Periodontology (from Greek peri 'around' and odous 'tooth')
Periodontology is the study of tissues which surround and support the teeth. These include the Gums, Alveolar bone and a specialised ligament called the Periodontal Ligament which anchors the roots of teeth to the supporting bone.
What is Gum Disease
Gum disease is an infectious disease caused by bacteria. Bacteria establish colonies in the space between the gums and the teeth and cause destruction of the Periodontal Ligament and the Alveolar bone surrounding the teeth. This results in the formation of deep areas between the teeth and gums known as Periodontal Pockets or simply as Pockets. These pockets progressively deepen, leading to further bone loss which ultimately leads to tooth/ teeth loss.
Gum disease is a silent disease as it rarely produces any symptoms till a very late stage. Even at later stages patients are usually unaware of its presence.
Unfortunately there is no permanent cure for gum disease since bacteria are always present in the mouth. It requires specific treatment by the Dentist followed by very good plaque control by the patient to keep the disease in check.
If left untreated, gum disease is an unpredictable and progressive disease. Even after treatment regular checks by your dentist are essential to maintain good gum health because it cannot be monitored by the patient.
Is there a link between Gum Disease and other Medical Conditions
Yes, there is scientific evidence that untreated Gum Disease can increase the likelihood of many Medical problems.
How is Gum Disease treated
The aim of treatment is to remove the bacterial colonies from the surface of roots and from the gum Pockets, returning your gums to health and to prevent gum disease from either progressing or from occurring again. Gum treatment may involve some or all of the following:
Non Surgical gum treatment: Root Planing
Non surgical treatment is the most important first step in the treatment of gum disease and for most areas of mouth, usually is the only treatment required. This treatment involves intensive cleaning of the roots, both above and below the gums.
The treatment is different from the usual scaling in that it involves much deeper scaling (subgingival scaling) and root planing. Root Planing is a critical part of treatment and the aim of Root Planing is to remove the thin layer of infected root surface where bacterial colonies have attached themselves. This procedure is done after the numbing the gums. Specialized instruments called Curettes are used to do Root Planing.
Most moderately deep pockets heal following Root Planing provided the patient maintains very good plaque control after the treatment.
What happens after Root Planing
After Root Planing is completed a review appointment is made after 3 months to assess how well the gums have healed and which areas need further attention. If some areas have not healed then a further course of treatment may be prescribed. The number of appointments required vary between individuals and depend upon the severity of disease, any complicating medical conditions like Diabetes and upon the standard of plaque control.
Surgical Gum Treatment: Flap Surgery
If after Root Planing some of the diseased sites (pockets) have not healed then gum surgery may be required to achieve better results. Surgical treatment may be required for severely deep pockets and/ or in areas where significant bone loss is present.
Surgical gum treatment involves raising a gum 'flap' after numbing the gums and gently lifting them in order to directly visualize the deeper root surfaces of the teeth. This improved access allows for more thorough Root Planing of the deeper parts of the roots. Following this the gum flaps are gently secured using sutures.
Another advantage of Flap Surgery is that the pockets can be treated and reduced immediately which allows for much easier cleaning by the patient.
Maintenance Phase: Regular check ups and Regular scaling
After gum treatment has been completed and the pockets have been either eliminated or reduced, the best way to ensure that the gums stay healthy is by regual check ups and cleaning (usually every 3 months).
At the check-ups the Dentist assesses the condition of your gums to ensure that they remain disease free. The Dentist will also assess carefully how well the patient is removing plaque from their teeth.
What is the link between Smoking and Gum Disease
Tobacco use is the most significant risk factor in the progression and treatment of Gum disease and quitting smoking is a prerequisite to successful Gum Treatment.
In the presence of smoking it becomes much more harder to eliminate or control Gum Disease because smoking hinders healing of gums after treatment. This also means that after treatment a more vigorous Maintenance phase (more frequent Gum check ups and more frequent Scaling) will be required to keep the disease under control.
Do the gums shrink after treatment
After treatment the swelling of the gums subside and it may appear that the gums have shrunk in size. Sometimes this may lead to increased sensitivity of the exposed roots but in most cases it is temporary and the sensitivity subsides after a few weeks.