WHAT IS THE PROBLEM?
Receding gums and pus around the teeth and gums are common signs and symptoms of advanced gum disease, periodontitis. You should consult a dentist as soon as possible to be examined and diagnosed. Only a dentist can tell you if you definitely have periodontitis. The bad taste or bad breath may be symptoms of the periodontitis or of other conditions occurring simultaneously. These are all signs of infection in the gums and bone around the teeth. Periodontitis is a serious condition and one of the most common causes of tooth loss.
Figure: The right side shows gum recession together with dental plaque and inflammation. The left side is normal and healthy for contrast.
HOW IS IT CAUSED?
Periodontitis is caused by the build-up of dental plaque. The body’s defense mechanisms react by causing an inflammatory reaction. Both the bacteria and the inflammation result in the irreversible destruction of the gum tissues that anchor the tooth into the jawbone. The result of this destruction is pus. Pus contains the dead and dying bacteria and the body’s cells and tissues, as well as other products from the inflammation. As the gum tissues are destroyed, the gums recede, making the teeth look longer and yellower. Receding gums may be a cause of tooth sensitivity.
Bad breath has many causes; the most common are bacteria that form dental plaque around the teeth and under the gums. Many bacteria can also build up on the surface of the tongue. Pus may also contribute to bad breath as it usually has an unpleasant odor. Not all bad breath comes from the mouth and your dentist will be able to advise you on the cause of the bad breath.
A bad taste in the mouth is most likely to be from any pus and other inflammatory products and bacteria involved in the periodontitis.
HERE’S WHAT TO DO:
- Arrange a dental check-up as soon as possible. Once your dentist has fully assessed your medical and dental status and made a diagnosis, he/she may decide to refer you to a periodontist who is an expert with advanced training in gum disease and dental implants or provide treatment him/herself.
Follow the advice of your dentist or periodontist and dental hygienist. This will include advice on techniques to more effectively clean your mouth. If a source of the bad breath includes the tongue, he/she will advise you how to use a tongue-cleaner.
- Attend all scheduled visits. Your dental team will work with you to remove the dental plaque, clean the periodontal pockets and help reduce the inflammation. Only your dental team can determine the best course of treatment to offer you. This may include further visits for additional scaling and root planning, gum surgery, or even extractions.
- Receding gums also occur due to incorrect cleaning techniques. These include using excessive pressure on the brush, harsh scrubbing actions, and a poorly designed toothbrush with hard bristles.
General advice for safe but effective oral hygiene is provided below. Remember to follow any specific advice provided by your dentist or dental hygienist.
For all teeth and gums:
Brush all teeth and gums thoroughly with a good quality toothbrush that is designed to reach into and help clean all the difficult-to-reach areas. It is here that the dental plaque builds-up – especially along the gum margin, under the gums, and between the teeth.
Figure: Toothbrushes with extremely tapered bristles can reach further under the gum and between the teeth in the hard-to-reach areas than regular “end-rounded” bristles.
Hold the brush so the bristles are pointing toward the gum margin at 45 degrees to the tooth roots and move the brush back and forth with short strokes, making sure all surfaces and sides of all teeth get brushed equally. This should take about two minutes to do well. Your dentist or dental hygienist will provide instructions for the technique that suits your mouth best.
Figure: A key feature of the Bass Technique is placing the bristles at a 45-degree angle to the tooth.
Between the teeth:
Toothbrushes are not able to clean in the hard-to-reach areas between the teeth – a place where bleeding often occurs and gum disease starts. Each day use an interdental brush to clean between each and every tooth. With the correctly designed product, this between-teeth cleaning is both very simple and very effective. Dental floss may be used in place of, or along with, an interdental brush but is typically perceived to be more difficult.