Gum disease: A major cause for concern
GUM DISEASE (known as Periodontal Disease), painlessly damages the supporting structures around the tooth (known as the Peridontium), causing it to loosen and shed. This affects mainly adults, and it is a major cause for tooth loss. If it were not for gum disease, there would not be so many people in the world wearing dentures.
Oral bacteria, housed in the form of dental plaque, slip down our gum lines and cause the gums to peel away from the tooth. It does this by releasing special poisons which destroy everything around it (rather like a chemical that can dissolve something). It wipes out the gums, the collagen fibers attaching the tooth, and the bone around it. When the gums are peeled, the bone around it disappears and the tooth shakes a lot.  There is never any serious pain from start to finish. There are even times when the tooth may come out by itself.
According to the latest United Kingdom Adult Dental Health Survey data, 40% – 45% of adults have moderate destructive gum disease, and 5 – 10% of adults have it in the advanced stages. It can affect young adults in their early 20s, but those who do have it almost always have very poor oral hygiene.
Having been a practising dentist in Guyana for over two decades, I would say we are certainly in a worse position than the  UK statistics indicate for that country.
Now, here are the first signs:
1.    The gums bleed every time you brush and floss.
2.    The gums feel uncomfortable between the teeth.
3.    Some of the teeth feel somewhat wobbly and appear to grow longer than the rest.
4.    Biting is uncomfortable, and there feels a swelling in the gums at the back.
5.    The gums can peel away from the teeth easily, revealing a lot of tartar inside.

It is now certain that gum disease is directly linked to the presence of bacteria in our mouths and plaque is definitely the culprit. With its presence, the rate and extent of the disease’s progression can also be influenced by our general health, immune system status, pregnancy, and hormonal and nutritional status (Vitamin C), all of which make some people more susceptible to it than others.
Smoking has harmful effects on the gums as it causes more tartar to form on the teeth. This is because the calcium concentration in the dental plaque of smokers is also remarkably higher than in nonsmokers. The gums are also never as healthy in the presence of tobacco, because it restricts the blood supply to the gums, giving them less nourishment. Oral health generally deteriorates as a result.
Gingivitis is the inflammation of the gums, which appears red, swollen, and are ready to bleed but it is usually not painful. Any damage done at this stage can be corrected, unlike gum disease.   Children and adults alike can get gingivitis if they leave the bacteria sitting on their gums, but it is completely reversed with good tooth brushing and flossing.  However, periodontitis is the inflammation of the ‘periodontium’ or the supporting structures around the root when bacteria had gone deeper under the gum-line. As this happens, there is the creation of a pocket. The bacteria collect deep within it and as they can no longer be reached by the toothbrush they invade deeper. The bacteria, dead gum cells, blood, and toxins can form a soup of pus during the process, which can either be trapped to form painful abscesses or it can leak painlessly out the gum line. When it leaks out, it releases foul odors to give a bad breath, and whenever the tooth is sucked, its tastes salty. The pus could be passed from person to person with social contacts, as in kissing, sharing food or drinks (passing the bottle) at a party gathering. The gum infection can spread sideways to infect other teeth around it, leading to their early losses.
Periodontitis is classified into Early, Moderate and Advanced stages, depending on the extent of the damage, and it mainly affects adults.

Prevention measures:

1.    Keeping a good oral hygiene is the main key to preservation. Brushing at the gum line is particularly important to deny plaque their chance to enter into your gums at the front and back of teeth. Flossing teeth is also important, because it removes the plaque from between your teeth where they could otherwise accumulate and proceed with entry. Use of interdental brushes is most important if you have to clean under any dental bridges that you have in the mouth. If your toothbrush looks worn, and the bristles have all flared, you must change for a new one. Never use the same toothbrush for over three months. As it is virtually impossible to remove every single spec of plaque in the mouth, some will remain to form tartar.
2.    Regular check-ups at least twice a year is important to have your gum pockets checked. A regular scale and polish done once or twice a year is important, and as there is no known cure available for gum disease, prevention in this way is the best and only form of treatment.

Treatment:
As tartar and stains will develop on your teeth regardless of your meticulous efforts, they must be removed professionally. Cleaning removes all bacteria, stains, tartar, and so on from your teeth, giving your gums a fresh start. Remember, cleaning does not change the colour of your teeth. If you want whiter teeth, the procedure is different.
Hand scalers or ultrasonic machine scalers are used to gently scrape off the tartar and other tooth deposits above and just below the gum line. The polishing, which is mainly for existing fillings, removes plaque, stains and all else on the surface with rotating rubber cups and polishing pastes. No injections are needed for a scale and polish unless the dentist has to clean beneath the gum line. All rough fillings should be replaced if necessary, because that can contribute to bad breath.
If the roots are contaminated deeper by tartar and bacteria, these must be completely scraped clean with special instruments.   Under local anesthesia, the infected tooth root is ‘root-planed’ with sharp instruments removing all tartar, stains, plaque, bacteria, toxins and pus. There is no method yet to induce the complete reattachment of loose gums back onto the tooth, and regeneration of bone back to the former height is, as yet, totally impossible. Once gum disease had passed beyond a certain point, the damage done is permanent. Deep-scaling only helps to stabilize the problem.