Gum disease often develops silently until damage is irreversible. An Ichilov specialist explains the warning signs, the risks of smoking and the latest treatments helping save teethIt does not always hurt or become noticeable, but it can dramatically affect oral health, and sometimes overall health as well. Gum disease is one of the most common diseases, yet many people recognize it only after significant damage has already been done.How can it be detected early? What actually works in a daily routine? And what mistakes do most of us make without realizing it? Dr. Meyrav Oman, periodontist at the Center for Oral and Dental Medicine at Ichilov, explains the basics and the small details that can make a big difference.What is gum disease, and how does it develop?
“Gum disease” is an umbrella term for two main conditions. The first is gingivitis, a common, reversible form of inflammation that affects only the gums and does not lead to bone loss.The second, more serious condition is periodontitis, a chronic inflammatory disease in which the inflammation spreads to the tissues that support the teeth, causing irreversible damage to the bone and the ligaments that connect the tooth to the bone. Without treatment, the process can lead to loose teeth and even tooth loss.5 View gallery Dental floss is best suited for tight spaces, but it is not always enough for people with gum disease(Photo: Shutterstock)Both conditions begin with the buildup of bacterial biofilm, or plaque, on the teeth. The biofilm is the initial trigger for inflammation, but the tissue damage is caused not only by the bacteria but also by the body’s immune response. “When the inflammatory response is prolonged and uncontrolled, it can destroy the supporting tissues,” Oman said.The disease’s severity and pace of progression depend on several factors, including genetics, smoking, poorly controlled diabetes, persistent plaque buildup and environmental factors such as stress. “In advanced stages, gum surgery may also be needed to regenerate the tissue,” Oman said.Oman said gum disease often begins with subtle signs that are easy to miss. “The early signs are subtle and usually painless, so many people ignore them,” she said. “The most sensitive sign is bleeding during brushing or cleaning between the teeth, which indicates active inflammation. Other signs include redness, swelling, sensitivity near the tooth’s neck (dental cervix) and sometimes bad breath. Healthy gums do not bleed.”The absence of pain does not mean there is no problem. “In most cases, there is no pain, even when there is significant tissue destruction,” Oman said. “That is why diagnosis is often delayed until irreversible damage has already occurred. Pain usually appears only in acute situations.”Bleeding, she stressed, should not be dismissed. “Bleeding indicates inflammation and requires treatment,” she said. In fact, there is no such thing as “normal” or “acceptable” gum bleeding. Healthy gums do not bleed at all, and any bleeding that lasts more than seven to 14 days, even with good oral hygiene, should prompt a professional evaluation.“The gold-standard routine includes three main components: brushing twice a day, preferably with an electric toothbrush; cleaning between the teeth, using interdental brushes or dental floss; and regular professional maintenance, such as with a dental hygienist or dentist, based on the person’s risk level, usually every three to six months,” Oman said. “The most important thing is personalized guidance and proper instruction.”5 View gallery Gum recession: Exposure of the tooth root, which can cause sensitivity and damage to the tooth
