Periodontal disease is the inflammation and infection of the gums. It is caused by plaque a thick sticky film of bacteria that builds up on the teeth. Plaque can harden to become calculus known also as tartar. Plaque and calculus are caused by poor oral hygiene; that is the teeth have not been cleaned thoroughly or often enough.

The most common form of periodontal disease is gingivitis an inflammation of the gums. This may progress to affect the surrounding tissues and is called Periodontitis. (gum disease) The effects of gingivitis are largely reversible with appropriate care, including plaque and calculus removal and then thorough regular brushing and flossing. If left untreated gingivitis can progress to periodontitis- which causes permanent damage to the ligament and bone that support the teeth.

Some of the common warning signs of gum disease are:

• Bleeding gums when you brush.
• Bad breath (halitosis)
• Receding gums.
• Loose or moving teeth.

Halitosis is caused by sulphur producing bacteria that normally live on the tongue and other surfaces of the mouth. The breakdown of these bacteria produce volatile sulphur compounds which produce the odur. Poor oral hygiene and gum disease are common causes of bad breath, along with other factors which can be discussed with your dentist/hygienist.

In most cases gum disease can be managed with appropriate care. Management of gum disease becomes more difficult the more advanced the disease. Therefore the sooner gum disease is diagnosed and treated the better.

Treatment of gum disease usually involves:

1. Professional cleaning of teeth above and below the gum line.
2. Achieving optimum home care
3. Reducing risk factors such as smoking
4. Regular reviews.

Gum disease causes permanent damage to the tooths supporting structures therefore the aim of treatment is to stop the progression of the disease. This is an ongoing lifelong activity.

Managing gum health is a joint effort that requires co-operation and motivation on behalf of both the patient and operator

Healthy teeth and gums make for a beautiful smile. You smile - we smile.

Bad breath or ‘Halitosis’ can be a distressing problem for those it affects, but can often be managed well with the right advice.

Causes of bad breath can include:

• Smoking
• Alcohol consumption
• Dental decay
• Periodontal or ‘gum’ disease
• Partially erupted or impacted teeth (often ‘wisdom teeth’)
• Tonsilitis
• Ulcerations/ fungal infections within the soft tissues of the mouth
• Some medications
• General illnesses (such as diabetes, respiratory and gastro-intestinal infections or diseases)
• Dry Mouth
• Consumption of odour-intense foods (such as garlic, onion etc)

Often the cause of the halitosis may be ineffective cleaning of food and/or odour-producing bacteria from the mouth.

Effective and gentle brushing and flossing of the teeth may be insufficient to bring these odours under control.  Sometimes food debris and bacteria may accumulate in the rough surfaces of the tongue and require removal with a specialised tongue scraper or ‘comb’ that removes bacteria from the tongue the same way a toothbrush removes them from the teeth.

Mouthwashes may be of some benefit, particularly those containing the ingredients ‘chlorhexidine’ and ‘triclosan’.  However, there is a shortage of evidence to prove their effectiveness and in some cases inappropriate uses of mouthwash may result in (reversible) tooth staining.  There have been some recent concerns about the link between alcohol containing mouthwashes and oral cancer.  While these links are tenuous and debatable, the routine use of alcohol containing mouthwashes is not advisable.

Patients must be wary of ‘covering up’ bad breath with a mouthwash rather than identifying and treating the underlying cause, given that the halitosis may often be a symptom of a more serious underlying problem.  Consultation with the dental team is the best first step to determine the cause of bad breath, and how to effectively manage the condition.

Source:  Therapeutic Guidelines: Oral and Dental 2007 Version 1