What are the treatments for Gum disease?

 (a)       Flap Surgery

Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar 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 tartar. The gums are then sutured back in place so that the tissue fits snugly around  the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes  results in the teeth appearing longer.

(b)        Bone and Tissue Grafts

In addition to flap surgery, your periodontist or dentist may suggest procedures to help  regenerate any  bone or gum tissue lost to periodontitis. Bone grafting, in which natural or synthetic bone is placed  in the area of bone loss,  can help promote  bone growth. A technique that can be used with bone grafting is called guided tissue regeneration. In this procedure,  a small piece of mesh-like  material 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.  Growth factors – proteins that can help your body naturally regrow bone – may also be used. In cases where gum tissue has been lost, your  dentist or periodontist may suggest a soft tissue graft, in which synthetic material  or tissue take from another area of your  mouth  is used to cover exposed tooth roots.

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 may things, including how  far the disease has progressed, how well the patient keeps up with oral care  at home, and certain risk factors, such as smoking, which may lower  the chances of success. 

How do I know if I have gum disease ?

Symptoms of gum disease include :

·         Bad breath than won’t go away

·         Red or swollen gums

·         Tender or bleeding gums

·         Painful chewing

·         Loose teeth

·         Sensitive teeth

·         Receding gums or longer appearing teeth.

Any or these symptoms  may be a sign of a serious problem, which should be checked by a dentist.

Oral cavity

The oral cavity has many important components; teeth are embedded within the alveolar  bone and are held firmly by a periodontal ligament with gingival (gums) surrounding the cervical aspect of tooth and alveolar bone. There is a muscular tongue with many functions, sturdy palate forming the roof  of the oral cavity and the rest is formed by stretchable mucosa forming the buccal (cheek) and floor of mouth  below the tongue. Awareness  of dental caries among general public  is high but  periodontal diseases do not enjoy  the same level of importance among them.

The prevalence of periodontal  diseases like gingivitis and periodontitis are very high  in India. In a few states like Orissa and Rajasthan, prevalence of periodontal disease  is shown to be  100% in the age group of 35-44 years and 65-74 years. Gingivitis, left untreated, would lead to periodontitis, leading to loosening of tooth and finally loss of tooth. Major aetiology of gingivitis is poor  oral hygiene with plaque depositing on the tooth, which harbour numerous pathologic micro-organisms responsible in brining about gingivitis and its sequelae.

Who gets gum disease ?

People usually don’t show signs of gum disease  until they are in their 30s or 40s. Men are more likely to have gum disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line

What happens at the dental check-up?

The following oral health care activities usually take place at the typical dental  check-up visit:

Oral examination: Your dentist will want to have a general look around the skin  of your mouth (technically, ‘the mucosa’). This should be a purely visual check up to make sure everything is healthy.

·         Your mouth is  like a small cave, and  to peer into it furthest recesses the dentist will use light. The dentist may be able to do a visual check using a small  mirror. He will then conduct an initial oral  examination of your gums and teeth. He will document any changes in your overall health and medicine use. He will clean  and polish your teeth, talk to you about  how to take care  of your teeth and gums, and  answer any questions you might ask. Your dentist will also conduct an oral exam of your mouth for any signs of oral cancer or other diseases, gums, and teeth and diagnose and oral health problems, He will ask about changes in your overall health or medicine use. The dentist may be able to do a visual check using a small mirror.

·         Cleaning: Although tooth brushing  and flossing help in removing plaque, only a professional cleaning  provided by your dentist  can thoroughly  clean your teeth  and remove  the hardened plaque (called calculus or tartar) that  builds up on your teeth. Most dentists use a series of metal  hand instruments to clean your teeth. Some are using ultrasonic scalars, which provide deep  cleaning above and below the gum line.

·         Polishing: After your teeth have been cleaned, they are polished to remove plaque and stains from the tooth surface. The polish contains an abrasive substance and fluoride, and is applied using a small rotating rubber  cup or brush attached to the dental hand piece.

·         Prevention: Your dentist  might offer  additional instructions  for you to follow at home, based on the results of your  exam. Do not hesitate to ask  your dentist  for instructions about brushing or flossing, or questions  about general  care of your teeth and gums.

·         X-rays: X-rays might or might not be taken during your check up. Your dentist will consider your  clinical examination, dental history, and risk for developing cavities in determining the need for X-rays.

Treatment recommendations: If any oral health  problems  are identified during your  examination, your dentist will make  recommendations for the best next steps, i.e. treatment. These might include referral to another oral  healthcare  specialist, additional diagnostic tests, or advice to return for restoration work or additional oral healthcare

Dental Check up

How often should one go to the dentist ?

The standard recommendation  is to  visit your dentist  twice  a year for check-ups and cleanings. This  frequency  level must be okay  with most people, although some people  with peculiar  problems might need to visit the dentist more  frequently  for optimal oral care. These  peculiar conditions include gum disease, a genetic predisposition for plaque build-up  or cavities, or a weakened immune system that call for increased frequency of visits.

Also, keep in mind  that certain events  in life, particularly those that cause  stress or illness, might  cause changes in our mouth. Likewise, the development of an infection might call for more frequent  visits to the  dentist necessary. People  who have taken great  care of their teeth and gums, and have for  years felt no problems whatsoever might choose  to have longer intervals between visits. It would be desirable to ask your dentist what  visiting schedule  works best for your state of dental health.

The main reasons that strongly  support the 6-monthly dental visit  schedule are:

·               It enables  your dentist to check for  any problems  that you might not  see or feel.

·               It allows your dentist to find early signs of tooth decay (decay does’t  become visible or cause pain until it reaches more advanced stages)

·               It facilitates  treatment  of any other oral health problems  encountered  (generally, earlier a problem is detected, the more  manageable it is)