Periodontology – Gum Treatments
Periodontology is a branch of dentistry that deals with gum diseases and their treatments. The word “periodontal” refers to the area around the tooth. Gingiva refers to the gums. The terms used for gum inflammation are “gingivitis” and “periodontitis”.
What are the Causes of Gum Diseases?
While plaque is the main cause of periodontal diseases, age, smoking, genetics, stress, cancer, hypertension, and other health problems are also risk factors for gum diseases.
Birth control pills, antidepressants, certain heart disease medications, teeth grinding, poor nutrition, and obesity also affect gum health.
Symptoms of Gum Disease
Gum diseases often progress without causing noticeable symptoms, and the symptoms may not appear until the disease reaches an advanced stage. However, the warning signs of gum disease include:
- Persistent bad breath
- Formation of mouth sores
- Pus coming from the gums
- Tooth loss or gaps between teeth
- Incompatibility with existing partial dentures
- Redness, swelling, sensitivity, and pain in the gums
- Gum recession that makes the teeth appear longer than they actually are
- Gum bleeding during brushing, flossing, or when eating hard foods.
Gum Disease: Gingivitis
Gingivitis is an early stage of gum disease. The gums become red, swollen, edematous, and prone to bleeding. At this stage, there is no destruction of the supporting bone around the teeth. Gingivitis often occurs due to inadequate oral hygiene. With proper oral care and treatment, the gums can return to their healthy state.
Factors that contribute to the progression of gingivitis include diabetes, smoking, genetic factors, systemic diseases, stress, improper nutrition, hormonal changes, pregnancy, HIV infections, and the use of certain medications.
Gum Disease: Periodontitis
Untreated gingivitis can progress to periodontitis. Over time, the toxins produced by bacteria in the plaque that accumulates on the teeth irritate the gums. The supporting bone and tissues around the tooth begin to break down. The gums separate from the tooth, creating a pocket. As the disease progresses the pocket deepens, and the destruction of the gum and bone increases. If left untreated, the bone loss in the teeth becomes severe, leading to tooth extraction.
Prevention of Gum Diseases
Periodontal diseases, also known as gum diseases, are caused by the accumulation of bacterial plaque between the tooth and the gum. When gum disease is left untreated, inflammation damages the structure of the gums and bone, leading to gum recession and tooth loss.
To prevent gum diseases, the following measures should be taken regularly:
- Brushing teeth
- Using dental floss
- Using mouthwash
- Dental cleaning (removal of tartar)
- Regular dental check-ups
- Knowing the risk factors
Tartar cleaning is the most common and preventive treatment for gum diseases. It involves removing tartar and plaque (which is also called calculus) from the root surface.
Dental plaque is a sticky substance composed mostly of bacteria. Plaque hardens over time and forms tartar. Plaque and tartar adhere to the tooth surface, especially below the gumline on the root surface. Since plaque has an affinity for rough surfaces, the root surfaces need to be smoothed. During this procedure, all tartar is removed, and irregularities on the root surface are corrected.
What to Do After Tartar Cleaning
Mild sensitivity to hot and cold and slight discomfort may occur for two to three days after the treatment. Painkillers can be used to alleviate the discomfort. In cases where oral hygiene is difficult due to discomfort, antiseptic mouthwashes can be used. Regular brushing and flossing should also be continued. Mild bleeding may occur on the first day after tartar cleaning.
Effects of Gum Disease on the Body
Inflammation caused by periodontal disease increases the risk of developing other diseases in the body. Treating inflammation not only helps with periodontal disease but also aids in the treatment of other chronic inflammatory conditions.
Cancer: Scientific studies have shown that men with gum disease have a 49% or higher risk of kidney cancer, a 54% risk of pancreatic cancer, and a 30% risk of blood cancer.
Diabetes: Individuals with diabetes are more likely to develop gum disease. The relationship between diabetes and gum disease is bidirectional. Severe periodontal disease raises blood sugar levels and increases diabetic complications.
Osteoporosis: There is a correlation between bone loss in the jaw and osteoporosis, as demonstrated in various scientific studies. Osteoporosis can lead to a decrease in bone density in the jaw, resulting in tooth loss.
Heart Diseases: Inflammation caused by periodontal disease has been found to increase the risk of heart disease. Periodontal disease can exacerbate existing heart conditions.
>Respiratory Diseases: It has been found that bacteria in the mouth can settle in the lungs through breathing and contribute to respiratory diseases such as pneumonia.
Surgical Periodontal Treatments
In surgical periodontal treatments, the gums are lifted from the teeth to gain access to the root surface and underlying bone. The goal is to eliminate the infection, remove inflamed tissues, clean bacteria from the pocket, remove calculus, and, if necessary, correct irregular and damaged bone surfaces. Regenerative procedures may also be performed, depending on the extent of bone loss.
Both surgical and nonsurgical treatments are crucial in reducing pocket depth and halting the progression of bacteria and periodontal disease. Adequate gum health alone is not sufficient. Daily proper oral hygiene practices and lifelong adherence to periodontal maintenance visits determined by the dentist are necessary to prevent disease recurrence.
Gingivectomy and Gingivoplasty
Gingivectomy is the surgical removal of gum tissue. And gingivoplasty involves reshaping the healthy gum tissue around the teeth. These procedures are performed by periodontists who specialize in gum and gum disease. Gingivectomy was initially developed for the treatment of gum disease. Today, it is also used for aesthetic purposes.
Gingivoplasty helps reshape the gum tissue to achieve a more natural appearance. It can correct shape irregularities or asymmetry of the gums caused by genetics, disease, or trauma. It can also be performed for purely cosmetic reasons. Gingivoplasty is generally performed as a standalone procedure. However, it can also be done after gingivectomy or gum grafting in cases where the gum line needs to be enhanced.
Gum Flap Surgery
In gum flap surgery, the gums are temporarily folded back from the teeth. This way, the dentist can access the root and bone.
The purpose of gum flap surgery is to treat gum disease (periodontitis). This procedure is recommended for individuals with moderate to advanced gum diseases. If a gum infection cannot be eliminated with a non-surgical method, gum flap surgery is used. Gum flap surgery can be performed in combination with another procedure called bone surgery.
Non-Surgical Periodontal Treatment
In non-surgical periodontal treatment, the plaque and tartar on the root surface and in the pocket are removed, bacterial toxins are eliminated, and the root surface is smoothed. This procedure is performed under local anesthesia. Local antibiotics, systemic antibiotics, host modulators, and dental lasers may be used as adjunctive treatments in some cases.
Gum Recession and Treatment Options
Gum recession due to periodontal diseases occurs as a result of bone loss. Sometimes, the gums are healthy, but recession still occurs. This can be caused by incorrect brushing techniques, teeth grinding habits, ill-fitting dental restorations or fillings, tooth misalignment or malpositioning, smoking, and aging. Another factor that determines the severity of recession is the thickness of the gum tissue.
Gum growths can develop as a result of bacterial inflammation, hormonal changes (such as during pregnancy and adolescence), medications, or benign and malignant tumors.
The treatment of gum growths involves removing the excessive tissues and restoring the gum to its healthy boundaries, as well as addressing the underlying causes.