How healthy are your gums?
Its all too easy to be slack when it comes to flossing, but good dental hygiene now could save you a fortune in the future. By Karen Evennett
You brush your teeth twice a day and you probably visit your dentist once a year. But are you really doing enough to look after your teeth, and would you even know if you weren't? Possibly not... Good dental health starts with strong, healthy gums - but according to the British Dental Health Foundation, 19 out of 20 of us suffer with some form of gum disease. And ignoring it can be traumatic and costly.
Swelling, soreness and infection of the tissues supporting the teeth all add up to gum disease, and there are two main types: gingivitis and periodontal disease. Gingivitis is reversible, but left to run its course, it can turn into periodontal disease - which is not reversible, and is a major cause of tooth loss in adults.
All gum disease is caused by plaque - a film of bacteria on the surfaces of your teeth and gums. The first thing you'll notice is blood-stained saliva when you brush your teeth, says Karen Coates of the British Dental Health Foundation. ‘At this point, it can be tempting to ease off the brushing, fearing you'll do more damage. But, in fact, it's a sign you need to step it up, as the bleeding is due to pockets of bacterial plaque around your teeth. If you're brushing and flossing properly, the bleeding should stop within a couple of weeks, and that's a sign that your gums are improving.
But if you're a smoker, not only are you at greater risk of gum disease (because smoking encourages plaque production), but you are less likely to know about it because smoking constricts the capillaries in your gums so they don't produce telltale blood.' In fact, periodontal disease can be symptom-free until you're producing pus and have shrunken gums, wobbly teeth and a nasty taste in your mouth, says Karen. ‘Bad breath is a sign that your gums are not in great condition. Lick the inside of your wrist and sniff it. If it smells, your breath probably does, too.'
If you suspect you have gum disease, see your dentist for a check-up. ‘Periodontal disease erodes the bone supporting the teeth and X-rays may be needed to assess the bone-loss,' says Karen. ‘Your dentist or hygienist will remove any hardened build up of plaque (tartar) and you may also need deep-root cleaning. If you keep the build-up at bay, further loss of bone will be slow and may stop.' An NHS dentist will give you a basic hygiene check, but if you need extra trips to a hygienist, expect to pay £40-£95.
Reduce your risk:
Brush (for two minutes at a time), floss and use interdental brushes to remove plaque. Most dental practices sell a selection of brushes and your hygienist can advise you on sizes.
● Take extra care around hard-to-clean, crooked teeth, fillings, crowns and bridges, which can become a breeding ground for plaque.
● If you need help, book an appointment with your practice's hygienist for a demonstration.
● Avoid sugary food and drinks that feed the bacteria. ‘If you have a drink of cola, incorporate it into your mealtime, finish it in one go, and do not brush your teeth for at least an hour after to avoid acid erosion,' says Karen.
● Plaque-removing mouthwashes (such as Dentyl Active, from 99p from supermarkets and pharmacies) can help by pulling debris off the tongue, so you see it when you spit out.
● After fruit - better than added sugars, but still sugary - eat cheese to restore a healthy pH balance in your mouth and prevent bacteria multiplying, or chew a sugar-free gum containing Xylitol, which stops plaque from sticking.
● Avoid eating dried fruit. It's very high in sugar and sticks in the teeth, causing bacteria to flourish.
● Eat fish and nuts - polyunsaturated fatty acids (especially DHA) reduce the risk of gum disease by 30 per cent and periodontitis by 20 per cent.
● Grinding your teeth may accelerate gum disease, so use remedies to prevent this - a gum shield is the traditional treatment, but Botox in the jaw is another option, although expensive and not widely available.
Gum disease: the ugly truth
Periodontal means ‘around the tooth' and gum disease also affects the bone supporting the teeth. Repercussions include:
● Splaying and gappy front teeth.
● Becoming ‘long in the tooth' - with roots showing dark and often stained.
● Lack of chewing teeth.
‘You're also at greater risk of cardiovascular disease, including heart attacks and strokes. Your risk of diabetes goes up, too, as the bacterial infection caused by periodontal disease reduces the body's ability to manage its insulin levels,' says cosmetic dentist Oliver Harman (theharmanclinic.com). ‘The damage to teeth is caused by toxins in the dental plaque, which diminishes bone turnover, so bone cells die. Gradually, the jaw bone disappears around the roots of the teeth.'
If dentures are used to replace missing teeth, this bone loss will continue, because there is nothing to stimulate bone regrowth. ‘But there are exciting new developments in bone regeneration,' says Oliver. ‘And the use of dental lasers are greatly improving the treatment of gum disease.' Currently, the choice for most people, once teeth are lost, will be between dentures and implants. The latter are extremely expensive but, even if you can afford them, there may come a point when so much bone has been lost that there's nothing to fix the implants to. Sometimes, a bone graft can facilitate implants - which is invasive and expensive - but if this isn't possible, dentures will be the only choice.
‘In some patients with very bad gum disease, we may even recommend removing the teeth before they become loose, while there is still enough bone left for implants to be installed,' says Oliver. A great advantage of implants over dentures is that they stimulate the bone to regenerate itself - but they aren't an option on the NHS, and cost £2000- £2500 each through private dentists.
One option is to travel abroad for treatment. Hungary has a great reputation for its dentistry, which is a fraction of the cost of the same treatment in the UK. But do your homework first. Any country will have good and bad dentists. The General Dental Council (gdc-uk.org) has a really useful leaflet on dental tourism that will help you do your research and make your decision.
How to brush and floss:
Place the head of your toothbrush against your teeth, then tilt the bristle tips to a 45-degree angle against the gum line. Move the brush in small circular movements, several times, on all the surfaces (including insides and biting surfaces) of every tooth.
Brushing alone only cleans about 60 per cent of the surface of your teeth, which is why it's so important that you also clean between your teeth every time you brush.
With dental floss or tape, use a gentle rocking motion to guide the floss between your teeth. Do not jerk the floss or snap the floss into the gums.
When the floss reaches the gum line, curve it into a C-shape against one tooth until you feel resistance.
Hold the floss against the tooth. Gently scrape the side of the tooth, moving the floss away from the gum. Repeat on the other side of the gap, along the side of the next tooth. Don't forget the back of your last tooth.
What are your options?
The snap-on smile costing £1000 per arch. If you still have your teeth, but want a better look, this is the dental equivalent of false nails, fitting over the teeth like a gum shield - for daily use or special occasions. ‘It's useful for covering teeth that no longer look so good, because of past gum disease - but if you have active gum disease, it could exacerbate it and wouldn't be recommended,' says dentist Dr Jagmail Basrai. Visit snaponsmile.co.uk.
Implants cost £2000-£2500 each, but are usually combined with crowns and bridges.
Dentures cost £1000-£2500 from a private dentist, or £4000 for a face-lifting version that promises to knock up to 20 years off your looks, preventing that collapsed-face look that often comes with normal dentures. Visit dentalfacelift.com.
You might also like...