This is a fascinating and occasionally frustrating area of dentistry.

The human mouth is host to a variable population of bacteria and from one brushing to the next they will regrow as what we call plaque.

Plaque is mostly made up of a fairly mild-mannered aerobic bacterium called Streptococcus mutans, which makes itself at home by turning the usual contents of our saliva into a sticky goo in which it can get on with the business of being a bacterium.

The problems start when the build up of plaque reaches the point where all of the available oxygen has been used up by the surface layers and the deeper areas, especially around the gumline, become anaerobic or stagnant.

This then provides an inviting habitat for less benevolent bacteria to start to thrive, and these are the bugs our gums really don’t like to be next to.

The result is similar to an allergic reaction, in that the gums become irritated and inflamed, and as they swell the connection between tooth and gum starts to break down.

Untreated, this over time creates a “ pocket “ around the tooth, into which the anaerobic bacteria can further grow. The process continues until eventually bone around the tooth is eaten away by the inflammatory process, and ultimately the tooth becomes loose and is lost.

Anybody can develop gum disease by neglecting their daily plaque control, but some unfortunate people are genetically predisposed to gum disease in that the tissues around their teeth are hypersensitive to cell wall toxins produced by certain anaerobic bacteria.

Once this predisposition has been identified, it is crucial that regular preventative care is made available to keep daily plaque control at the highest levels and remove any tartar deposits as early as possible.

Recent research has identified a direct link between chronic gum disease and heart disease, and further work is under way to see whether such chronic processes are linked to a variety of other prevalent conditions such as Alzheimer’s disease.

It’s really important to look after our gum health, not just to prevent unnecessary tooth loss but also for our general wellbeing.

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