Gingivitis is the infection caused by bacteria in the plaque, so it’s simply a bacterial infection of your gums and is the first sign of gum disease. The good news is that it’s relatively easy to treat if it is diagnosed early. Typical symptoms are bleeding gums, or simply gums that have become swollen and red. Your dentist can carry out a professional thorough cleaning that should eliminate the problem, providing you follow up by maintaining a regular daily program of that includes flossing  as well as brushing.

Periodontitis is the other end of the gum disease scale, where it has become advanced. Untreated, it can attack the gum tissue and even the bone that forms the foundation for your teeth, and eventually lead to your teeth loosening and moving around.  These symptoms are typical of adult periodontitis. It can also happen in children or at any stage in life. Normally it progresses fairly slowly in between bouts of more aggressive decay.

Rapid progression of gum disease is called aggressive periodontitis. It can manifest itself in patients who appear to be totally healthy. It is not restricted to the gum are but can attack other parts of the mouth or the whole mouth. It presents as very rapid deterioration of bone and tissue.

It is possible that some systemic conditions, such as stroke or diabetes, may be causative factors in periodontal disease. Ongoing research appears to link the two but the results are not yet conclusive.

Regular dental checkups are one proven way to detect gum disease. Because it often goes unnoticed, you can at least depend on your dentist to diagnose it if it occurs. How it is treated depends on the condition of your gums and mouth and just how advanced the disease has progressed. Prevention starts with a sound but simple program of daily dental and oral hygiene. While anybody can contract gum disease, you should never have to lose your teeth because of it. Just remember to brush at least twice daily, floss between your teeth, avoid sugary snacks and drinks and see your dentist every six months. That should keep you on the right road to a bright smile and a carefree dental outlook.

Your gums are simply tissue that acts as the foundation for your teeth and helps support them. When they become infected it’s called gum or periodontal disease and, amongst adults, it is a significant factor for losing teeth. Usually you may be quite unaware that you have a gum disease because it is often painless. The root cause is the sticky and invisible film of bacteria called plaque, which sticks to the surfaces of your teeth and keeps the bacteria and the acid that they generate in constant contact with the enamel of your teeth.

These are some of the symptoms of gum disease:

• Loose teeth
• A noticeable difference in your bite
• Loosening or a sudden bad fit with partial dentures
• Gums that are swollen, tender, and red
• Bleeding gums
• Receding gums
• A bad taste or bad breath that does not go away

There are certain conditions and activities that can contribute to gum disease:

• Not following your daily dental hygiene program
• Smoking cigarettes or any tobacco products. Chewing tobacco.
• Your genetics
• Teeth that may be difficult to brush, like crooked teeth
• Becoming pregnant
• Contracting diabetes
• Oral contraceptives and certain medications, such as some calcium channel blockers, steroids, cancer therapy and anti-epilepsy drugs

Your dentist has a genuine and active interest in knowing what medications you are taking because some can have in influence on prospective dental treatments. One such category is called antiresponsive agents and they are used to fight against osteoporosis, which is thinning of the bones or brittle bones. They strengthen your bones but they have also been associated with a rare condition called osteonecrosis (pronounced OSS-tee-oh-ne-KRO-sis), which can cause severe damage to your jawbones.

The antiresponsive agents that are taken orally include Actonel, Boniva, Atelvia , Didronel, Fosamax. They can be used to treat or to help prevent osteoporosis. They also fight Paget’s disease, which leads to irregular bone destruction and also regrowth, which can lead to deformities. Agents that are administered by injection include Prolia, Reclast and Boniva IV. They are prescribed in high dosages with greater frequency to cancer patients who suffer from pain in their bones and extremely high blood calcium levels, called hypercalcemia of malignancy usually associated with multiple myeloma, metastatic breast cancer and prostate cancer.

What impact do these medications have on my dental treatment program?

You may be wondering how those medications can impact your dental treatment procedures. The reason is that osteonecrosis of the jawbone can occur following dental work that involves the bone or even tissue surrounding the bone. An extraction is a simple example of such a procedure. Therefore you will understand how important it is to tell your dentist if you are taking any antiresponsive agents.

It’s impossible to predict whether or not you might suffer osteonecrosis. 9 out of 10 sufferers of ONJ who were on these medications are also cancer patients who were or are still taking a course of antiresorptive agents in high dosages by an infusion. The remainder of ONJ sufferers were also on a course of these medications but in lower doses in response to osteoporosis. Consult your dentist if you may be about to start on a course of antiresorptive agents to treat osteoporosis so that your dentist can ensure that you have an oral health check and a maintenance plan for dental and oral health  for the duration of your treatment.

Continue to visit your dentist regularly.

There is no need to put dental treatment plans on hold for the duration of your course of antiresorptive agents for osteoporosis. The chances of you going on to develop osteonecrosis in your jawbone are extremely low indeed. Therefore it figures that you should continue your regular dental health program because the results of not attending to some dental diseases might be a progression to something more serious that could impact your jawbone or the surrounding tissues. That would require more significant dental surgery.

Tell your physician if your course of treatment is coming to an end.

Having said that, your dentist may well suggest postponing any plans for significant or invasive procedures while you are taking antiresorptive agents to treat a cancer. It would be best to speak with your dentist before starting on the course of treatment so that any dental issues can be remedied first. So inform your dentist if your will be taking these medications and also tell your physician if you have recently had significant dental work. Always tell your physician when you are coming to the end of such a course of treatment.

Here are some symptoms typical of osteonecrosis of the jawbone:

• Infection in your jawbone or gums, or any pain or swelling
• Gums that do not appear to have healed properly following recent treatment or injury
• A sensation of weight or a numb feeling in your jawbone
• Bone that has become exposed
• Loose teeth

It would be prudent to check with your dentist if you display any symptoms like these following some dental procedure.

Dry mouth refers to a condition in which the mouth is unusually dry. It's a symptom of something, not a disease. Usually dry mouth is a result of less than normal saliva being produced by the salivary glands in your mouth. It can often be a side effect of certain medication such as, decongestants, diuretics, antihistamines, pain killers, and several others. Less commonly, it may be related to or caused by a condition affecting your salivary glands. Dry mouth is also known as xerostomia (pronounced zeer-o-STOE-me-uh).

The importance of saliva in dental health is that it is main defense in fighting tooth decay. It supports the health of gums and both hard and soft oral tissues. It naturally removes food debris from the mouth and helps neutralize the acids caused by bacteria and contains substances that naturally fight mouth diseases.

Dry mouth can lead to knock-on problems, such as dry nasal passages, hoarseness, difficulty swallowing and speaking and a burning sensation or sore throat. It may also indicate a condition known as Sjögren’s syndrome, which is an auto-immune condition that causes the body to attack its own salivary and tear glands – the gland that produce moisture – and other organs also.

Tooth decay may result from insufficient saliva, so it’s best to check with your dentist for assistance in restoring saliva flow. Oral rinses and artificial saliva are possible solutions, while something as simple as sugar-free gum or candy stimulates the flow of saliva.

Visit the Sjögren’s Syndrome Foundation for more information.

Carbohydrates, the sugars and starches in food, are consumed by the bacteria that live in plaque. They produce acids that eat into the enamel, which is the hard outer coating of your tooth. Plaque itself is a sticky film that keeps on forming on the surface of your teeth and it keeps the bacteria and the acids in constant contact with the enamel. The breakdown of the enamel and the cavities that form beneath the surface is what constitutes tooth decay.

The majority of cavities are found in children. With adults, the aging process causes the gums to gradually recede from the teeth. When you add gum disease, the combination can expose the roots of teeth to plaque. The roots do not benefit from being coated in hard enamel instead, they are encased in a softer tissue called cementum. Roots suffer decay easily and that can lead to sensations of extra sensitivity to extremes like heat and cold or sweet tastes. The over 50 age group is very susceptible to decay in the roots of their teeth.

A factor in the tooth decay problem in older people is that fact that dental care was not as advanced as it is nowadays. The benefits of fluoride were not known when they were growing up and seeking dental care was not as widespread a practice as it is now. Also, fillings in older people tend to wear out around the edges and that’s where decay can set in. Fillings have a limited lifespan. Over time they weaken and can crack, especially at the edges. This is where bacteria can accumulate, producing acid that breaks down the fillings, enters the tooth and causes decay.

Simple basic dental and oral hygiene is easy, and the most effective defense against tooth decay when it is practiced daily. Make these a part of your routine:

• Brush your teeth at least twice a day with a fluoride toothpaste
• Clean between your teeth daily
• Eat a healthy balanced diet and minimize sugary snacks and drinks
• Book a checkup with your dentist twice a year. On your next visit, ask about supplemental fluoride. This has a teeth-strengthening effect. Also ask about sealants, which are a kind of plastic coating that your dentist can apply to the chewing surfaces of your teeth to keep out plaque, bacteria and acid.

Smoking can have a more damaging effect on your teeth and dental health than just bad breath and yellowing. Most people are completely unaware of the effects of smoking on their oral health, their teeth, gums and mouth. There is a higher incidence of gum disease in smokers than in non-smokers.

And it's not just smoking either. Chewing tobacco has harmful effects too. Here are some of the threats posed to oral health by tobacco products:

• Oral cancer
• Gum disease
• Reduced healing times following an extraction or other dental surgery
• Teeth and tongue stained
• Sense of smell and taste dulled
• Harder to correct some cosmetic dental issues

The Surgeon General has been warning about the health dangers of smoking since 1964. The year 2014 was the 50^th anniversary of that first Surgeon General’s report on Smoking and Health. In that period, smoking killed 20 million Americans. While the majority of those deaths were amongst adults, a starting fact is that2.5 million were passive smokers who died because they breathed in somebody else’s smoke. To coincide with the anniversary, the US Department of Health and Human Services added to the list of damage and illnesses that are caused by smoking.

There is only one way to eliminate the threats that smoking and tobacco products in general pose to your dental health and this is to quit completely. Nicotine is a highly addictive substance but there are many support groups out there to help you in your objective. They understand what is involved to be successful in quitting and they can provide backup reading material and suggestions. Some simple techniques are known to be useful, such as listing the reasons you want to quit, making a plan with a starting date for quitting, exercising, chewing gum and so on. There are also several nicotine replacement products available that are proven to help you through the early days. That’s called Nicotine Replacement Therapy or NRT and makes a big difference because it reduces cravings.

You can get a free booklet on quitting from the Surgeon General’s office. Visit the Surgeon General's website for more information. Or visit Smokefree.gov to see what help and resources are available.

Bruxism is a dental or medical term for unconsciously grinding teeth or excessive jaw clenching. Grinding is the act of sliding your teeth to and fro under pressure, thus causing excessive wear. You can be clenching and grinding without being aware of it both day and night, although night time bruxism is usually the major problem because it is more difficult to control. If it goes untreated it can result in excessive wear on the tooth surfaces. In some cases it does no damage but that is unusual.

Bruxism is usually a result of stress but it can also be caused by sleep problems, crooked or missing teeth or an abnormal bite. Some of the symptoms include:

• Sore jaw or painful / loose/ fractured teeth
• Sleeplessness
• Stress, tension and anxiety
• Depression
• Earache
• Eating disorders
• Headaches
• Excessive sensitivity in the teeth

Your dentist can repair resulting damage, such as ground down teeth, and will fit a mouth guard for you to wear while sleeping. It is important to address the underlying cause and it’s best to consult your physician. Stress can have many causes and sometimes it requires specialist help to pinpoint both the cause and the remedy.

Children can also suffer from bruxism for different reasons. It can be less damaging for them than it is in adults because they are constantly growing. Quite often they have grown out of it by adolescence. Some of the reasons may be:

• Badly aligned teeth
• An allergy
• Soreness in the mouth

Your dentist ca advise about the possible causes and the best course of treatment for your child.

The most important activity in basic oral hygiene is brushing your teeth. This is what he ADA says about how to brush properly for good dental health:

• Brush teeth at least twice daily – ideally with soft bristles. Choose your toothbrush sensibly so that it is comfortable in your mouth and so that you can easily access and clean all the surfaces of your teeth.
• A worn out toothbrush is not as effective as new one. You should replace your toothbrush every three months. Inspect it frequently and watch for signs of early wear and fraying.
• Choose only toothpastes that have met the basic ADA requirements and are approved.

Follow these guidelines on how to use your toothbrush:

• Use your toothbrush at a 45 degree angle to the gums
• Brush right and left in short strokes to clean the outer and inner surfaces and the chewing surfaces
• When cleaning the inner front surfaces hold the brush vertically. Then brush in a short up and down motion.
• Don’t forget to brush your tongue to remove the potentially harmful bacteria that lodge there.

To complete your full oral hygiene daily program, also include these activities:

Bacteria cause tooth decay so you need to remove all food particle and plaque for those harder to reach areas of your mouth also. Use floss or an interdental device to clean between your teeth and blow your gum line.

A health and well balanced diet contributed to dental health as well as overall physical and mental wellbeing.

Download our PDF – how to brush

The ADA stamp of approval is something you should watch out for when selecting dental products. It means that the item has passed the ADA’s basic checks for safety and suitability. It is always advisable to speak with your dentist about all aspects of oral hygiene and dental care. Don’t assume that you know the answer.

Prophylaxis is the term give to actions or treatments given to prevent disease. Pre-emptive medical care if you like.

New guidelines issued in 2012 by the American Association of Orthopedic Surgeons started that antibiotic prophylaxis is not now recommended for everyone with artificial joints or for those who already have orthopedic implants and who are about to undergo dental procedures. This has been endorsed by the ADA.

Your dentist will therefore take each patient’s requirements on a case by case basis. There are still valid grounds for prescribing antibiotic prophylaxis where patients have orthopedic implants. This is to prevent orthopedic implant infection. Example of appropriate scenarios include patients who have rheumatoid arthritis, diabetes, long term steroid users, cancer sufferers or those undergoing chemotherapy. All these reduce the effectiveness of the body’s immune system, which could lead to an increased risk of orthopedic implant infection.

Do, make your dentist aware if you have an orthopedic implant or if you suffer from a heart condition. Your dentist will then discuss the suitability of antibiotic prophylaxis prior to dental procedures.

General thinking regarding the excessive use of antibiotics has led to a re-examination of the justification for prescribing them in many situations. There are known risks in the use of antibiotics. These range from simple upset stomach to severe allergic reactions that may be life threatening (anaphylactic shock), a well as possible intestinal problems like C. difficile infection.

In the case of dental procedures, new thinking sees no benefits in taking antibiotic prophylaxis before dental procedures as no evidence has emerged that this prevents infections of orthopedic implants or of the heart.

Feel free to consult your dentist if you have any concern regarding antibiotic prophylaxis.

Can there be a link between unhealthy gums and heart disease? It does appear so although medical science is unable to explain it yet. Good oral hygiene may mean more to your body’s general health than just a great smile and fresh smelling breath.

The American Heart Association published some findings in 2012 that apparently links gum disease to an increase in heart disease. Other studies appear to back up this statistical finding. Gum disease affects the tissues that support the structure of your teeth. But until the linkage and causes are fully understood, the best thing that you can do is continue to practice good oral hygiene as recommended by the ADA and MouthHealthy – and that includes preventing decay and cavities.

• Brush your teeth at least twice daily and use a toothpaste that us recommended by the ADA
• Floss daily or use another cleaner as recommended by your dentist
• Do not over indulge in high sugar snacks or drinks
• Book six monthly check-ups with your dentist