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Periodontal Disease (Gum Disease) Assessment & Treatment

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Periodontal Disease (Gum Disease) Assessment & Treatment Overview

Periodontal disease (also known as gum disease) is an inflammatory disease affecting the tissues surrounding the teeth. It is a bacterial infection caused by accumulation of dental plaque on the teeth.

It affects the gums and supporting structures of the teeth (bone). The word periodontal literally means ‘around the tooth’. As plaque continues to build without proper cleaning, gums become infected and the bone level tends to reduce. Teeth may become sensitive as the root becomes exposed, pus may be produced and pockets may form between the gum and tooth. These processes are not visible to the naked eye, and if left undetected and untreated it can lead to loss of teeth.
In the early stages, periodontitis has very few symptoms, and in many individuals the disease has progressed significantly before they seek treatment.

Symptoms may include:

Redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food
Gum swelling that recurs
Spitting out blood after brushing teeth.
Bad breath, and a persistent metallic taste in the mouth
Gingival recession, resulting in apparent lengthening of teeth.
Deep pockets between the teeth and the gums
Loose teeth

Additional Information

Prevention:

Prevention of periodontal disease requires excellent oral hygiene, possible use of antimicrobial mouthwashes and regular visits to a dentist/hygienist. Particularly those with diabetes who are more likely to develop infections of the gum and periodontal disease. Other risk factors include puberty and pregnancy as well as bruxism (clenching and grinding of teeth) which can put stress on the structures around the teeth and loosen them. Smoking is also a significant factor in the development and progression of periodontal disease.

Daily oral hygiene measures to prevent periodontal disease include:

Brushing for 2 minutes on a regular basis (at least twice daily), with the patient attempting to direct the toothbrush bristles underneath the gum line, helps disrupt the bacterial growth and formation of plaque.

Flossing daily or using interdental brushes.

Visit your dental hygienist on a regular basis.

Repair/Treatment

There are four types of periodontal treatment:

Pocket reduction – this is where the gum line and gum tissue are folded back to expose the bacteria that is below the gum line. This bacteria is then removed and gum tissue is secured back into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where bacteria are hidden. This allows the gum tissue to reattach to healthy bone.

Regenerative procedures – this is where the gum line and gum tissues are folded back to expose the bacteria below the gum. The bacteria is then removed and membranes or tissue-stimulating proteins are used to encourage regrowth of the bone and tissue.

Crown lengthening – is a procedure to remove excess gum and bone tissue to reshape and expose more of the natural tooth. This can be done to one tooth, to even the gum line, or to several teeth to expose a natural, broad smile. It is a restorative or cosmetic dental procedure. If the tooth is decayed or broken below the gum line, or has insufficient tooth structure for a restoration, it can be extracted and a bridge can be used.

Soft tissue grafts – stop further dental problems and gum recession and improve the aesthetics of the gum line. Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. Gum tissue from the palate or another donor source covers the exposed root. A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve the aesthetics of the smile.

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