PERIODONTAL DISEASE

“Perio” means around and “dontal” means tooth. Periodontal disease is an infection that gradually destroys the tissue surrounding your teeth and the jawbone that supports them. Nearly 3 out of 4 people will be affected with some form of gum disease at sometime in their life. This, if left untreated, often progresses to periodontitis and eventual tooth loss.

Check out if you have gum disease:

Are you gums swollen or puffy?

Do you gums bleed when you floss or brush?

Do you have bad breath no matter what you eat?

Are the tips of your gums a colour other than pink?

Have your gums pulled back from your teeth?

Have the spaces between your teeth increased?

Do some or all of your teeth feel loose?

Has the way you bite down changed?

The more times you check “yes”, the more likely it is that you need professional treatment.

Know your mouth

Our mouth is full of bacteria. In fact, our teeth are constantly being coated with a white layer (film) of debris and bacteria. This layer is called plaque. In a healthy mouth there is a natural balance of different bacteria. You can never completely get rid of all the bacteria in your mouth, but brushing and flossing help reduce the bacteria by removing plaque. If plaque is not removed over time, it will harden to form calculus (tartar). This calculus must then be removed by a dentist.

Healthy Teeth & Gums      

   How does periodontal / Gum disease develop?

 Common causes of gum disease:

Poor oral hygiene: the root cause of gum disease is plaque.

Diet: nutritional deficiencies (e.g. vit. C deficiency), excessive alcohol consumption.

Habits: smoking, pan (betelnut/arachanut) chewing, tobacco chewing, excessive use of toothpicks.

Dental causes:  large unattended cavities, irregular teeth,  ill fitting dentures

Medical causes:  diabetes, pregnancy, use of oral contraceptives, steroids, etc.

Gum disease comes in Stages

Stage 1: Gingivitis-- poor brushing and flossing habits allow dental plaque to build up on teeth. Plaque contains germs which cause gum disease. Early signs of gingivitis may include some swelling, bleeding, tenderness or bad breath. At this point, gums may be loose, but are still attached high on the teeth. This inflammation of the gums is called gingivitis and is the first stage of gum disease.

Stage 2: Periodontitis-- When gingivitis is left untreated, plaque is allowed to accumulate and it begins to calcify (harden) and forms calculus or tartar. This calculus slowly begins to break down the gum and bone support of the teeth, leading to pocket formation and bone destruction. As the disease progresses, more bone gets destroyed, the teeth loosen and eventually fall out or may need to be extracted. Periodontitis is a silent disease, where the bacterial infection of the gums and the supporting tissues usually occurs without pain.         

 

Signs of Periodontitis include:

Bad breath

Red or swollen gums

Loose teeth

Sensitive teeth

Pus coming from around the teeth

Pain on chewing

Bleeding gums

Sudden appearance of spaces between teeth

      

Stage 3:  Advanced Periodontitis: You may experience receding gums with exposed roots, darker calculus, pus if you press on your gums, and some symptoms from stage 1 and 2.

Stage 3: Periodontal pocket (Advance Periodontitis)

Treatment Option

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 and 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, and the risk of infection, and stop further damage.

Treatment option may be non-surgical or surgical -

Non  - surgical options

Scaling and root plannin

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

                     Root planning : The dentist smoothens the root surface so that supportive 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 and anti  inflammatories.

     3.  Bite correction.

     4. Splinting [using adjacent strong teeth to support the week 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 may be indicated.

      1.  Gingivectomy

     This procedure removes an overgrowth of gum tissue taking the gum level back to it’s 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 and tartar are then removed. The gum is then replaced on the tooth near the original gum line.              

 

3.     Reshaping the bone

 Your Dentist may perform osseous (bone) surgery to shape the bone after the flap surgery. The gums are sutured below the original gumline to reduce areas that trap plaque.

Prevention

 Just professional treatment is not a cure for gums disease; it needs your dedication.

Follow these simple tips as part of a self care programme:

1)      Brush your teeth twice a day.
2)      Floss regularly to remove plaque from between teeth.
3)      Rinse your mouth thoroughly after each meal.
4)      Replace your brush every 3 to 4 months.