygiene should be supplemented by a professional cleaning done after every six months to keep your gums in optimum health. This will help keep your smile fresh and your teeth and gums healthy.