What Causes Gum Disease and Tooth Decay?

5 minute read

Tooth decay and gum disease are the most common dental problems in Australia and leading causes of tooth loss for all ages. Both diseases are caused by plaque that can build up on the teeth and gums over time, depending on how well you care for your oral health.

The good news is that, like most oral health problems, gum disease and tooth decay can usually be prevented. To protect yourself or your family against dental diseases and improve your chances of keeping healthy teeth for life, it’s important to understand what causes these problems to develop in the first place.

What is Dental Plaque?

Plaque is a thin, sticky film of bacteria (biofilm) that can build up on teeth during the day and night between cleans. These bacteria are protected by a sticky coating, allowing them to multiply as they feed on sugars and carbs that enter your mouth from food and drink.

Some plaque may be removed when you brush and floss your teeth or use an antibacterial mouthwash, but this doesn’t usually remove all traces, especially from hard to reach areas. Plaque that isn’t removed hardens into tartar (also called calculus) which needs to be removed by a dentist or hygienist.

The more plaque and bacteria are allowed to spread in your mouth, the higher your risk of developing tooth decay, gum disease and other oral health concerns.

What is Tooth Decay?

Tooth decay (also called dental caries) happens when bacteria in plaque convert sugar and carbs into energy and release acids as a waste product. The protective outer layer of teeth (enamel) is exposed to these acids and gradually dissolves, leading to mineral loss and wearing down of the tooth over time.

Tooth decay can affect people of all ages. It’s especially a danger for children, as baby teeth are smaller and thinner than adult teeth, so can damage more easily. It’s thought that around half of children under 6 in Australia have untreated decay.

Stages of Tooth Decay

The first sign of tooth decay is often a white or dark spot close to the gum line. Tooth decay can still be reversed in this stage before it causes permanent damage.

If the disease develops, the enamel can start to wear down, exposing the more sensitive dentine layer beneath or even reaching the soft pulp at the centre of the tooth. This can cause the tooth to feel painful or more sensitive to hot and cold food and drink. You may also notice the tooth darkening in colour or holes (cavities) forming.

Untreated tooth decay may eventually reach the gums, leading to gum disease, an abscess or tooth loss in severe cases. Untreated decay in children may stop their jaw from developing properly or their ability to eat and speak normally.

Ways to Treat Tooth Decay

If tooth decay is caught early by your dentist, they can remove the plaque from your teeth and recommend improvements to your oral hygiene routine. This can usually reverse the problem and help to protect teeth against further damage.

If a tooth has already started to wear down or has a cavity, your dentist can remove the diseased tissue and restore the shape and strength of your tooth. They may recommend placing a white filling, inlay/onlay or , depending on the extent of the damage.

If bacteria has reached the centre of your tooth and caused infection or inflammation of the tooth pulp, your dentist may recommend root canal therapy. This involves removing the infected tissue, filling it and restoring the tooth with a crown.

If a tooth is too badly damaged to save, the only option left is usually removing it. Dentists only extract a tooth as a last resort and they will recommend replacing it with a bridge, denture or dental implant to help maintain your bite and your oral health.

If your dentist thinks you or your child may be at risk of tooth decay, because of bad oral hygiene habits or small pits in your teeth surfaces, they may recommend fissure sealants as a preventive measure. This involves adding a protective layer to the back teeth that prevents plaque from entering and makes the teeth easier to brush.

What is Gum Disease?

Gum disease (periodontal disease) is also caused by plaque. When bacteria in plaque reach the gum line, they can infect or irritate the gum tissue around the teeth. The body’s immune system responds by creating inflammation to fight the bacteria, which can lead to the gum swelling and being more likely to bleed when touched.

Around 3 in 10 adults in Australia have moderate to severe gum disease, which can cause permanent damage or even tooth loss if it’s not treated. Gum infections can also make you more prone to other oral infections and may be a risk factor for other serious health conditions, including:

diabetes
heart disease
kidney disease
respiratory diseases
rheumatoid arthritis

Treating gum disease and improving your oral health can help to lower these general health risks.

Stages of Gum Disease

There are two distinct stages of gum disease: gingivitis and periodontitis. Symptoms and treatment options vary considerably as gum disease develops.

Gingivitis

The early stage of gum disease affects the surface of the gum. It can normally be treated without any lasting damage to the gums, teeth or jaw.

You may have gingivitis if your gums are red, swollen or bleed when you brush your teeth. Bad breath or a bad taste in the mouth are other common symptoms, though these can have other causes.

Periodontitis

If gingivitis is not adequately treated, it can develop into periodontitis. This advanced form of gum disease may cause gums to pull back from the teeth or pockets to form inside the gum where bacteria can enter.

Over time, this can lead to the deterioration of the jaw bone and structures connecting the tooth to the jaw. This can cause teeth to feel loose or eventually fall out. Bacteria inside the gum can also form a dental abscess, which is a dental emergency.

Ways to Treat Gum Disease

If you think you might have gum disease, make an appointment with your dentist. They will examine your mouth and discuss your different treatment options, depending on how far the disease has progressed.

Mild gingivitis can usually be treated with professional cleaning and scaling to remove plaque and tartar from your teeth and beneath the surface of the gums. A hygienist may also apply fluoride to protect your teeth against further plaque in the short term and you’ll be advised how to maintain healthy teeth and gums at home.

More severe gum disease may require antibiotics to clear the infection or more intensive cleaning to remove bacteria from around the tooth roots or inside the gum, which may involve oral surgery. If any gum or bone has been damaged, these may be repaired with a tissue graft.

Risk factors for Tooth Decay and Gum Disease

Dental plaque is more likely to build up on teeth and around the gums if you have poor oral hygiene. This could be because you don’t brush and floss properly, don’t drink enough water or consume too much sugar in food and drink.

You may also be more likely to develop oral health problems if:

your teeth are misaligned, crowded or damaged, which can make them harder to clean
you have poor nutrition
you smoke, drink excessive alcohol or use drugs
you’re taking medication that causes dry mouth
you’re pregnant
you have an existing medical condition linked to gum disease, such as diabetes

How to Prevent Gum Disease and Tooth Decay

Most dental disease can be prevented when you take steps to improve your oral hygiene routine and address other controllable risk factors.

To reduce the growth of plaque and maintain healthy teeth and gums, dentists recommend:

Brush your teeth, gums and tongue twice a day. Use fluoride toothpaste and a soft toothbrush and brush gently for 2 minutes.
Floss before brushing at least once a day. This helps to clean parts of your mouth that your toothbrush can’t reach.
Cut down on sugar in food and drink that feeds plaque. You can reduce the impact of sugar by having any sugary snacks or drinks alongside meals and rinsing your mouth with water.
Eat a balanced diet rich in vitamins and minerals that help to support teeth and gum health and general health.
Drink plenty of water, especially tap water if your local supply is fluoridated. Fluoride is a natural defence against plaque and is maintained at safe levels.
Chew sugar-free gum if you need to increase your saliva flow.
Talk to your doctor if your medication is causing mouth dryness.
Quit smoking and avoid drinking too much alcohol or using illegal drugs.
Don’t share food and drinks or cutlery with children, as this can pass bacteria from your mouth to theirs.
Visit a dental clinic once or twice a year for your regular check-up and clean. Routine check-ups improve the chance of your dentist catching any problems before they can cause damage or affect your health.

Read more on clever ways to substitute sugar to reduce your overall intake.

Talk to a Dentist in Kelmscott and Armadale

Are you worried about your teeth or gums, or due for a check-up? We’re currently offering a comprehensive dental assessment for $150 to new patients at Kelmscott Dental, including x-rays if needed.

Call our team today on (08) 9495 7999 or contact us to book an appointment at our Kelmscott dental clinic. We also welcome patients from Armadale, Gosnells and other nearby Perth suburbs.