Gum infection treatment: A Guide by Dr Marlene Teo

What is a gum infection?

Although you may brush your teeth and gums daily, and practice generally good oral hygiene habits, many of us may be unaware that we perform our daily brushing and flossing imperfectly. This leftover plaque can lead to gum disease over time, like gingivitis or even periodontal disease. Did you know that gums can get infected by bacteria and plaque that is left on the gum and teeth due to our imperfect oral hygiene practices? When should we seek treatment and how do we know when urgent gum infection treatment is needed?

Gingivitis is the inflammation of the superficial gums around the teeth and it’s considered the milder form of gum disease. If gingivitis is left untreated, this gum disease infection can lead to periodontal disease or Periodontitis, (per-e-o-don-TIE-tis) which is a serious gum infection that damages the soft gum tissue and destroys the bone that supports your teeth. When the supporting bone is destroyed, the tooth starts to become mobile and it can eventually fall out. (mayoclinic.org, 2019)

It is highly recommended that you see a dentist if you suspect you have gingivitis or another gum disease! Prevention is much better than cure. Practising good oral hygiene goes a long way in keeping your teeth and gums healthy. Frequent brushing and flossing of your precious teeth and gums will keep plaque levels low and help prevent gingivitis, periodontitis, and other forms of gum disease.

What causes gum infection and disease like gingivitis?

The major cause of gum disease is bacterial plaque, a sticky white film composed of food debris and bacteria that forms on the teeth. If plaque is not removed, it causes the gums to become inflamed, red and irritated. Furthermore, once the immunity is weakened from smoking, stress, or systemic disease, the bacteria in the plaque win and the bone and gums surrounding the teeth dissolve due to chemicals released by the body.

These chemicals are meant to fight the bacteria but they can end up harming our own body if our inflammation response is not optimum. When this happens, the gums separate from the teeth, forming pockets that fill with even more plaque and causing even more bacterial entry and infection, leading to a worsening of the gum disease.

A vicious cycle now ensues. The bacteria and food become calcified under the gums and turn into tartar. Tartar looks like very very big blackheads under the skin. It’s just stuck on the teeth and continues to irritate the body to produce even more inflammation and bone loss. It leads to shaky teeth and bad breath from the build-up of bacteria in the gums. (efp.org, 2019)

What is a gum boil? Is it a gum infection?

Sometimes the immune system gets so weak especially during times of intense stress that the chronic gum diseases turn acute. It looks like a gum boil and its scientific name is “periodontal abscess”. (Periodontal abscess: aetiology, diagnosis and treatment)

The periodontal abscess is an acute destructive process of the structures surrounding the teeth, resulting in localized collections of pus. The pus may drain through the gums and emit a foul smell. Pus is a thick, opaque, usually yellowish-white, fluid matter that is formed as part of an inflammatory response typically associated with an infection and is composed of exudate chiefly containing dead white blood cells (such as neutrophils), tissue debris, and pathogenic microorganisms (such as bacteria) (Merriam-webster.com, 2019)

Gum infection treatment in Singapore

One of the most common gum infection treatment procedures for gingivitis and periodontitis is a deep cleaning of the gum line (scaling and root planing) – usually performed by a dentist or periodontist. (Nonsurgical treatment of periodontitis, 2012)

Scaling and root planing is considered the gold standard of Periodontitis treatment and is commonly done. The area will be numbed with a local anaesthetic by your dentist or periodontist and the tartar is broken up by instruments and flushed out with water. The root surfaces of the affected teeth are then smoothened by the dentist to decrease the plaque retentive tendencies.

In the situation where a periodontal abscess is present, further management is needed. The pus needs to be drained either through the gum pocket or through the sides of the abscess. The periodontist or dentist may need to extract the tooth if there is advanced attachment loss and the prognosis of the tooth/teeth is poor. (jcda.ca, 2019)

The dentist may also give further medical advice or recommend systemic antibiotics if the abscess threatens to spread to vital areas like the brain or the throat region. (The periodontal abscess: a review, 2001)

Gum Infection Home Remedies: Tips to Relieve Discomfort

Rinse with saltwater

Salt can help reduce swelling and soothe the infected area. Mix ½ teaspoon of salt in a glass of warm water and rinse for 30 seconds. You may repeat 2 to 3 times a day.

Rinse with hydrogen peroxide

Aside from salt, you can also use a hydrogen peroxide rinse to help reduce bacterial growth and plaque on your gums. Mix equal parts of 3 percent hydrogen peroxide with water and rinse for 30 seconds. Overuse of hydrogen peroxide may cause irritation, so only use this rinse a few times a week.

Apply a cold compress

Place a cold compress outside of your cheek where you feel pain for 10-15 minutes. This may help alleviate the pain and decrease swelling.

Aside from the tips above, you are also advised to maintain a healthy oral care routine, which involves brushing twice a day and flossing daily. You can also use an antibacterial mouthwash to help improve oral hygiene. Although home remedies may help soothe the discomfort for early stages of gum infection, if the pain persists, book an appointment with a dentist immediately for professional intervention.

When is gum infection treatment urgent?

It is very urgent when you get systemic signs like a fever or a rapidly growing swelling around the gums or face. If these health problems happen, see a dentist immediately! It could mean that the acute gum infection has spread and you might need medical treatment in conjunction with dental treatment.

Gum infection treatment is also needed when you notice these signs and symptoms. (Not as urgent as the above, but you still need to see a dentist or periodontist as soon as possible)

• Red, swollen or tender gums that persist more than 1 week
• Spontaneous bleeding from gums
• Pus from the gums
• Persistent bad breath
• Continuing gum recession
• Longer teeth
• Increasing spaces between teeth

(Mayoclinic.com, 2019)

Conclusion

If you notice one or more of these symptoms, something is not quite right. Your dentist may need to check if you need gum infection treatment. Remember, an early diagnosis or treatment is always better, so don’t keep waiting! Always maintain a regular routine of brushing and flossing. For best practice, it is recommended to brush your teeth after every meal! Good oral hygiene habits will keep your gums and teeth in good condition and help prevent gingivitis and other forms of gum disease. Although persistent bad breath cannot kill you, it is still wise to seek treatment with a dentist or periodontist or a consultation with a dental hygienist as soon as possible to prevent the gum infection from getting worse and spreading.

Our Doctor

Dr Marlene Teo

Periodontist in Singapore – Special interest in complex full mouth rehabilitation and dental implants

Dr Marlene Teo is a periodontist currently practising in Singapore. She graduated from the National University of Singapore, where she was the sixth dental graduate in its 64-year history to be awarded BDS Honours. Throughout her course of study, Dr Teo was awarded a total of 11 academic and clinical medals, including the Lee Kuan Yew gold medal (Best Student Throughout Course of Study), the Tratman Silver Medal (Most Distinguished Graduate) and the Dr FAC Oehlers Gold Medal (Best Clinical Student).

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References

1. https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473
2. https://www.efp.org/patients/what-is-periodontitis.html
3. Valyi, Gorzo (2004, Periodontal abscess: etiology, diagnosis and treatment)
4. https://www.merriam-webster.com/dictionary/pus
5. Sanz L, Alonso B, Carasol M, Herrera D, Sanz M (2012, Nonsurgical treatment of periodontitis)
6. J Can Dent Assoc, 2013;79:d8
7. Herrera, Roldán, Sanz (2001, The periodontal abscess: a review)
8. https://www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473