Our mouths are naturally always full of bacteria. These bacteria constantly form a sticky, colourless ‘plaque’ on teeth that causes the enamel to decay, and without daily brushing and flossing plaque can harden and form tartar that brushing alone cannot remove. Only professional cleaning by a dentist or dental hygienist can remove tartar. The longer plaque and tartar remain on teeth, the more harmful they become, eventually leading to inflammation of the gums known as gingivitis where the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. If gingivitis is left untreated it can lead to periodontitis, which literally means ‘inflammation around the tooth’. In periodontitis, gums pull away from the teeth and form spaces called pockets that become infected. The body’s immune system fights the plaque as it spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed. In some studies, researchers have observed that people with gum disease, when compared to those without, were more likely to develop heart disease or have difficulty controlling blood sugar. The type of treatment you will have will depend on how severe your gum disease has become. If you have gingivitis, your dentist or hygienist will clean your teeth thoroughly with abrasive toothpaste using an electric toothbrush and a special instrument called a scaler. If gingivitis has developed into periodontitis you may need more extensive scaling to remove plaque and tartar from the periodontal pockets. This can require several appointments. Your dentist or hygienist will monitor the size of the periodontal pockets during the following months to make sure the treatment has been successful and the periodontitis isn’t getting any worse. Your dental hygienist can show you how to brush, and also how to use floss and inter-dental brushes to remove plaque and food debris from places toothbrushes can't reach. Maintaining these levels of excellent oral hygiene is the most important factor in preventing periodontal disease.