What is gum disease?
Gum disease refers to inflammation of the soft tissue
(gingiva) and abnormal loss of bone that surrounds the teeth and holds
them in place. Gum disease is the second most common cause of toothache.
What causes gum disease?
Gum disease is caused by toxins secreted by bacteria in "plaque" that
accumulate over time along the gum line. This plaque is a mixture of food,
saliva, and bacteria.
What are symptoms of gum disease?
Early symptoms of gum disease include gum bleeding
without pain. Pain is a symptom of more advanced gum disease as the loss
of bone around the teeth leads to the formation of gum pockets. Bacteria
in these pockets cause gum infection, swelling, pain, and further bone
destruction. Advanced gum disease can cause loss of otherwise healthy
How is gum disease treated?
Treatment of early gum disease involves oral hygiene and removal of
bacterial plaque. Moderate to advanced gum disease usually requires a
thorough cleaning of the teeth and teeth roots called "root planing" and
"subgingival curettage." Root planing is the removal of plaque and tartar
(hardened plaque) from exposed teeth roots while subgingival curettage
refers to the removal of the surface of the inflamed layer of gum tissue.
Both of these procedures are usually performed under local anesthesia and
may be accompanied by the use of oral antibiotics to overcome gum
infection or abscess. Follow-up treatment may include various types of gum
surgeries. In advanced gum disease with significant bone destruction and
loosening of teeth, teeth splinting or teeth extractions may be
It is a progressive inflammatory disease of the gums and the
surrounding tissue around the teeth. It is commonly known as gum disease
and was referred to as pyorrhea in the old days. It is estimated that up
to 80% of the population above the age of 40 may suffer from this disease
with the severity varying drastically from one person to another.
Periodontitis is the number one cause of tooth loss after the age of 40.
Certain medical conditions or medications can make you more susceptible
to gum disease. They include pregnancy, diabetes, epilepsy, and such
medications as chemotherapy, birth control pills, antidepressants, and
those for heart problems.
If you notice any of the following signs of gum disease, schedule an
- gums that bleed when you brush your teeth
- red, swollen or tender gums
- gums that have pulled away from the teeth
- bad breath that doesn't go away
- pus between your teeth and gums
- loose teeth
- a change in the way your teeth fit together when you
- a change in the fit of partial dentures
- Scaling and Root
Planing: Manually removing the plaque and tarter from
the root surfaces of your teeth below the gum line.
- Antibiotics: Because bacteria cause periodontitis antibiotics may be prescribed as
pills or as an Antibiotic fiber. The fibers are used in conjunction with
scaling and root planing. They are placed directly into the pockets and
are removed within 7-10 days later. Antibacterial mouth rinses may also
be recommended to help plaque control.
correction: An imbalanced bite may accelerate bone
destruction. Your teeth may be adjusted for proper and better function.
A Bite-guard (removable retainer fitting over teeth) may be required to
protect teeth surfaces and relax tense muscles.
- Splinting: This technique attaches weak teeth together, combining them into a
stronger single unit, making them more stable and offering more
- Flap Surgery: The Periodontist separates the gum from the teeth
creating a "flap" and accesses the infected pocket. It aims to reduce
pocket depth and increase the ability to maintain the remnant pockets
- Gingivectomy: This procedure is
performed when excess amounts of gum growth around the teeth have
occurred. This results in false pocket formation and the inability to
keep them clean.
- Osseous (bone)
surgery: This procedure is done to smooth shallow
craters and defects in the bone due to mild or moderate bone loss.
Guided Tissue Regeneration: This procedure is done in combination with a
surgical flap operation where gum growth into a defect is barriered off
to allow slower growing bone, cementum and ligament cells to populate a
- Bone Grafts: Tiny fragments of the patient's bone, synthetic bone or bone obtained
from a bone bank are used to fill a bony defect around the teeth. These
grafts act as a scaffold on or around which patients own bone is
conducted or induced to grow.
- Soft Tissue
Graft: In cases of gum recession a graft is usually
taken from the palate and transplanted onto the receding area to
reinforce the thin gum and to inhibit further gum recession.
Flap and Bone
When gum is inflamed severely (periodontitis), alveolar bone will be
absorbed, and defected. Periodontal ligaments which connect between the
alveolar bone and the teeth will disappear. Severe bone loss will cause
tooth moving and missing. Flap and bone surgery is done in order to contour the
bone, deeply clean the tooth to reduce the inflammation, and promote bone
re-growing and connections firm.
1. Presurgical bone defect. Gum inflamed and reddish.
incision to make gum retracted, and the bone shows out.
3. The bone
is contoured, and remain tartar is removed.
4. Gum is sutured
5. After periodontal surgery, the bone defect disappears, and
gum becomes healthy pink