When you contact your dental practice or Health Board for a dental appointment, you MUST tell them if you have tested positive for coronavirus (COVID19) OR you are currently self-isolating OR you have possible symptoms.

Dental practices have to comply with social distancing measures so please do not attend without having made an appointment first.

What is gum disease?

Gum disease is a very common condition where the gums become swollen, sore or infected. The early stage of gum disease is known as gingivitis. If you have gingivitis, your gums may bleed when you brush your teeth and you may have bad breath. Gingivitis can be reversed by effective cleaning of the teeth and gums.

If gingivitis is not controlled, a condition called periodontitis can develop. This results in loss of the bone which supports the teeth. It can lead to some tooth movement and wider gaps between teeth. Teeth can become loose and may eventually fall out.

What causes gum disease?

Gum disease is caused by a build-up of plaque on the teeth. Plaque is a sticky substance that contains bacteria. Some bacteria in plaque are harmless, but some are very harmful for the health of your gums, particularly those bacteria which like undisturbed dental plaque.

If you don’t remove plaque from your teeth by brushing them, it builds up and irritates the gums. This can lead to redness with bleeding, swelling and soreness and loss of bony support.

Smoking also causes gum disease and can make it worse. If you are a smoker, do your best to give up as this will benefit your general health as well as your gum health. For support with giving up call 0800 085 2219 or visit www.helpmequit.wales

Certain medical conditions, such as diabetes or conditions that affect your immune system, can make gum disease worse.

Some people are more prone to gum disease as it can be genetic (run in families).

What can I do about gum disease?

The most important things that you can do to prevent gum disease are:

• Brush your teeth for 2 minutes twice a day

• Clean in between the teeth with floss or interdental brushes once a day

• If you are a smoker, consider giving up.

You can receive support by calling 0800 085 2219 or visiting www.helpmequit.wales

• If you have diabetes, controlling this well will also help to control gum disease

See your dentist for check-ups as regularly as they recommend.

If your gums bleed when you brush your teeth, call your dental practice for advice. They will carry out remote consultation over the phone/video before seeing you in person at the practice if treatment is required.

If you do not have a regular dentist, you need to call the appropriate dental helpline number for your Local Health Board area.

If you have gum disease, your dental team may recommend that you visit regularly for treatment. This may involve professional cleaning of the teeth by a dentist or dental hygienist to remove tartar.

For treatment of gum disease to be successful, you must maintain a good level of oral hygiene. This means brushing your teeth well, including where the teeth meet the gums, at least twice a day and cleaning in between the teeth with floss or interdental brushes regularly.

Healthy gums should be pink, firm and keep your teeth securely in place. Your gums shouldn't bleed when you touch or brush them. If they do bleed that is a sign you need to improve your cleaning.

What happens if gum disease is not controlled?

If gingivitis is untreated, the tissues and bone that support the teeth can also become affected. This is known as periodontitis, or periodontal disease.

Symptoms of periodontitis can include:

• bad breath (halitosis)
• an unpleasant taste in your mouth
• loose teeth that can make eating difficult
• receding (shrinking) gums can make teeth appear longer
• bigger gaps between teeth, which can trap food
• gum abscess (collection of pus forming under your gums or teeth)
• tooth loss

As well as getting advice and/or treatment from your dental practice, you should also clean your teeth and gums as well as you can, including brushing the teeth well for 2 minutes (or more) twice daily and cleaning between the teeth (using floss and/or other interdental cleaning aids). Antiseptic mouthwashes containing chlorhexidine or hexetidine can also help control gum disease and are available over the counter from pharmacies.

The British Society of Periodontology has lots of useful information on gum disease for patients. To find out more please click here.

Acute necrotising ulcerative gingivitis (ANUG)

In rare cases, a condition called acute necrotising ulcerative gingivitis (ANUG) can develop suddenly.

The symptoms of ANUG are usually more severe than those of gum disease and can include:

• bleeding, painful gums
• painful ulcers
• receding gums in between your teeth
• bad breath
• a metallic taste in your mouth
• excess saliva in your mouth
• difficulty swallowing or talking
• a high temperature (fever)

As well as the oral hygiene advice given above, ANUG may require painkillers. For pain relief try Paracetamol or Ibuprofen (following dosage instructions on the packet).

Call your dental practice for advice and treatment if necessary. Antibiotics are sometimes required and your dentist will be able to provide a prescription for these if necessary.

If you do not have a regular dentist, you need to call the appropriate dental helpline number for your Local Health Board area.