September is National Gum Care Month

September is National Gum Care Month, which is especially important in a nation where nearly half of adults suffer from some form of gum disease.

Gum tissue must be healthy and managed before, during, and after orthodontic treatment. In this article, we define gum disease and discuss how gum disease and orthodontic treatments are connected.

What causes gum disease?

The mouth is a complex ecosystem of bacteria. Like the gut, the mouth houses different types of bacteria to create a symbiotic oral microbiome. When oral bacteria is unbalanced, pathogens evade,  infect gingiva, and cause gum disease.

The two stages of gum disease are:

  • Gingivitis, the mildest form of gum disease, often showcases as inflammation, discomfort, and bleeding. With professional intervention and consistent oral hygiene routines, gingivitis is reversible.
  • Periodontitis, the advanced form of gum disease, evolves from untreated gingivitis. Periodontitis may cause the teeth to become loose, gums to form pockets filled with debris and pus, and destroy the underlying bone. Periodontitis can only be treated, not reversed.

Poor oral hygiene is typically the root cause of gum disease, but certain health conditions, genetics, and lifestyle choices can also contribute to development.

Braces vs. Clear Aligners for Healthier Gums

When comparing fixed oral appliances (braces) and clear aligners, patients treated with clear aligners tend to have healthier gums. Because clear aligners are removable, patients have direct access to enamel and the cracks between their teeth. After the patient temporarily takes out the trays, bacterial plaque and food particles are easier to remove with brushing and flossing.

Removing debris may be more challenging for patients with fixed, conventional braces. If plaque accumulates around the brackets, this may lead to dental decay and inflamed gums (gingivitis). Again, gingivitis is reversible. However, when gingivitis advances, it morphs into incurable, damaging periodontitis.

How Periodontal Disease Affects Systemic Health

Periodontal disease is the leading cause of tooth loss in adults. Still, the damage is not restrained to the mouth: gum disease is associated with an increased risk of serious degenerative diseases. When oral bacteria leeches into the gums and the bloodstream, it can increase inflammation throughout the body.

Scientists at Harvard believe that inflammation is a response from the immune system. The immune system sends white blood cells to eliminate bacteria and disease, but gum tissue becomes collateral damage.

Patients with advanced periodontitis are associated with a higher risk for diabetes, chronic respiratory disease, and other systemic inflammatory conditions. Periodontitis is less likely to develop in patients who use clear aligners.

Orthodontic Treatment and Aggressive Periodontitis

According to a journal posted by the International Scholarly Research Notices, gum disease can happen at any stage of orthodontic treatment, so providers must monitor and manage aggressive periodontitis before, after, and during treatment. Removable aligners and routine checkups can help dentists prevent the effects of aggressive gum disease, including bone loss.

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