Gum disease can lead to teeth loss, worsen other conditions

When fitness coach Gerard Yeo felt a sharp, shooting pain in his mouth one morning, he was horrified to find his gums bleeding badly, but he brushed it off yet again and chose not to see a dentist.

Mild pain and bleeding in his gums have been a part of life for Mr Yeo for over 25 years, since he was a teenager, but the problem eventually became too much to bear, and he decided to drag himself to a dentist.

That was when he was diagnosed with periodontitis – a severe gum disease that can destroy the bone that supports teeth and lead to teeth falling out if left untreated.

Mr Yeo, who was just 38 at the time, had three of his teeth extracted and parts of his gums surgically removed.

Speaking to The Straits Times, he said: “By the time I hit 35, my gums had started hurting and bleeding more and more, and my teeth felt loose.

“I did not want to visit a dentist because I was afraid it would be painful. I was also worried about the cost.”

Mr Yeo, now 43, said he regrets not going for regular dental check-ups, which would have prevented the gum disease from getting worse, and resulting in long-term damage to his teeth.

“Now, I am no longer able to enjoy my favourite snacks like tapioca chips and cereal tiger prawns without my dentures because I cannot chew properly,” he added.

Mr Yeo is just one of thousands of Singaporeans afflicted with gum disease.

A poll involving 1,196 adult Singaporeans from a range of household types and ethnic backgrounds in 2019 found that 90 per cent suffered from some form of gum disease.

The poll – known as the National Adult Oral Health Survey and conducted by SingHealth and the National Dental Centre Singapore – also found that just more than half, or 53.9 per cent, of the participants visited the dentist at least once a year.

Also, 34.4 per cent sought dental care only when experiencing problems with their teeth, mouth or dentures.

Dr Dawn Siow, an associate consultant at the National Dental Centre Singapore who specialises in periodontics or diseases linked to the gum, said the high prevalence of gum disease among Singaporean adults is due to the low frequency of dental visits.

She added that a lack of awareness about gum health was a key issue, with 25.7 per cent of participants in the 2019 survey – the latest data available – not knowing what caused gum disease.

As for ways to prevent gum disease, 47.5 per cent did not know regular brushing is key, and 78.9 per cent did not know regular dental checkups are also essential.

Speaking to The Straits Times, Dr Siow – who was not involved in the study – said 57 per cent of the participants suffered from moderate to severe periodontitis, which can lead to inflammation and worsen conditions like diabetes and cardiovascular diseases.

Dr Vandana Garg – the medical and scientific affairs lead for South-east Asia and Taiwan at British pharmaceutical giant Haleon – said periodontitis is linked to more than 57 illnesses, and also increases the risk of cardiovascular diseases.

Dr Siow said severe periodontitis is also linked to the presence of a high bacterial load in the mouth.

She said: “This bacterial load can lead to inflammation not only of the gums but also, systemically, the whole body. There is strong evidence that untreated severe periodontitis may worsen blood sugar control in people with diabetes mellitus.

“In patients with heart disease, severe periodontitis has also been associated with an increased risk of cardiovascular events, such as strokes and heart attacks.”

Oral health includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain and discomfort, according to the Switzerland-based FDI World Dental Federation.

Dr Garg said poor oral health “negatively impacts a person’s quality of life and can take away from their comfort and impact enjoyment of life”.

She said: “Pain and associated complications resulting from dental caries can interfere with sleep and lead to poor sleep quality.”

Dr Vivian Wong, a senior dental surgeon at Hougang Polyclinic, said “gum disease is a chronic silent killer”.

She said: “Symptoms are obvious only when the disease is severe, such as shaky teeth, teeth shifting in original position, red and bleeding gums, and loose teeth which may fall out.”

By the time a person notices the symptoms, the gum disease would have progressed to an advanced stage, she added.

To combat gum disease, Dr Jeremy Peter – a dental surgeon at Singapore dental clinic chain Tooth Stories – said maintaining good oral hygiene through consistent brushing and flossing, as well as regular dental check-ups, are key.

He added that it is also important to undergo professional cleaning to remove plaque and tartar that regular brushing at home cannot address.

He said: “In my practice, we frequently encounter patients who are anxious about visiting the dentist, and most come with late-stage dental problems.

“It cannot be stressed enough how seriously dental fears and anxieties paralyse many patients from seeking timely dental care.”

Dr Jeremy said he encourages patients to communicate their fears to their dentists, fostering mutual trust and ensuring they receive comfortable and timely care.

He added that delaying treatment can lead to more extensive problems, and the cost of addressing advanced dental issues can be a significant financial burden.

March 20 is World Oral Health Day.