Periodontal [Gum] diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.
Periodontal [Gum] diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost. Gum disease is a threat to your oral health. Research is also pointing to possible health effects of periodontal diseases that go well beyond your mouth (more about this later). Whether it is stopped, slowed, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.
Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless "biofilm" (previously known as plaque) on teeth. Brushing and interdental cleaning such as flossing removes and disrupts biofilm. Biofilm that is not removed can harden and form bacteria-harboring "calculus" (sometimes referred to as tartar) that brushing doesn't clean. Only a professional cleaning by a dentist or dental hygienist can remove calculus.
The longer biofilm and calculus remains on teeth, the more harmful they become. The bacteria creates inflammation of the gums that is called "gingivitis." In gingivitis, 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. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.
When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth.") In periodontitis, gums pull away from the teeth and form "pockets" that are infected. The body's immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body's enzymes fighting the infection actually start to break down the bone and connective tissue that hold teeth in place. If not treated, the bones, gums, and connective tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
People usually don't show signs of gum disease until they are in their 30s or 40s. Men are more likely to have periodontal disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when biofilm is allowed to build up along and under the gum line.
The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. Additionally, modifying certain behaviors, such as quitting tobacco use, might also be suggested as a way to improve treatment outcome.
The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and full mouth disinfection. Scaling means scraping off the calculus from above and below the gum line. Full mouth disinfection is the disruption and removal of the biofilm (bacterial colonies) that live above and below the gums. This treatment is not usually started until a good level of oral hygiene can be demonstrated and as much inflammation can be reduced as possible by the patient. This initial therapy is usually followed up with regular maintenance visits, where the gums are checked and further biofilm disruption is undertaken.
Flap Surgery. Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A periodontist may perform flap surgery to remove calculus deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the calculus. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. Bone and Tissue Grafts. In addition to flap surgery, your periodontist may suggest bone or tissue grafts. Grafting is a way to replace or encourage new growth of bone or gum tissue destroyed by periodontitis. A technique that can be used with bone grafting is called guided tissue regeneration, in which a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow. Since each case is different, it is not possible to predict with certainty which grafts will be successful over the long-term. Treatment results depend on many things, including severity of the disease, ability to maintain oral hygiene at home, and certain risk factors, such as smoking, which may lower the chances of success.