Periodontal disease is an infection that gradually destroys the tissue surrounding your teeth and the jawbone that supports teeth.
This condition, if left untreated, often progresses to ‘Periodontitis’ and tooth loss.
Our mouth is full of bacteria. In fact, our teeth are constantly being coated with a white layer of debris and bacteria. This layer is referred to as ‘PLAQUE’.
In a healthy mouth, there exists a natural balance of different types of bacteria. You can never get rid of all the bacteria in your mouth, but brushing and flossing helps in reducing the bacteria by removing plaque. If plaque is not removed over time, it will harden to form ‘calculus’.
This calculus must then be removed by a dentist.
The common causes of gum disease are:
- Poor oral hygiene: The root cause of gum disease is plaque. Poor oral hygiene leads to accumulation of plaque and calculus on and around the tooth.
- Diet: Nutritional deficiencies could lead to improper health of the gums and the periodontium and could lead to periodontal disease.
- Habits: Smoking, tobacco chewing, excessive use of tooth picks, excessive alcohol consumption and drug abuse could cause periodontal disease.
- Dental causes: Irregularly placed teeth, cavities in teeth, ill fitting dentures, improper fillings, ongoing orthodontic treatment are some of the various causes that could lead to plaque accumulation.
- Medical causes: Diabetes, Pregnancy, Use of oral contraceptives, Steroids, long term use of medications like antibiotics would predispose an individual by reducing his immunity.
Gum Disease generally occurs in stages:
Stage 1: Gingivitis
Poor oral hygiene leads to accumulation of plaque on the tooth surface. Plaque contains bacteria that cause gum disease. Early signs of gingivitis include:
- Swelling of the gums
- Bleeding from the gums
- Bad breath
This inflammation of the gums, due to presence of local irritants is called ‘Gingivitis’.
Stage 2: Periodontitis
When gingivitis is left untreated, plaque is allowed to accumulate and it gets calcified to form calculus or tartar.
Calculus is a hard deposit that forms on the tooth surface.
This calculus slowly begins to break down the gums and the bone support of the teeth, leading to pocket formation and bone destruction.
If left untreated, the condition can worsen and eventually teeth could become loose.
Periodontitis is a silent disease, where the infection of the gums and the supporting tissues usually occurs without pain.
Signs of Periodontitis include:
- Bad breath
- Red ,swollen gums
- Loose teeth
- Sensitive teeth
- Bleeding and or pus discharge from the gums
- Pain on chewing
- Tender gums
- Appearance of spaces between teeth
Stage 3: Advanced Periodontitis
This is an advanced stage of gum disease where you may experience receding gums with exposed roots, presence of darker calculus, pus discharge from the gums and loose teeth apart form the signs and symptoms of stages 1 and 2.
TREATMENT OPTIONS
Treatment of periodontal disease depends on the severity of the condition and the extent of damage the disease has caused.
Treatment for periodontal disease is often extensive.
The primary goal of all professional treatment is to
- promote healthy reattachment of healthy gums to teeth,
- to reduce swelling of the gums
- to reduce the depth of pockets
- to stop further damage of supporting structures and
- to reduce the risk of repeat infections
Non surgical treatment:
- Scaling and root planning: Scaling involves removal of plaque and tartar from the teeth surface and below the gum line. The root surface can be planed or smoothened to promote reattachment of the gums. This procedure can be performed under local anesthesia.
- Antibiotics and anti inflammatory medications could help in reducing the swelling and could promote healing of gums.
Surgical treatment options:
- Soft tissue curettage: the infected gums can be removed with the help of specialized instruments. Treatment can be done under local anesthesia.
- Gingivectomy: in this procedure the overgrown and excessive gums are removed to get the gum level back to its original position
- Flap surgery: an incision is made to elevate a ‘flap’. The gums are than gently separated from the teeth, creating an access to the infected pockets. Deep deposits of calculus are then removed along with the removal of infected gum tissues. Bone reshaping and recontouring, if required can also be performed. The gum flap is then sutured back on to the teeth.
Prevention of Periodontal disease
Professional treatment can remove the presence of infection.
However, it is very important to try and prevent the occurrence of this disease. Follow these simple tips as part of a self care programme:
- Brush your teeth twice a day
- Floss regularly to remove plaque from between teeth
- Rinse your mouth after every meal
- Replace your brush after every 3-4 months
- Regular visits to your dentist.
