GUM DISEASE MANAGEMENT

BLEEDING GUMS (GINGIVITIS):
Gingivitis is a gum disease which is characterized by inflammation of the gums. Gingivitis is mainly caused by a build of plaque between the teeth. Plaque is a soft, sticky film made up of bacteria. The bacteria release toxins which begins to irritate the gums. This leads to swelling of the gums and causes bleeding from the gums.
If plaque is left untreated, it turns hard and forms what we call tartar or calculus. If we leave this tartar build up too long, the gums will become more and more irritated and this could progress to a more serious condition called periodontitis. Gradually the gums loosen their grip over the teeth and begin to recede leading to pocket formation. Periodontitis is also responsible for bad breath, pain and sensitivity of teeth. The surrounding bone level is also reduced leading to loosening of teeth.
Recent studies have linked gum disease to an increased risk of cardiovascular disease such as endocarditis or stroke. Gum diseases during pregnancy have also been linked to an increased risk of low birth weight babies.
How can we prevent Gingivitis?
Proper brushing technique: Brushing your teeth and gums is essential to avoid gingivitis. Brushing the gums gently ensures that any plaque building up on the area where the base of the tooth meets the gum line is removed and bacteria are brushed away from the area.
Professional cleaning: To prevent gum diseases regular professional cleaning is recommended every 6 months.
PROFESSIONAL CLEANING (SCALING) AND CURETTAGE: Professional cleaning helps to remove resistant plaque or calculus that is difficult to remove manually at home. During scaling resistant plaque or calculus is removed either manually with a hand scalers or with the help of Ultra-sonic scaler. This may require two or more appointments depending on the extent of the gum diseases. After scaling is complete, the teeth are polished to smoothen their surfaces. At times curettage (subgingival/deep scaling) and root planning may be required.
Curettage removes the soft tissue lining of the periodontal pockets in order to completely eliminate bacteria and diseased and inflamed soft tissue. It may be used along with Scaling and Root planning, to achieve a deeper and more complete cleaning

MANAGEMENT OF MOBILE TEETH:
Teeth can become mobile due to a variety of reasons:

Periodontal disease (Gum disease): Teeth are held in place by healthy bone support around its roots. Gum disease destroys this bone support and makes it loose. This is the number one cause for teeth mobility.

Injury to teeth: Usually injury result in temporary tooth mobility which resolves after its treatment.

Pregnancy or hormonal problems: Sometimes lead to generalized increased teeth mobility.

Tumors or bone destructive disorders: Usually rare, but can lead to mobile teeth, which require tooth removal.

Treatment: The treatment of tooth mobility involves a combination of various treatments like periodontal surgery, occlusal adjustment, and splinting. The ultimate goal of successful management of mobile teeth is to restore function and comfort by establishing a stable occlusion that promotes tooth retention and maintenance of periodontal health.
SPLINTING: Is a method by which teeth are immobilized. Teeth splinting may be indicated for individual mobile teeth as well as for an entire dentition. The affected teeth are built together and stabilized with a wire or fiber reinforced ribbon. At time tooth coloured composite resin is used to bond together the affected teeth.
FLAP SURGERY: In advance gum disease which do not respond to non-surgical management, flap surgery is recommended. During flap surgery procedure an incision is made in the gums under local anesthesia and gums are reflected exposing the roots of the affected teeth. Residual calculus and infected tissue is removed and the affected bone is also recontoured. Sometimes membranes and bone grafts are placed to restore and strengthen the bone and the supporting tissues of the teeth. The flap is then sewn back around the teeth.

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