The treatment of Gingivitis is simple………………….remove the bacteria or germs from around the gums and you will be cured. This is done by your dentist or hygienist by a process called Dental Prophylaxis, Scaling and Polishing or simple cleaning. In this procedure a mechanical instrument called the scaler or cavitron is used. This machine is basically a very fast vibrating tip which removed the germs and washes it away with water. Some dentists also use hand scalers in which the plaque and calculus is removed by hand instruments. Both methods are Ok although it is much better to use the machine. Once the mouth is cleaned with the scaler the teeth are then polished the patient is instructed to brush their teeth at least three times a day and floss the teeth regularly. Research has shown that the plaque and calculus (Germs) start to build up slowly and it takes six months on average, for the gums to get infected again and cause Gingivitis. This is why dentists recommend to have a cleaning every six months. If you do this you will have a pristine mouth and we can check for any cavities or other problems.
It is Ok to use a mouth wash like Listerine once a day, mouthwashes also keep the bacteria under control.
Necrotizing Gingivitis has a specific treatment which includes scaling and polishing as well as the use of antibiotics and stress reduction.
The most commonly asked question by our patients is that the cleaning process removes the enamel from the tooth surface and makes the teeth weak. Keep in mind that enamel is the hardest substance in the body even harder than your bone, the process of scaling DOES NOT remove any enamel, yes you can have sensitivity after scaling but that is because you have gum recession and even if you do it is temporary. So contrary to popular belief scaling actually FIRMS the teeth more as the bacteria is removed and gums are brought back to health.
PERIODONTAL DISEASE (GUM DISEASE)
Gum disease (periodontal disease) is the terms used to describe a disease of the mouth which involved the gum tissue and the bone surrounding the root of the tooth. Periodontal disease can affect a single tooth, a number of teeth or it can affect the whole jaw both upper and lower.
The hallmark of periodontal disease is the loss of supporting bone around the teeth. This bone loss can be just a little bit or a lot, so that the root of the tooth can have very little bone loss or almost all the bone around the tooth is lost with the tooth moving and almost falling out.
The cause of periodontal disease is bacteria or germs. The germs that cause periodontal disease are different from the germs that cause gingivitis, in technical terms the germs causing gingivitis are mostly gram positive and the germs causing periodontal disease are gram negative. In addition the germs are of a very specific nature.
In general, you always have gingivitis first and then periodontitis, but you can have gingivitis and no periodontitis. Therefore it is imperative that you see your gum disease specialist the moment you have bleeding gums so that the disease does not spread any further than your gums.
There are different type of periodontal diseases including, Site specific periodontitis,adult periodontitis, generalized periodontitis, Aggressive periodontitis also called Juvenile periodontitis, gum recession, Necrotizing periodontitis, and specific causes of periodontal diseases for example in diabetes, cancer, bone loss due to trauma etc.
The most important concept to understand is that gum disease in all its forms is caused bu germs, or bacteria. So the treatment is directed towards removing or reducing the bacterial load is the prime aim for treatment of gum disease.
SITE SPECIFIC PERIODONTITIS
It is important to understand that in a lot of cases a person can have bone loss around a single tooth, a number of teeth in the jaw or all the teeth can have bone loss. Therefore when your specialist or dentists does a examination of your mouth he puts in a pointed metal instrument under the gums called a Periodontal proble which has calibrated markings on it. What he is doing is measuring your pocket depths, this means how deep does the proble go before it reaches the bone, in normal cases this should not be more than 2-3 mm. So if he/she is probing and all of asuuden one spot has a 100 mm pocket depth that means there is some problem in that area or a number of areas.
Site specific disease means that in the whole mouth you might have one area of bone loss and that site should be treated.
In site specific periodontal disease your specialist will aim towards removing the bacteria from the sites that he has determined by means of periodontal surgery or scaling and root planning.
As the name signifies Adult Peridontitis is a form of gum disease which is found in adults mostly over the age of around 40, but could be found earlier. In this case it is a slow progressing bone loss around the teeth. It is diagnosed by taking x-rays of thewhole jaw to see the bone levels around the teeth.
The treatment in most cases is to do a cleaning of the teeth followed by gum surgery to eliminate the pockets around the teeth so that no more bacteria can colonize the root surfaces under the gums. In most cases there is almost 100% recovery and if you do good oral hygiene and visit your specialist regularly you should be abe to keep your teeth for a long time.
Aggressive periodontitis if not treated in a very forceful manner will result in the loss of teeth. This form of periodontitis can attack the gums at any age and is usually found in young adults almost from the age of 10 onwards.
The cause of aggressive periodontitis is a specific bacteria that colonizes the pocket depth resulting in severe loss of bone around the teeth and if not treated early will result in the loss of teeth. The disease progresses very fast and unless and until a specialist sees you it can have devastating consequences.
The treatment of aggressive periodontitis includes immediate gum surgery, possible grafting procedures and the aggressive us e of antibiotics. It is imperative that after surgery you visit your dentist every three months for a cleaning and observation.
Gum recession is one of the most common complaints that we see in our office. Gum recessions can be around one tooth, around a few teeth or even around all the teeth in the mouth. The causes of gum disease varies but can be due to a hard tooth brush, malaligned teeth, after you have braces put on, due to bone loss around the teeth, deposit of plaque and germs around your gums.
The treatment of gum recession is very much possible. The procedure is called a gum graft (specifically a connective tissue graft). In some cases the surgery is done to prevent further loss of gum tissue and in some cases we can cover the exposed root surfaces.
DIABETES AND OTHER SYSTEMIC DISEASES.
Diabetes has a major role to play in gum disease. All the research has shown that people with diabetes have more gum disease. This may be due to the excessive sugar in their blodd, or maybe due to the low resistance that most diabetics have when they have an infection. Similarly cancer patients, patients who have Hepatitis and other generalized medical conditions need to make sure that they have a germ free mouth and their gums are in very good health.
There is a lot of research now showing that gum disease is one of the risk factors for heart disease. The bacteria found around the gums have been found in heart vessels so it is imperative that if you have any form of cardiovascular disease you must visit our specialists who will advise you on how to keep your mouth healthy.
Ongoing research has also shown that gum disease is a risk factor for uncontrolled diabetes. We have shown that once your gum disease is under control, it helps lower your blood sugar, HbA1c levels and lower diabetes medications.