Tissues holding the teeth, substance covering the root of the teeth called cementum, the portion of the jaw bone that contains the tooth sockets to hold the teeth called Alveolar Bone and ligaments connecting the cementum and jaw bone called periodontal ligament are collectively called Gums or Gingiva.
Infection caused by germs and hereditary are the main reasons for gum diseases. Germs originating from dental plaques and other accumulated waste (calculus), produce toxins which causes various infections in the gum. Diabetes, certain liver diseases, blood related diseases etc is connected with gum disorders. Side-effects caused by certain medicines can also lead to gum infections. Pregnant women due to hormonal imbalance can get gum infections.
Gingivitis is a common periodontal disorder where inflammations are caused to the tissues holding the teeth, called Gingiva (Gums). There will be swelling, color will be reddish in the gum region. During eating, there are chances of bleeding.
1. Swelling of the gums
2. Reddish color to the gums
3. Pain in the infected area
4. Bad breath
5. Bleeding - during eating or brushing of teeth
Gingivitis conditions is advanced stages, the inflammation worsens causing gaps between teeth and the gums called pockets. This causes intense pain and pus discharge when some pressure is applied in the region.
Abscess (is a collection of pus) affecting the gums are called Periodontal Abscess. This is caused by the accumulation of pus in the pockets. This pus grows in size gradually and in about 4 days, breaks and discharges pus which has a very bad smell. This condition causes intense pain and eventual loss of the teeth.
Other conditions affecting younger people even from 14 years of age is Juvenile Periodontitis. Any particular reason for this condition is unknown. But inadequate dental hygiene, heredity, low immunity etc can be reasons.
This is a progressive disease, so symptoms don’t show up in the initial stages. The tooth becomes loose and shaky in later stages, and eventually causes tooth loss.
Desquamative Gingivitis is a condition affecting skin of gums and mouth. This causes of shedding of the skin, giving a ulcerated appearance.
1. Shedding of skin in the gums and the mouth
2. Reddish color due to shedding of the skin
3. Pain during eating spicy food
4. Swelling is noticed in later stages
There are no cut- and- dried causes for this condition. People suffering blood related disorders, hormonal imbalance and ageing are some conditions favoring the cause.
Gingival hyperplasia is a common periodontal condition caused by the enlargement of tissues in the gum. The main causes for enlargement of gums are inflammatory conditions caused by germ infections and side-effects from certain medicines. Side-effects are normally seen in patients using medicines for epilepsy. Is is also seen that, pregnant women are prone to such infections.
Acute Necrotizing Ulcerative Gingivitis (ANUG) is a very serious periodontal disorder. This is caused by bacterial infection in the gum tissues. This infection is caused by the combined attack of bacteria, Bacillus Fusiformis and Vincent’s Bacteria. Poor oral hygiene, mental problems, smoking etc are some of the reasons for this infection. This condition is commonly seen is people who live in unhealthy, unhygienic environments, for eg, soldiers, prisoners, people living in areas with poor sanitation etc.
1. Swelling and discharge of pus
3. Bad breath
4. Sever pain inside the mouth and infected area
5. Swelling in the face and neck area
6. Difficulty in eating and opening of mouth
In the advanced stages, causes degeneration of tissues, degrading tissues of the bones in the face. This condition is called Noma or Cancrum Oris.
Treatment of Periodontal Disorders
The diagnosis and subsequent treatment is to be performed by a dental professional in a dental clinic or hospital.
Periodontal Laser Treatment
This is the most effective and common treatment in periodontitis. It is the most common treatment procedure because it is less painful (only local anesthesia is required), more accuracy and hence less chances of complications.
In periodontal laser treatment the dentist uses laser to access and remove the infected gum tissues in the root area. The next procedure is root scaling.
This involves scraping off the calculus and plaque built up in the pockets and around the root. The dentist then smoothen the root with specific instruments to remove any rough spots that can cause further infections. The area between the gum and root (called pockets) are then left to regenerate and heal.
Other treatment procedures are also employed depending on the extent of infection-
The first process is the removal of plaque, dirt and other germs from the infected area. The dentist performs this activity with the help of special instruments. This procedure is called Scaling. Certain mouth washes and solutions are used in cleaning causative agents.
Ultrasonic Scalers and curettes are used to clean the pockets generated between the gums and the teeth. In addition to this root planing is done. Root planing is the process of removing plaques, calculus and other dirt which causes infections. Root planing is also done by scalers and curettes.
Advanced stages of periodontal diseases, requires Gingivectomy. This is a process of excision of gingiva. This is done by removing the pocket wall, to better visibility and accessibility to completely remove the calculus creating a favorable environment for healing of gingiva.
In cases where the pockets are very deep, flap surgery is done. During this procedure, the gingiva is torn apart to perform curetting and root planing. Disinfectant solutions are applied to the region and then stitched back. This procedure is also applied in conditions like fractures in the root, complications in root canal treatment, chronic periapical abscess, dental cyst etc. The adjacent tissue near the root is torn to get access to the end of the root. Infected part of the root, bone, cyst and other infected tissue is then removed and sealed with suitable substances. The gum is then stitched back.