Gum Disease [ PERIODONTITIS ]


Periodontitis, is the name of a collection of inflammatory diseases affecting the tissues that surround and support the teeth. Periodontitis involves progressive loss of the bone around teeth which may lead to loosening and eventual loss of teeth if untreated. Periodontitis is caused by bacteria that adhere to and grow on tooth surfaces (microbial plaque or biofilms), particularly in areas under the gum line. Periodontitis is very common in most populations. Dentists diagnose periodontitis by inspecting the tissues around the teeth with a probe and by radiographs to detect bone loss around the teeth. Although the different forms of periodontitis are bacterial diseases, a variety of factors affect the severity of the disease.

Important "risk factors" include smoking, poorly controlled diabetes, and inherited (genetic) susceptibility.

Signs and symptoms

Symptoms may include the following:

  • occasional redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food (e.g. apples) (though this may occur even in gingivitis, where there is no attachment loss)
  • occasional gum swellings that recurs
  • halitosis, or bad breath, and a persistent metallic taste in the mouth
  • gum recession, resulting in apparent lengthening of teeth. (This may also be caused by heavy handed brushing or with a stiff tooth brush.)
  • deep pockets between the teeth and the gums.
  • loose teeth, in the later stages (though this may occur for other reasons as well)

Patients should realize that the gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume that painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that patient.

The Various Of Gum Disease

Prevention.

  • Brushing properly on a regular basis (at least twice daily), with the patient attempting to direct the toothbrush bristles underneath the gum-line, so as to help disrupt the bacterial growth and formation of plaque and calculus.
  • Flossing daily and using interdental brushes (if there is a sufficiently large space between teeth), as well as cleaning behind the last tooth in each quarter.
  • Using an antiseptic mouthwash. Chlorhexidine gluconate based mouthwash or hydrogen peroxide in combination with careful oral hygiene may cure gingivitis, although they cannot reverse any attachment loss due to periodontitis. (Alcohol based mouthwashes may aggravate the condition)
  • Regular dental check-ups and professional teeth cleaning as required. Dental check-ups serve to monitor the person's oral hygiene methods and levels of attachment around teeth, identify any early signs of periodontitis, and monitor response to treatment.

Treatment Options

Treatment of periodontal disease depends on how much damage the disease has caused. Since periodontitis affects more than just the gums, it cannot be controlled with regular brushing & flossing. Treatment of periodontal disease is often extensive. The primary goals of all professional treatment are to promote reattachment of healthy gums to teeth, to reduce swelling, the depth of pockets, & the risk of infection, & stop further damage

Treatment Options maybe Surgical / Non-Surgical.

Non-Surgical Options :

  • 1. Scaling & Root Planing

Scaling : This is a type of cleaning. It removes plaque & tartar from the teeth & below the gum line.

Root Planing : The Dentist smoothens the root surfaces so that supporting tissues can reattach to the tooth surface. Local Anaesthesia may be used, as this procedure goes deeper than regular cleaning. Your Dentist may remove a small amount of infected gum tissue with a procedure called soft tissue curettage.

  • 2. Antibiotics & Anti inflammatories.
  • 3. Bite Correction.
  • 4. Splinting [ using adjacent strong teeth to support the weak or mobile teeth ].

Consult your Dentist for more information on specific procedures.

Surgical Options :

In later stages of the disease, depending on the severity, any of the following procedures maybe indicated :

  • 1. Gingivectomy
  • This procedure removes an overgrowth of gum tissue taking the gum level back to its original position.
  • 2. Flap Surgery
  • During this procedure, an incision is made, a flap is lifted. The gums are gently separated from the tooth, creating an access to the infected pocket. Deep deposits of plaque & tartar are then removed. The gum is then replaced on the tooth near the original gumline.
  • 3. Reshaping the bone
  • Your Dentist may perform bone surgery to shape the bone after the flap surgery. The gums are sutured below the original gumline to reduce areas that trap plaque.