Gum disease

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The gums (gingivae) are firm fibrous tissue attached to the bone of the jaw. They cover the bottom part of the crown of the tooth and extend down to the cheek. Healthy gums are around 1mm thick and have a good blood supply.

The tooth is attached to the bone of the jaw by a fibrous ligament, the periodontal ligament. This can stretch and acts like a cushion for the tooth in the bone of the jaw.

The gums are at their thickest around the tooth. When healthy, the gum forms a tight collar around and between each tooth. The gum collar dips downwards on the inner and outer surface of each tooth but rises between the teeth.

The gums may recede slightly with age according to the natural bone level of the tooth. This can expose more of each tooth. If the sensitive dentine of the root is exposed, the tooth can become sensitive.

Most of the adult population have some degree of gum disease. This can vary from a mild inflammation of the gums (gingivitis) to advanced gum disease (periodontal disease or periodontitis), when the fibres of the periodontal ligament attaching the tooth to the bone become affected and the bony support of the tooth is eaten away. The teeth eventually become loose and may be lost. In the past periodontal disease was known as pyorrhoea. More teeth are lost from gum disease than dental decay.

A small degree of gingivitis is common during pregnancy. Bleeding gums become much more common but the condition can be easily controlled with extra attention to tooth cleaning.

Acute ulcerative gingivitis, also known as Vincentâ€™s disease or trench mouth, is due to a bacterial infection of the gums. It is extremely painful and causes painful ulcers and an acute destructive inflammation of the gums.