PERIODONTITIS

Overview

Advanced gum disease is called Periodontitis. It is a chronic bacterial infection of the gums and the bone supporting the teeth. It can affect one tooth or several teeth and if left untreated, may lead to bone loss. Periodontitis is a progression of gingivitis.

Causes
Inflammation of the gums caused by toxins from plaque, which left untreated, will progress to Periodontitis.

The gums start to pull away from the teeth, forming a “pocket”. As the plaque spreads and grows beneath the gum line, the body's immune system fights the bacteria. Bacterial toxins and the body's response to the infection break down the bone and connective tissue that hold teeth in place.

If left untreated, the bones, gums and connective tissue are destroyed. The teeth may eventually become loose and have to be removed. Periodontitis can range from mild to moderate to even severe forms.

You may experience some or all of these symptoms:

• Bleeding gums when brushing
• Red, swollen, puffy-looking or tender gums
• Pus secreting from between the teeth and gums
• Shaky teeth
• Teeth appearing to drift apart from its original position
• Receding gumline (gum recession)
• Persistent bad breath
• Vague discomfort or dull-ache of gums and teeth
• Severe pain from gum abscesses (see periodontal abscess)

Risk Factors
You may be prone to gum disease if you,

• are a poorly controlled diabetic
• smoke or use tobacco
• are going through puberty, pregnancy or menopause
• have a weakened immune system eg HIV
• are taking certain medications or on chemotherapy
• have poor nutrition
• have a genetic susceptibility; some individuals are more prone to gum disease than others.

Prevention
Plaque forms within 24hours after it has been removed from your teeth. Prevention of gum disease lies in the effective daily removal of plaque. Routine six monthly visits to your dentist allow early detection of disease. Reduce risk factors such as smoking.

When to Seek Help
Consultation with a dentist or, if necessary a gum specialist, is recommended if a person experiences the following:

• Ulcers in the mouth
• Persistent bleeding gums despite thorough brushing and flossing
• Sudden onset of pain in the gums
• Sudden onset of gum boils in the mouth
• Shaky or drifting of teeth
• Longer looking teeth

Treatment
The type of treatment and number of visits will vary depending on the extent of the disease. Regardless of the treatment modality, it is important the patient maintains good oral hygiene. In addition, quitting smoking and tobacco use is advised as a way to improve treatment outcome.

Non Surgical Treatment of Periodontitis
Scaling and root planing is a procedure of deep-cleaning the gums and surrounding tissues.
The procedure involves,

• scraping off the tartar from above and below the gum line
• using special instruments to remove tough calculus and bacteria deposits along the root surfaces under local anaesthesia

After root planing, as your gums heal, a little of the root surface may be exposed. This may cause a temporary sensitivity to cold food/drinks. If this occurs, your dentist can recommend you a toothpaste for sensitive teeth. can use atoothpaste for sensitive teeth.

Periodontal (Gum) Surgery
This is performed after initial periodontal treatment.
Surgery removes any residual tartar in deep pockets and recontours the gums to make cleaning easier. (see periodontal surgery)