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Periodontology or Periodontics is the specialty of dentistry that studies supporting structures of teeth, diseases, and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament.

Periodontal diseases are bacterial infections of the gums, bone and periodontal ligament (fibers that support the teeth and hold them in the jaw). They destroy the gums and supporting bone that hold your teeth in your mouth. As a result, teeth may loosen and fall out or need to be removed and replaced with dental bridges or implants.

Periodontal plastic surgery may be required to cover exposed tooth root surfaces, correct gum and jawbone indentations or reshape and repair the gum tissue. Dental implants are placed to provide an artificial tooth root to support dental restorations that will later be created by your dentist or prosthodontist.

Causes of Periodontal Disease

The primary cause of periodontal diseases is bacterial plaque, a sticky, colorless coating that forms on your teeth. If left untreated – generally as a result of poor oral hygiene habits – the bacteria in plaque infect the gums, release toxins that redden and inflame the tissue, and gradually destroy the tissues supporting the teeth and underlying bone. When this happens, the gums separate from the teeth, forming pockets that fill with more plaque and cause additional infection.

Other factors that can affect the health of your gums include:

Plaque Traps.
Decayed teeth, broken or badly fitting partial dentures, crowded/crooked teeth and improperly filled teeth can “trap” plaque buildup, making it difficult to remove by routine oral hygiene methods.

Negative Behaviors and/or Practices. Your periodontal health can suffer due to poor personal oral hygiene practices, oral piercings, smoking, and drug and/or alcohol abuse. A stressful lifestyle and poor nutritional habits, both of which can diminish your body’s ability to fight infection, also can make you more susceptible to periodontal disease.

Systemic Factors. People with diseases such as diabetes and leukemia, on certain medications or with systemic conditions such as human immunodeficiency virus (HIV) infection, malnutrition or immunosuppression, may be especially vulnerable to gum disease due to lower resistance levels.

Hormonal Factors. Predominantly true for women, hormonal fluctuations during key life stages – puberty, pregnancy and menopause – can trigger tissue changes throughout the body, including the mouth. At such times, a woman’s chances for developing periodontal disease may increase.

Genetic Influences. Genes and family history can indicate a predisposition for developing periodontal diseases.

Tobacco Use. Tobacco users show a greater incidence of calculus formation on teeth, deeper pockets between gums and teeth, and more loss of bone and fibers that hold teeth. Chemicals in tobacco (tar and nicotine) diminish the healing process and likelihood of success after periodontal treatment. Smokeless tobacco users also are at higher risk of developing oral cancer.

Medications. You should inform your dentist of any medicines you are taking, as certain medicines (e.g., oral contraceptives, antidepressants and some heart medicines) can adversely affect your gums or have contraindications for antibiotics.

Types of  Periodontal Diseases?

Periodontal diseases/conditions include:

Gingivitis. An inflammation of the gums surrounding the teeth, gingivitis is the mildest form of periodontal disease. At this stage, there is typically no discomfort. If not properly treated, it may progress to periodontitis.

Periodontitis. There are various forms of periodontitis, including the following.

Chronic periodontitis, the most common form, results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. It is diagnosed by bone loss (through dental X-rays), pocket formation and/or gum recession. It typically affects adults who are 35 or older, but it can occur at any age. Attachment loss may progress slowly, but periods of rapid progression also can occur.

Aggressive periodontitis, a less common form, is characterized by rapid attachment loss and bone destruction. It usually occurs in patients who are otherwise clinically healthy. There are two forms of aggressive periodontitis: localized aggressive periodontitis, which most often occurs near puberty and usually involves attachment loss around first molars and/or front teeth; and generalized aggressive periodontitis, which usually affects people under 30 years old and involves attachment loss on three or more permanent teeth as well as first molars and incisors.

What causes Periodontitis? Periodontitis is caused by excessive plaque buildup and untreated gingivitis.

Signs and symptoms of Periodontitis. Some of the most common signs are:

  • Swollen or recessed gums
  • An unpleasant taste in your mouth
  • Bad breath
  • Pain in one of your teeth while eating
  • Loose teeth
  • Drainage or pus around one or more teeth

How can you reduce your chance of developing Periodontitis? You can reduce your chance of developing periodontitis by brushing your teeth daily, regular flossing and frequent professional cleaning.

Periodontitis Treatment

Non-Surgical Therapy

Scaling and Root Planing: Manually removing the plaque and tarter from the root surfaces of your teeth below the gum line.

Antibiotics: Because bacteria cause periodontitis antibiotics may be prescribed as pills or as an Antibiotic fiber. The fibers are used in conjunction with scaling and root planing. They are placed directly into the pockets and are removed within 7-10 days later. Antibacterial mouth rinses may also be recommended to help plaque control.

Bite correction :An imbalanced bite may accelerate bone destruction. Your teeth may be adjusted for proper and better function. A Bite-guard (removable retainer fitting over teeth) may be required to protect teeth surfaces and relax tense muscles.

Splinting: This technique attaches weak teeth together, combining them into a stronger single unit, making them more stable and offering more comfortable chewing.

Surgical Therapy Flap Surgery: Our periodontist , separates the gum from the teeth creating a “flap” and accesses the infected pocket. It aims to reduce pocket depth and increase the ability to maintain the remnant pockets clean.

Gingivectomy: This procedure is performed when excess amounts of gum growth around the teeth have occurred. This results in false pocket formation and the inability to keep them clean. Osseous (bone) surgery: This procedure is done to smooth shallow craters and defects in the bone due to mild or moderate bone loss. Guided Tissue Regeneration: This procedure is done in combination with a surgical flap operation where gum growth into a defect is barriered off to allow slower growing bone, cementum and ligament cells to populate a bony defect.

Bone Grafts: Tiny fragments of the patient’s bone, synthetic bone or bone obtained from a bone bank are used to fill a bony defect around the teeth. These grafts act as a scaffold on or around which patients own bone is conducted or induced to grow. Soft Tissue Graft: In cases of gum recession a graft is usually taken from the palate and transplanted onto the receding area to reinforce the thin gum and to inhibit further gum recession.

Flap and Bone Surgery

When gum is inflamed severely (periodontitis), alveolar bone will be absorbed, and defected. Periodontal ligaments which connect between the alveolar bone and the teeth will disappear. Sever bone lose will cause tooth moving and missing. Flap and bone surgery is order to contour the bone, deeply clean the tooth to reduce the inflammation, and promote bone re-growing and connections firm.

  • Treatment is not painful,no hospitalisation,minimal force application to teeth and jaws to correct your face.It will not hamper your daily activities.
  • As age advances treatment duration can prolong little bit ,but will not make any difference.
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  • A beautician and a fashion designer will advise you at the end of the treatment to make your looks and personality more attractive.

Symptoms of Gum Disease

You may have gum disease and not even know it. Often, there is no pain and periodontal diseases may not exhibit symptoms until serious bone loss has taken place. However, it is important to see your dentist or periodontist at the first sign of these common symptoms of periodontal disease:

  • Red, swollen or tender gums
  • Gums that bleed easily when brushing or flossing
  • Gums that pull away from teeth
  • Loose or separating teeth
  • Pus between gums and teeth
  • Persistent bad breath
  • Change in your bite (occlusion) and/or fit of removable dentures

How is gum disease treated?

Treatment of early gum disease involves oral hygiene and removal of bacterial plaque. Moderate to advanced gum disease usually requires a thorough cleaning of the teeth and teeth roots called “root planing” and “subgingival curettage.” Root planing is the removal of plaque and tartar (hardened plaque) from exposed teeth roots while subgingival curettage refers to the removal of the surface of the inflamed layer of gum tissue. Both of these procedures are usually performed under local anesthesia and may be accompanied by the use of oral antibiotics to overcome gum infection or abscess. Follow-up treatment may include various types of gum surgeries. In advanced gum disease with significant bone destruction and loosening of teeth, teeth splinting or teeth extractions may be necessary.