Periodontal (GUM) Disease

Periodontal disease is an infection of the tissues that support the teeth.

Teeth are supported by the gums, or gingiva. A tooth's root is anchored to its socket by fibers called periodontal ligaments.

The gums do not attach to the teeth as firmly as one might think. A shallow, V-shaped gap called a sulcus exists between the teeth and the gums. Periodontal disease affects this gap. Eventually, in periodontal disease, the tissues supporting the tooth break down. If only the gums are involved in this breakdown, the disease is called gingivitis. If only the connecting tissues and bone are involved, it is called periodontitis.


What Causes Periodontal Disease?

Periodontal disease is caused by bacteria in dental plaque, the sticky substance that forms on your teeth a couple of hours after you have brushed. Interestingly, it is your body's response to the bacterial infection that causes most of the problems. In an effort to eliminate the bacteria, the cells of your immune system release substances that cause inflammation and destruction of the gums, periodontal ligament or alveolar bone. This leads to swollen, bleeding gums, signs of gingivitis (the earliest stage of periodontal disease), and loosening of the teeth, a sign of severe periodontitis (the advanced stage of disease).


Risk Factors: 

  • Smoking 

    Need another reason to quit smoking?  Smoking is one of the most significant risk factors associated with the development of periodontitis.  Additionally, smoking can lower the chances of success of some treatments.


  • Hormonal changes in girls/women 

    These changes can make gums more sensitive and make it easier for gingivitis to develop.


  • Diabetes 

    People with diabetes are at higher risk for developing infections, including periodontal disease.


  • Stress  

    Research shows that stress can make it more difficult for our bodies to fight infection, including periodontal disease.


  • Medications 

    Some drugs, such as antidepressants and some heart medicines, can affect oral health because they lessen the flow of saliva.  (Saliva has a protective effect on teeth and gums.)


  • Illnesses 

    Diseases like cancer or AIDS and their treatments can also affect the health of gums.


  • Genetic susceptibility.

    Some people are more prone to severe periodontal disease than others.


Prevention: 

  • Brush your teeth twice a day (with a fluoride toothpaste).
  • Floss every day.
  • Visit the dentist routinely for a check-up and professional cleaning.
  • Eat a well balanced diet.
  • Don't use tobacco products.


Symptoms: 

  • Bad breath that won't go away.
  • Red or swollen gums.
  • Tender or bleeding gums.
  • Painful chewing.
  • Loose teeth.
  • Sensitive teeth.

Any of these symptoms may signal a serious problem, which should be checked by Dr. Geeta. 


Treatment

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 you 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.


Deep Cleaning (Scaling and Root Planning)

DR. Geeta removes the plaque through a deep-cleaning method called scaling and root planning.  She then does scaling. It means scraping off the tartar from above and below the gum line.  Root planning gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.


Medications

Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on the severity of gum disease, Dr. Geeta or periodontist may still suggest surgical treatment. Long-term studies will be needed to determine whether using medications reduces the need for surgery and whether they are effective over a long period of time. 


Surgery: 

  • 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 tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for you to keep the area clean.  This common surgery involves lifting back the gums and removing the tartar.  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 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 re-grow.

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.  Ask Dr. Geeta what the level of success might be in your particular case.


Can periodontal disease cause health problems beyond the mouth? 

Maybe.  But so far the research is inconclusive.  Studies are ongoing to try to determine whether there is a cause-and-effect relationship between periodontal disease and:

  • an increased risk of heart attack or stroke.
  • an increased risk of delivering preterm, low birth weight babies.
  • difficulty controlling blood sugar levels in people with diabetes.

In the meantime, it's a fact that controlling periodontal disease can save your teeth -- a very good reason to take care of your teeth and gums.


Call Dr. Geeta for regular checkup to prevent GUM disease.


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