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PERIODONTICS

“Periodontal (gum) disease is a leading cause of tooth loss and may be associated with other chronic diseases, including diabetes and heart disease”

Periodontal disease is diagnosed when gingival or gum tissue attachment to the teeth is abnormal and bone changes may be evident through x-rays. Therefore, gum treatment is needed, which slow or stop the progression of gum disease. Since there are different stages of gum disease (from gingivitis to advanced periodontitis), there are different levels of treatment.

In health, the gums firmly grip the neck of the tooth. If food is allowed to accumulate between the tooth and the gum margin, it forms plaque along with the microbes. The resultant irritation of the gum margins produces a condition called as Gingivitis which is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. It is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

However in untreated cases, it can advance leading to chronic inflammatory response in which the body turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. The condition is then called PERIODONTITIS or PYORRHOEA. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose, unable to withstand chewing forces, pus forms in the gums and foul smell starts from the mouth and teeth may have to be removed.

Treating Periodontal Disease

On detection of periodontal disease, you will first be recommended for a few behavioral changes including an enhanced oral hygiene program, quitting smoking, and some additional changes.

In the early stages, most treatment involves scaling and root planning-removing plaque and calculus around the tooth and smoothing the root surfaces. In most cases of early gum disease, called gingivitis, scaling and root planning and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums, and removing the hardened plaque build-up and recontouring the damaged bone.

This procedure is designed to include scaling and root planning (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis. So, periodontal health can be achieved in the least invasive and most cost-effective manner.

Most patients do not require any further active treatment. However, the few patients will require ongoing maintenance therapy to sustain health. Non-surgical periodontal treatment does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

Gum disease often results in the recession of the gums, causing the teeth to look longer. In the past, the cutting away of the gums, called gingivectomy, also made the teeth look longer. Newer techniques have been developed that require less removal of tissue and superior results.

More aggressive form of Gum disease that are too difficult to manage with daily at-home oral hygiene and a professional care routine will require surgical approach

The procedure also called as flap procedure, involves the cleaning the roots of a tooth and repairs bone damage. This procedure is done under local anesthetic to numb the area, then gums are reflected by 1-11/2mm and complete debridement is done.

In certain cases however it is possible to regrow the lost bone by use of certain bone substitutes called Bone grafts. Such cases provide the ideal outcome of therapy by regenerating the lost tissues.

Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk.

Patients should visit the dentist every 3-4 months (or more, depending on the patient) for an overall exam. In between visits, they should brush at least twice a day, floss daily, and brush their tongue. Manual soft nylon bristle brushes are the most dependable and least expensive.