Gum disease is usually caused by a build-up of plaque, an invisible sticky layer of germs that forms naturally on the teeth and gums. Plaque contains bacteria, which produce toxins that irritate and damage the gums. Consequently bacteria in plaque cause the gums to become inflamed (red and swollen) and often easily bleed during tooth brushing.
Gum disease can occur at any age, but most cases are seen in adults. When detected in its early stages, the condition can be reversed.There are a few stages between healthy gums and severe periodontitis. Understanding these stages will allow you to know whether you need treatment and where you can turn for help.
- 1) Healthy Gums : In the mouth of an individual who has healthy teeth and gums, the gum tissue, also known as gingival tissue, will appear pink. Healthy gums feel firm to the touch and are resilient.
- 2) Gingivitis : The stage of gum disease that shows the first sign of a problem is known as gingivitis. At this stage, the gum tissue appears inflamed at the neck of the teeth and its colouring is of a deeper red than the surrounding pink tissue. There is some pocket depth of the gaps between the teeth and gums. There is also some bleeding of the gums when stimulated with a toothbrush.
- 3) Early Periodontitis : Now that periodontitis has set in, there is inflammation of the periodontal ligaments, which are tiny fibers that attach the root of the tooth to the surrounding bone. When these fibers immediately around the teeth become damaged, the attachment of teeth becomes less stable and deeper pockets develop.
- 4) Moderate Periodontitis : Once the condition reaches this stage, the damage that has been done to the bone and fibers’ holding the teeth in place is approaching a level that may be beyond repair. Now, pocket formation is noticeable and food and plaque can be trapped between the gums and teeth. While the damage may be irreversible, proper dental treatment may help prevent further damage done to the teeth.
- 5) Severe Periodontitis : The final stage of gum disease is characterized by the severe destruction of the bone and structural fibers that hold the teeth in place, leading to a shifting or loosening of the teeth. If aggressive treatment is not taken as soon as possible, the teeth may need to be removed.
These stages of gum disease are spurred by a buildup of plaque at and below the gum line. If plaque is not removed in a timely fashion, it will harden to form tartar, which promotes bacterial infection. The condition will continue to progress through each stage as you fail to control the disease. If you begin to notice any of the early signs and symptoms above, there is nothing you can personally do to control it. It takes the professional assistance of skilled dental hygienist to help you control it. Do not hesitate to set an appointment with a knowledgeable dentist.
Precaution for Gum Disease
Hundreds of types of bacteria live in the mouth, so keeping plaque at bay is a constant battle. That’s why brushing and flossing every day — and regular trips to the dentist — are so important.
- 1) Smoking : Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment.
- 2) Hormonal changes in girls/women : These changes can make gums more sensitive and make it easier for gingivitis to develop.
- 3) Diabetes : People with diabetes are at higher risk for developing infections, including gum disease.
- 4) Other illnesses : Diseases like cancer or AIDS and their treatments can also negatively affect the health of gums.
- 5) Genetic susceptibility : Some people are more prone to severe gum disease than others.
- 6) Medications : There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medications can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep gums clean.
Treatment of Gum Disease
Gum treatment involves simple procedures like Scaling & Root Planing to surgical procedures like Periodontal Flap Surgery, Gingivectomy, Bone Grafting, Gingival Depigmentation, Gingival Recession Treatment,Laser Treatment etc. If a patient has a serious case of periodontal (gum) disease then some form of surgical methods are usually employed to treat the patient.
Laser Periodontal Therapy is a newer technique used to treat gum disease. This new technology helps to replace the cutting of the gum tissue with Laser Treatment. It does not require stitches since there is no cut involved. This helps the patient in easier recovery with minimal blood loss, preservation gum tissue, reduced root exposure and sensitivity. This procedure is cost effective when compared to traditional gum treatment.
- ♦ Much lesser pain when compared to traditional surgery.
- ♦ Easy and quicker recovery with minimal bleeding since gum tissue is not cut.
- ♦ It is a gum tissue preserving technique where the gum is not cut away
- ♦ It reduces the exposure of the root
- ♦ Possibility of any infection is drastically reduced
SCALING & ROOT PLANING
Nobody plans on getting gum disease, but it happens to most of the population! In fact, like cavities, gum disease is caused by a buildup of dental plaque bacteria, resulting in dental calculus, or dental tartar. Over time, dental plaque and its cohorts will creep beneath the gum line, forming “pockets” between the teeth and gums. The larger these pockets grow, the worse the gum disease gets. This procedure is done to remove excess plaque and bacteria that has formed on the teeth and around the gum line. Using an ultrasonic scaler, periodontal hand scalers, or curettes, a dentist will carefully scrape along the visible surface of the tooth, which removes any plaque and also helps to smooth the tooth surface so it is more resistant to build up in the future.
This procedure involves the debridement of an ulcerated epithelial attachment and subjacent gingival connective tissue to eliminate inflammation, thereby, leading to shrinkage and restoration of gingival tissue health. The removal of the inflamed tissue wall of a periodontal pocket (area surrounding a tooth) is done with a curette (a spoon-shaped instrument for removing material from the wall of a cavity or other surface).
PERIODONTAL FLAP SURGERY
Periodontal flap surgery is a procedure wherein, gum is separated from the teeth to create a “flap”. This allows the surgeon to access the infected pockets that were inaccessible previously and clean the area thoroughly up to the level of the bone. In totality, periodontal flap surgery tries to reduce the pocket depth and also helps to maintain the remaining pockets clean.
BONE GRAFTING (Periodontal Regeneration)
A regenerative procedure is often recommended when the bone supporting your teeth has been destroyed. It is possible to reverse some of the damage by regenerating lost bone and tissue. The gum tissue is folded back and the bacterium which is causing the disease is removed. Guided tissue regeneration (GTR) membranes (filters), bone grafts or tissue-stimulating proteins can then be used to encourage your body’s natural ability to regenerate bone and tissue. There are many methods which will enhance support for your teeth and help to restore your bone to a healthy level. With thorough daily oral hygiene and professional maintenance care, the chances of keeping your natural teeth will be increased.
Gingivectomy is needed when there is an excessive amount of gum growth that has occurred around the teeth. This might occur as a result of poor oral hygiene over a prolonged period of time, due to some medications viz. dilantin sodium, nifedipine, cyclosporine, etc. or due to hereditary predilection.Due to the gingival overgrowth, a person cannot keep his teeth clean because of the formation of false pockets. Gingivectomy arrests this problem, thereby helping a patient to maintain clean teeth and thus avoid gum problems. Ginigivectomy is also done for situations where the patient has a gummy smile or in cases where the third molars are covered by a pericoronal flap. It can be done with the help of a surgical knife or by using an electrosurgery unit with a specially designed electrical cutting tip. The electrosurgery unit uses electricity to cut the gum tissues and at the same time, causes the gum tissues to clot and stop bleeding.
The procedure involves adjusting the levels of the gum tissue and bone around the tooth in question, to create a new gum-to–tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It also helps us in providing enough tooth structure for the retention and stabilization of new crowns & bridges so that they do not come loose easily in the future. The procedure enables an individual to be able to clean the edge of the restoration while brushing and flossing to prevent decay and gum disease.