There are a number of treatment options available for gum disease patients, each of which varies depending on the severity of the condition.
In order to determine the treatment modality that best meets your needs, the dentist will evaluate the extent of the damage caused by gum disease to develop a conservative initial plan. Your oral hygiene evaluation will determine if plaque (soft deposits on the tooth) is being removed on a daily basis.
Next step, calculus (also known as tartar) must be removed through a professional cleaning,and sometimes through the additional procedures of deep scaling and root planning. A local anaesthetic may be administered during these procedures.
Signs and Symptoms of Gum Disease
As a gum infection progresses, the bone tends to recede; the gums may or may not recede. In some cases, the root of the tooth becomes exposed, occasionally causing tooth sensitivity. Furthermore, pus may be produced, and pockets may form between the gum and tooth.
There are some common signs of gum disease;both you and the dentist can look for:
- Bleeding gums during tooth brushing or otherwise
- Sensitive, red or swollen gums
- teeth that are loose or appear to have shifted
- Bad breath that won’t go away
- Red or swollen gums
- Tender or bleeding gums
- Painful chewing
- Receding gums or longer appearing teeth
Causes of Gum Disease
- Improper Dental Hygiene
- Organic Changes in the Mouth: Changes that occur in metabolism and hormone levels during pregnancy, puberty and menopause may affect the organic balance in the mouth, and make teeth more susceptible to gum disease.
- Medical Conditions: Serious conditions that affect the body's ability to produce sugar (such as diabetes or kidney disease) may contribute to periodontal disease.
- Saliva Flow Inhibitors: Certain medications that produce oral side effects or dry mouth syndrome (xerostomia) may contribute to a reduction of protective saliva flow, and potentially to gum disease. Seniors may be more susceptible to dry mouth syndrome because of the natural reduction of salivary flow associated with age.
- Poor Functional Habits: Teeth grinding or clenching may impair the surrounding tissue and is a possible contributor to gum disease.
The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called “gingivitis.” In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.
When gingivitis is not treated, it can advance to “periodontitis” (which means “inflammation around the tooth”). In periodontitis, gums pull away from the teeth and form spaces (called “pockets”) that become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line. Bacterial toxins and the body’s natural response to infection start to break down the bone and connective tissue that hold teeth in place. If not treated the bones, gums and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
- Smoking. Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of gum disease. Additionally, smoking can lower the chances for successful treatment.
- Hormonal changes in girls/women. These changes can make gums more sensitive and make it easier for gingivitis to develop.
- Diabetes. People with diabetes are at higher risk for developing infections, including gum disease.
- Other illnesses. Diseases like cancer or AIDS and their treatments can also negatively affect the health of gums.
- Medications. There are hundreds of prescription and over the counter medications that can reduce the flow of saliva, which has a protective effect on the mouth. Without enough saliva, the mouth is vulnerable to infections such as gum disease. And some medicines can cause abnormal overgrowth of the gum tissue; this can make it difficult to keep teeth and gums clean.
- Genetic susceptibility. Some people are more prone to severe gum disease than others.
How is Gum Disease Treated?
The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. The doctor may also suggest changing certain behaviours such as quitting smoking, as a way to improve treatment outcome.
Deep Cleaning (Scaling and Root Planning)
The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planning. Scaling means scraping off the tartar from above and below the gum line. Root planning gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease. In some cases a laser may be used to remove plaque and tartar. This procedure can result in less bleeding, swelling and discomfort compared to traditional deep cleaning methods.
Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment. Long-term studies are needed to find out if using medications reduces the need for surgery and whether they are effective over a long period of time.
How can I keep my Teeth and Gums Healthy?
- Brush your teeth twice a day (with fluoride toothpaste).
- Floss regularly to remove plaque from between teeth. Or use a device such as a special brush or wooden or plastic pick recommended by a dental professional.
- Visit the dentist routinely for a check-up and professional cleaning.
- Don’t smoke.
Advanced Gum Disease Treatments
- If the bone has been destroyed, the dentist may employ a new technique called tissue regeneration, which involves grafting the bone to offer a better chance of bone re-growth. To strengthen thin gums, soft tissue grafts may also be used.
- Guided tissue regeneration involves the insertion of a membrane to help in the bone regeneration process.
Pocket Elimination Surgery
In some cases, surgery may be part of the treatment plan to help prevent tooth loss resulting from gum disease. Periodontal flap surgery may be performed to reduce the pocket gap between the teeth and gums. And if the jaw bone has craters housing bacteria and contributing to gum disease, the bone may be reshaped through bone surgery to eliminate the craters and help prevent future recolonization of bacteria growth.
- Laser therapy may be used to reduce pocket size; with different types of laser modalities.