The surprising reason it’s vital to keep your gums healthy

Surveys consistently show that a third of us only brush our teeth once a day, but experts agree that twice is necessary for good gum health. Photo / Lesly Juarez, Unsplash

Concerned the blood in the sink when brushing your teeth could indicate gum disease? A new test means it may soon be possible to find out within 10 minutes, without a trip to the dentist.

The at-home test, which resembles a lateral flow test for Covid-19, has been developed by scientists at the University of Cincinnati. It detects a toxin created by the bacteria responsible for gingivitis, or gum disease.

Gum disease is widespread, with around eight in 10 over-35s having had some level of the disease that causes bleeding, according to the European Federation of Periodontology. If not treated, gingivitis can develop into a more serious gum infection called periodontitis, which affects up to half of British adults – and the damage can lead to serious illnesses like heart disease and Alzheimer’s.

Kate Rosenberg, 58, is currently battling gum disease which has caused several painful infections and dental pockets - the space between her gums and teeth. “I’ve spent a fortune on treatment and have had to take antibiotics several times. I now have my teeth cleaned by a specialist hygienist every two months to try to reduce the pockets,” she says.

“My dentist was talking ominously about extractions and implants so I’m now putting a lot more effort into dental hygiene, but I wish I’d paid much more attention to it when I was younger.”

Currently, gum disease is spotted during a dental exam. Researchers hope the new technology, which isn’t yet available to buy, will enable more early detection and minimise the risks caused by gum disease to not only oral health, but the whole body system due to its links to a host of other serious illnesses.

Here’s everything you need to know to optimise your gum health.

Why is it important to keep gums healthy?

“Our mouth is the door to our body and when we have gum disease, bacteria from the mouth can get into the bloodstream,” says cosmetic dentist Dr Krystyna Wilczynski. Photo / Nhia Moua, Unsplash

Our gums are the foundation for our teeth and vital for oral health. Gum disease can result in bad breath, receding gums, infections, abscesses and, eventually, tooth loss.

It also has serious implications for our general health, increasing our risk of Alzheimer’s disease, diabetes, rheumatoid arthritis, heart disease and respiratory diseases. In 2021, a study also found that patients with severe gum disease were almost nine times more likely to die from Covid than those not suffering from it.

“Our mouth is the door to our body and when we have gum disease, bacteria from the mouth can get into the bloodstream,” says cosmetic dentist Dr Krystyna Wilczynski. Research has shown, for instance, that gum-disease bacteria has been found in the brains of people who have died from Alzheimer’s.

These bacteria can spark a harmful chronic inflammatory response throughout the body, according to periodontist Dr Sonia Joshi of Harley Street Dental & Implant Clinic. “Gum disease is linked to systemic inflammation,” she says. So healthy gums could literally save your life.

What is gum disease?

Gum disease is an infection of the tissues which support the teeth. It is caused by an inflammatory reaction to dental plaque, a sticky film of bacteria that builds up and hardens. Usually, the first sign of trouble is puffy, swollen and bleeding gums.

Gingivitis is the first stage, meaning the inflammation is limited to the gums. “In some people, gingivitis can progress to periodontitis, which causes deeper, irreversible damage to the bone, ligaments and cells around the roots of teeth,” says Dr Joshi. “This can create a space below the gum line known as a periodontal pocket, in which bacteria can thrive. If left untreated, it can lead to tooth loss.”

What are the risk factors?

Stained teeth are a notorious sign of a smoker, but tobacco is also the most significant risk factor for gum disease. Smokers are more likely to produce bacterial plaque, and once gums are infected, they have more severe gum disease than non-smokers and a poorer response to treatment.

Other risk factors include hormonal changes in women, including pregnancy and menopause, genetics, drinking, stress, lack of sleep and poor oral hygiene. It’s also more common during midlife due to the body’s decreasing ability to fight off infections as we age.

Can you cure gum disease without a trip to the dentist?

Experts recommend visiting the dentist as soon as gums appear inflamed and are bleeding, because at home it’s impossible to know the extent of the problem.

“Your dentist may need to remove the build-up of plaque using specialist dental instruments,” says Dr Sam Jethwa of Bespoke Smile. “Without seeing a dentist, the chances of the gingivitis developing further are higher.”

How is gum disease treated?

Early gum disease can usually be reversed with regular professional cleaning and good oral hygiene.

For the more severe version, in which periodontal pockets are over 5mm deep (5-7mm means moderate periodontitis, while 7-12mm means it is advanced), a procedure called scaling and root planing may be required.

“It’s a deep-cleaning, nonsurgical procedure, done under a local anaesthetic, where plaque and tartar from above and below the gum line are scraped away – scaling – and rough spots on the tooth root are made smooth: planing,” explains Dr Asif Hamid, specialist dentist and founder of Privé Clinics. This enables gum tissue to heal around the root and helps shrink the pocket.

Early gum disease can usually be reversed with regular professional cleaning and good oral hygiene. Photo / 123rf

In some cases, pocket surgery may be done, in which small incisions are made in the gums to allow a portion of gum tissue to be flapped back. This exposes the tooth’s roots so that deeper scaling and root planing can take place.

In the most extreme instances, teeth may have to be extracted and replaced with expensive implants. These often fail, due to peri-implantitis, whereby the area around the implant also becomes inflamed.

“Periodontitis cannot be reversed, but effective treatment with a dentist, good oral hygiene and regular maintenance visits with a hygienist can keep it under control,” says Dr Joshi.

How to get and keep healthy gums

There’s no substitute for a good oral hygiene regime, which is vital to prevent harmful bacteria building up. Surveys consistently show that a third of us only brush our teeth once a day, but experts agree that twice is necessary for good gum health. Brush for two minutes at a time, using a fluoride toothpaste and ideally an electric toothbrush, which can get into the crevices more effectively than a manual.

“So many people do not realise how important it is to brush their teeth from the inside of the mouth, not just the outside,” says Dr Jethwa of the most common mistakes he sees. He also recommends using an antiseptic mouthwash to remove bacteria, but warns not to do it immediately after brushing: “This will wash away the fluoride.”

Flossing and using interdental brushes once a day is also advised to reach the areas toothbrushes miss. And if our gums bleed during brushing or flossing, that’s not a signal to leave inflamed areas alone; we actually need to intensify our cleaning of those areas.

What foods are good for gum health?

“There is a large body of emerging evidence indicating that healthy and varied macro and micronutrient consumption can assist in supporting healthy gums,” says Dr Joshi.

We all know too much sugar is bad for our teeth, but it’s also bad for gums. “Diets high in sugars and ultra-processed foods are pro-inflammatory,” she says.

Instead, we should be choosing anti-inflammatory foods such as those found in the Mediterranean diet - wholegrains, fruits, vegetables, seafood and pulses - which, research shows, reduce inflammation associated with gum disease.

Joshi recommends plenty of vitamin C through the likes of strawberries, kale and oranges for strong collagen in the gums. “Lower vitamin D levels are also associated with higher rates of gum disease,” she says; for most people, the best way to ensure they get enough is via a supplement. Research suggests lycopene, found in red fruits such as tomatoes, could also help reduce the risk.