HOW TO TACKLE GUM DESEASE ?

PERIODONTAL Disease (PD) is commonly referred to as "Gum Disease". "Periodontal" means surrounding the tooth. PD is the disease of the surrounding structures of the tooth — the bone, gums and fibres that attach the tooth to the bone. There are different kinds and may affect one or multiple teeth. It can be broadly classified into the following stages.

Gingivitis: This is the first stage in which only the gums are affected. The gums get red, puffy and tend to bleed easily. This is a reversible stage and can be cured with simple procedures.

Early Periodontitis: Gingivitis, if untreated, progresses into Early Periodontitis when plaque and calculus burrow in between the gums and the tooth creating a pocket. This weakens the support and makes the tooth loose. This stage generally requires more advanced forms of treatment, which may also be surgical.

Advanced Periodontitis: This is the most severe form that sees a lot of bone damage. The teeth become very mobile. This stage is quite difficult to treat and requires very advanced treatment modalities.

Causes

The prime cause is plaque, a sticky film composed of bacteria and its by-products that are constantly formed around the teeth. If not regularly removed it turns into a hard calcified substance called calculus, which can only be removed with special instruments. The bacteria in plaque produce toxins, which cause differing grades of infection leading to destruction of the periodontal structures. Other factors that might aggravate PD are smoking, pregnancy and puberty, medications like Phenytoin and Nifidepine, uncontrolled diabetes and other systemic diseases.

Symptoms

The most common symptoms are bleeding gums, especially while brushing; red and puffy gums; persistent bad breath; gums separating from the teeth; pus-like discharge from the gums; mobile and drifting teeth with discomfort while biting.

Some people do not have any of these symptoms. Many experience almost no pain till the tooth has reached its last almost untreatable stage.

Treatment

A general dentist usually treats early forms. To manage advanced stages a Periodontist or a specialist in the diagnosis, prevention and treatment of PD is required. A small measuring instrument called the periodontal probe is used and X-rays are taken to assess the destruction. The treatment varies from scaling procedures to surgical therapy. In some cases Tissue Regenerative therapy may be suggested. Scaling is the removal of all visible plaque and calculus. Contrary to popular belief, this does not harm your teeth. Patients are generally advised to get their teeth scaled once a year. Advanced treatment involves surgical correction to arrest the disease and to repair and regenerate the lost structures.

Prevention

Once PD is treated, patients require Supportive Periodontal Treatment (SPT). During SPT, the periodontist evaluates periodontal health, examines and removes any new formation of plaque and calculus and traps the disease process, if it recurs, in its initial stages. This addresses only 50 per cent of the problem, it will arrest the disease process and possibly repair some damage. The other part is to be able to maintain the state of health in what is now slightly compromised dentition.

PD is a chronic disease and often recurs without ongoing supportive therapy. Supportive therapy involves getting a regular check up and scaling once in six months; brushing regularly twice a day; and seeing the dentist the moment any symptom appears.

Brushing

Use fluoride toothpaste as fluoride makes teeth stronger and more resistant to acid attacks. This in turn helps to prevent tooth decay. Brushing the teeth combats plaque, which builds up daily. Removing plaque not only makes the teeth feel clean, but also helps to prevent bleeding gums, and makes your breath fresher too. Try to brush in the morning and last thing at night. Brushing at night is important as it protects teeth against acid attack while you are asleep.

Choose a soft or medium (not hard) brush with a small head to reach difficult corners. Replace the brush once it wears out.

Place the bristles of the toothbrush where the teeth and gums meet. Then, move the toothbrush back and forth using small, gentle movements to remove plaque from the gum region where it collects.

Hold the toothbrush like a pen, so that brushing is not too hard. Use a finger grip, not a fist grip. Don't hurry. Make time to clean every tooth.

Always remove partial dentures and braces before brushing and clean them separately.

Your dentist or hygienist can check if teeth are cleaned properly and can remove any tartar that may build up that brushing can't remove.

They can also give advice about the need for dental floss or other special cleaning aids.