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Gum Disease
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What is Gum Disease?
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Gum disease is a most common dental problem. Gingivitis and periodontitis are two
types of Gum disease. It is most common disease in India and nine out of ten adults
have periodontal disease and loose teeth from periodontal disease than other dental
disease
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What are Healthy Gums?
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• Firm and resilient
• Coral pink color
• Orange peel texture,
• Scalloped shape edge that follows the contour of tooth.
• No bleeding while brushing.
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What are Signs of Gum Disease? |
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• Bleeding Gums while brushing
• Red swollen or tender gums
• Receding Gums
• Persistent bad breath
• Pus discharge
• Loosening of teeth
• Loss of orange peel structure.
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How Does Gum Disease Start? |
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It starts with accumulation of plaque - which is a soft sticky colorless film of
bacteria. If you do not clean properly, it produces acid, toxins and irritants.
It then hardens to calculus - Tartar
It appears as brown or black deposit around neck of tooth. Each day new plaque forms
on the surface of calculus and tooth in such a way that no toothbrush and floss
can ever remove it. Plaque is capable of starting and worsening periodontal disease.
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What Happens if Left Untreated? |
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Gum disease like any other disease can have disastrous effects if left untreated
and as more bone gets destroyed the tooth can loosen and eventually fall out.
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Stages of Periodontal Disease
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Gum disease works very efficiently and quickly to cause serious damage to your beloved
32 teeth. There are usually 4 stages before all hell breaks loose:-
- Gingivitis
- Early Periodontitis
- Moderate Periondontis
- Severe Periodontitis
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Gingivitis |
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It is early stage of gum disease and there is a superficial infection that is limited
to the gum tissue and does not affect the underlying bone. Gums become red and puffy,
bleed while brushing and lead to bad breath. Good dental care and good home care
can arrest the gum disease at this stage. The gums become normal without any damage
to underlying tissue.
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Early Periodontitis
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The gum attachment moves below the gum line that causes inflammation in pockets
– depth ranges up to 5 mm. It also destroys the underlying bone. Good Dental
care and Home care can slow or stop the progress of the disease at this stage.
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Moderate Periondontis |
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The gum attachment further moves down and causes more bone loss. Pocket depth ranges
up to7 mm. Gaps starts appearing between the teeth. Good dental care and home care
can slow or stop the progress of the disease at this stage.
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Severe Periodontitis
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As the infection spreads further the margins of gum moves downward and more bone
gets destroyed. In the early phase tooth is not loose. At this stage good dental
care and home care can slow or stop the progress of the disease. In Later phase
the tooth becomes loose and good dental care and proper home care does not help
much.
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Life Threatening Diseases
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Studies have shown that the oral bacteria found in periodontal disease can enter
the blood stream and. they are known to cause fatty deposits that affect the immune
system. It is analyzed that the incidence of following diseases are higher with
periodontal disease
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Stroke
Heart disease
Infective Endocarditis
Diabetes
Spontaneous pre-term births
Weakened immune systems
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Treatment Procedure
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The main objective of treatment is stopping the gum disease at a stage when it is
diagnosed because it is very difficult to cure advanced form of the disease.
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1st Phase |
1. Clinical examination is carried out.
2. X-ray is taken to assess the bone level.
3. Pocket depth is measured
Treatment method depends upon the type of disease and extent of bone loss then any
of the following procedure is planned. |
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2nd Phase
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Scaling and polishing
Deep sub gingival scaling and root planning
Curettage
Flap Surgery
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Scaling and Polishing |
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It is recommended in early stages of gum disease. This involves the removal of plaque
and tartar deposits from the tooth surface and from below the gum line
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Deep Sub Gingival Scaling and Root Planning
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It is recommended when pocket depth is up to 2mm.
Local anesthesia is given
Deposits are removed below the gum line.
Root surface is planed to smooth.
It allows the inflamed gum tissue to heal and reattach to the tooth.
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Curettage |
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It is recommended when pocket depth is up to 4mm
Local anesthesia is given where very deep cleaning is done to remove plaque, tartar
and infected tissue. This helps rejuvenate the tissue and cling better to the teeth.
Flap surgery may be required in advance cases.
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Flap Surgery |
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Local anesthesia is given
Incision is given
Usually gums are lifted away
Removal of tartar, plaque, and the infected bone, which causes chronic infection
and delay healing, can be removed easily
Root planning is carried out
Infected tissue under the flap is removed
Reshaping of bone is carried out if required.
In some cases, to get good results bone grafting is done and Membranes may be used
guided tissue regeneration.
The gums are sutured back into place.
Periodontal pack is given |
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Incision is Given |
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Usually Gums are Lifted away
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Removal of tartar, plaque, and the infected bone, which causes chronic infection
and delay healing, can be removed easily |
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Infected Tissue Under the Flap is Removed |
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Reshaping of Bone is Carried Out if Required.
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In some cases, to get good results bone grafting is done and Membranes may be used
guided tissue regeneration. |
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The Gums are Sutured Back Into Place.
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Periodontal Pack is Given |
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Post Operative Instruction.
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Control of Pain
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You may have discomfort that can be controlled by a painkiller.
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Control of Bleeding and Swelling |
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Bleeding and swelling can be controlled by application of ice. If bleeding persists
after 2 to 3 hours then contact the Dentist immediately.
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Medications |
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Antibiotics and painkillers are prescribed that control the pain and infection.
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Periodontal pack |
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Which is placed on gums hardens in few hours’ helps in healing, protects from
Irritation and prevents bleeding. It should remain in place as long as possible,
if it comes out contact the dentist immediately. |
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The pack will be removed after 7 days. Post removal of the pack there may be little
bleeding, which will stop gradually.
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Oral Hygiene |
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Don't brush over the pack but other areas should be cleaned properly by brush and
floss. Tongue also should be cleaned.
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Rinse |
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Chlorhexidine mouthwash or saltwater should be used from next day onwards that helps
in removal of food particles, prevents growth of microorganism and eliminates bad
breathe.
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Avoid |
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Don't smoke, rinse your mouth vigorously, spit, or drink through straw, which will
dislodge the clot, pack and delay healing. Don’t carryout strenuous activity
for next 24 hours.
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Anesthesia |
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The effect of anesthesia will last for few hours till that time don’t chew
or bite from that side.
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Diet |
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You can have liquids and soft food on first day, from next day onwards you can have
solid food. Don’t have alcoholic beverages and hot food on first day.
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Duration of Treatment
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The treatment of gum disease can take anything from one week to one month. It all
depends on how much gum has damaged.
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Disadvantage
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While the advantages of treatment are manifold and the disadvantages are minimal,
most are temporary as:-
Some teeth don’t respond to treatment
Post-operative sensitivity may occur
Shrinkage of gum tissue in rare cases |
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Home Care |
Brush your teeth, twice a day usually with fluoride toothpaste
Flossing carried out only in early stages.
Interdental cleaners in progressive stages
Mouthwash to prevent growth of microorganism
Massage your gums regularly
Eat a balanced diet
Visit dentist regularly |
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Alternative |
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Remember there is no alternative other than prevention of gum disease, which cannot
be cured only by professional care, it is only half the battle in treating periodontal
disease. The essential other half depends on how you brush and floss everyday. Your
proper home care and our dental expertise can slow down or arrest the gum disease. |
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Summary and Conclusion
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Remember, if your gums are healthy, your teeth can last lifetime. Good periodontal
health has many more benefits. You can chew with more comfort, can smile and speak
with greater confidence. A commitment to preventive and maintenance therapy is a
commitment to a better health. You can save money, time and suffering by preventing
the gum disease.
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How to Prevent Gum Disease?
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Remember that you can prevent gum disease, by practicing daily oral hygiene at home,
eating nutritious meals, and making regular dental visits. Maintaining good oral
health is your responsibility and that will help to ensure your mouth stays healthy.
A bright healthy smile can make you feel look good – throughout the life. |