Treating periodontal or gum disease: improve interdental health

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Dr Christopher Turner outlines the most important facts about periodontal or gum disease and why correct interdental brushing is essential

Here are some facts you may not know about gum disease. It is the most common disease in humans and has been reported that over 90% of the population will be affected at some stage during their lifetime.

Nearly 90 years ago it was found that diabetics have a higher risk of gum disease than the rest of the population, however, more recent research has shown that if gum disease is controlled in diabetics, their insulin or drug requirements can reduce.

And it’s not just affecting diabetics. There is proven association between gum disease and a higher risk of heart disease, a link between gum disease and a greater risk of Alzheimer’s disease or dementia, and there may even be an association between gum disease and an increased risk of kidney disease.

Bleeding gums are never normal. They are a sign of inflammation caused by toxins or antigens from bacteria in dental plaque. However, this is not the typical type of inflammation we all know about – such as inflammatory diseases like meningitis – but the body’s reaction to these specific antigens and this varies from person to person and from place to place within your mouth.


About 17% of the population are very susceptible to these antigens and have a rapidly progressive form of periodontitis. Others have an adult form of periodontitis characterised by loss of bone between the teeth and eventual tooth loss. More teeth are lost as a result of gum disease than decay.


Why does the problem lie between your teeth? Because the most widely used method of brushing, concentrating at the back and front of the teeth, leaves plaque in the crevices or interdental spaces between teeth and this is where bone loss can start and progress over time. As gums recede a space of varying size develops between teeth and gum where this plaque accumulates and can be hard to remove unless special interdental bottle brushes are used.
Inflamed gums also produce calculus or tartar below the gum line and this needs to be removed as part of your dental treatment.

Fortunately gum disease can be prevented. The most important factor is efficient and effective daily plaque removal, supplemented by regular visits to a dentist or dental hygienist who should be able to help you find the best type and size of toothbrush for your mouth and monitor your brushing methods.

But, effective cleaning of the spaces between your teeth needs a different approach. One study has shown that the size of these interdental spaces vary around the mouth, and every mouth is as unique as a fingerprint. It therefore follows that if you are only using one or two different sizes of interspace brush you are unlikely to remove all the plaque in every space, and unfortunately, however hard you try, your gum disease will continue to get worse.

A British invention called Spacemark Dental will help overcome this problem. Ask your hygienist or dentist to check each space size and then record the results on the computerised chart for you to follow at home. This chart will only cost them one pound to download, and can be updated as time goes on, a small price to pay.

Finally, the ideal time to brush is before breakfast and very last thing at night after which no food or drink (other than water) should be consumed until the following day.