Periodontology (Gum Diseases)
Periodontal diseases are inflammatory diseases that occur in the tissues that support the gums and teeth.
Healthy Gums
The healthy gum is a light pink color, tight consistency, matte finish, which ends like a knife back where it joins the teeth, and when it is looked through with the naked eye after drying, it is a tissue that looks like orange peel on its surface. There is a gap of approximately 1-1.5 mm between the tooth and the gingiva. This gap is called the gingival groove. Periodontal diseases take their source from this gum groove. Healthy gums do not bleed during brushing.
What is a dentist?
When the teeth are not cleaned properly, food residues that accumulate on them and between them produce bacteria. These deposits, which we call bacterial plaques, are the primary responsible for dental caries and gingivitis, and over time, they combine with saliva and form their gumstones.
How do gum diseases progress?
When the teeth are not brushed, deposits on the teeth are called bacterial plaques. Harmful substances produced by the bacteria in this plaque harm the gums. These substances wash the supporting tissues around the gums, the fibers that firmly connect the gingiva to the tooth are destroyed, the gum moves away from the teeth, more bacterial plaques and gumstones accumulate in the formed periodontal pockets. As periodontal disease develops, pockets become deeper. Thus, it is easier for bacteria and its products to move to deeper tissues, it goes down to the bone and destruction begins in the alveolar bone that supports the tooth. If the bone support of the teeth disappears, if it is not treated until this stage, the teeth begin to shake and are finally pulled.
Gingival recession and its causes
- Advanced Gingivitis
- Tooth stones
- Incorrect brushing of teeth (pressing with excessive force)
- Incorrect crowns or fillings
- Withdrawal of physiological gums caused by aging
- Distortions in the tooth array
- Habits such as the constant insertion of foreign objects, such as a toothpick or a pin, between the teeth
- Morphological changes in tooth roots cause gingival recession.
Problems and treatments caused by gingival recessions
Aesthetic disorder
Excessive dentin sensitivity
Root surfaces exposed due to gingival recessions are mostly not covered by cement, the outermost layer of the root. Dentine tissue, the middle layer of the root, was exposed. This dentin tissue is very sensitive to thermal, chemical and mechanical stimuli. If success is not achieved with the drugs, the relevant area can be covered with a filler.
Root rot
Caries can also be found on the root surfaces exposed due to gingival recessions. These can be treated with filling applications. Consult your dentist as soon as you think you have a gum recession. Your dentist will first identify the cause of it and make a treatment plan accordingly.
Things to consider for healthy gums
- Brush your teeth properly and use dental floss every day,
- Eat a balanced diet, avoid empty calories and very sticky foods,
- Learn to examine yourself and do it routinely. So you can catch the first signs of any oral or dental changes.
- Go to the dentist at least twice a year to have control and dental calculus cleaning
It is very important to have regular visits to the dentist. Although daily oral care keeps the formation of dental stones to a minimum, it cannot completely prevent it. Dentist cleaning by a dentist; It provides the removal of hardened tooth stones in areas that you cannot clean with toothbrush, dental floss.
What are the symptoms of gum disease?
- Bleeding in the gums when using brush-floss (gums cannot bleed in a healthy mouth.)
- Redness and swelling in the gums
- Mild pain when pressing on the gums, inflammation leaking from the gums
- Withdrawal of gums, separation from root surface and formation of gingival pockets
- Sensitivity on root surfaces exposed due to gingival recession,
- Black areas on the edges of the gums caused by tooth stones,
- Shaking, elongation and opening between the teeth,
- The feeling of change in your closing when you close your mouth,
- Smell and bad taste due to inflammation,
- Itching sensation in the gums
- If there is a prosthesis in the mouth, its compliance is impaired
Gingival diseases can sometimes reach advanced stages without any symptoms. Therefore, it is extremely important to go to the dentist at regular intervals.
Reasons
Inadequate oral hygiene
The most important reason is the lack of oral hygiene. If the person has a predisposition and causes for gum disease, he / she should keep the oral care at the best level.
Daily oral care should be performed correctly and regularly in order to protect teeth and gums. In other words, teeth should not be brushed 3 times a day for 2 minutes. The bacterial plaque on the teeth should be removed.
Daily oral care procedures can minimize tooth formation, but may not prevent it completely. It is also necessary to clean areas that cannot be reached with a toothbrush, dental floss or other cleaning tools. Your dentist will give you the best information about this, so it is very important to go to the dentist regularly.
Diabetes, diabetes
Diabetics fall into a high risk group for gum disease. In cases where people are very vulnerable to infection, such as uncontrolled diabetes, gum disease is often much more severe and difficult to control. They should definitely take care of their oral hygiene by performing routine gingival controls.
Malnutrition
It causes the body to weaken the immune system and, accordingly, to fight infections, including gum infection.
Genetic predisposition
If you have a genetic predisposition, the probability of developing gum disease increases 6 times with poor oral care. If there is a person with a gum problem in the family, you should definitely go to a dentist for a checkup
Cigaret
Smoking causes many important diseases such as cancer, lung and heart diseases. Apart from all these, it prepares the environment for the development of gum diseases which are very harmful for the oral mucosa and gums.
Drug use
Some medications like birth control pills, anti-depressants, heart medications affect your oral health. So if you are using one of these drugs, please tell your dentist and care about your oral care.
Hormonal changes
During periods of intense hormonal changes such as pregnancy, adolescence, menopause, menstruation, the gums become more sensitive and react more than normal to even the slightest stimulus, which prepares the ground for the formation of gum diseases. During this period, you need to take care of your oral hygiene.
Stress
Besides being one of the causes of many diseases such as hypertension and cancer, it is also a risk factor for gum disease. Research has shown that stress, including periodontal diseases, makes it difficult for the body to fight infection and its ability to protect against diseases.
Clenching and grinding teeth
It causes periodontal tissue destruction due to microtraumas constantly coming to the teeth and gums. One reason for the withdrawal of the gums is to clench teeth. If you have such a habit, plaques should be made to prevent the damage of these traumas. Your dentist will tell you what works best.
Poorly made crown bridges and fillings
Fill, crowns, and bridges that press on the gingiva and cause flooding create problems in the gums.
Some diseases
Diseases affecting the body's defense system, such as leukemia, AIDS, can make the condition of the gums worse.
Types
Gingivitis
Periodontal diseases begin with gingivitis. It is an early stage of gum disease. At this stage, the gums are red, shiny, swollen and bleeding. It usually progresses painlessly. It may not cause much discomfort in the early period. If left untreated, the disease can progress to periodontitis, causing irreversible damage to the alveolar bone that supports the gums and teeth.
In its treatment, bacterial plaque and tooth stones, which are the main causes of the disease, are cleaned. Oral hygiene training is given. After the procedure performed by the physician in the clinic, the disease can be prevented easily thanks to the regular oral care that patients will apply at home.
Periodontitis
It is a more advanced stage of periodontal diseases. It occurs when the inflammation of the gums progresses to the deep tissues (alveolar bone) of the tooth. At this stage, gingivitis bulgaria and tooth accumulation, alveolar bone destruction, gingival recession and deep pocket formation between the teeth and gums are observed. The presence of periodontal pocket facilitates the placement of the infection and the progression of the disease.
In its treatment, flap operations and oral hygiene training are applied in order to eliminate tartar cleaning, root surface correction, subgingival curettage and pockets formed according to the severity of the disease.
Treatment
In the majority of cases in the early period of gum disease, daily dental care is sufficient for successful treatment, following cleaning of the teeth, plaque removal and maintaining a smooth root surface.
In the treatment of gum disease, the depth of the pockets formed between the tooth and the gingiva should be measured with a special tool.
The diagnosis is made according to the localization and depth of the amount of these pockets and treatment is planned. Since deep pockets will prepare a suitable environment for the rapid progression of gum disease, the purpose of the treatment is to eliminate them as much as possible. Because it is impossible to completely clean the microorganisms placed in deep pockets by patients with brushing and flossing.
Generally, this treatment is sufficient for adaptation of the gum to the tooth or for the gum to shrink and eliminate the pocket.
More advanced cases may require surgical treatment. The purpose of this treatment is to clean the teeth in the deep periodontal pockets surrounding the teeth, to eliminate the pocket by shrinking and to provide a smooth root surface and to create a gum form that is easier to clean.
After periodontal treatment, patients should be examined regularly by the dentist, plaque control and new dental stone deposits should be removed from the environment. But it should not be forgotten that; No process can be more beneficial for the maintenance of those achieved through periodontal treatment than the daily oral care procedures of the person.
TREATMENT SHAPES
Tooth stone cleaning
While routine cleaning and checks are done every 6 months, people who have periodontal disease or who are inclined to it are cleaned at shorter intervals determined by the physician. The microorganisms in the plaque that settles in the pockets multiplies enough to damage the bone within 3 months. Frequent dental cleaning ensures that bone is not damaged by preventing this buildup.
Root surface straightening
The flattening of the root surface, known as curettage among the people, is the process of scraping the attachments attached to the root surface with the help of special curettes, removing them from the surface and revealing the healthy root surface and allowing the gum to adhere to the root surface again.
Gingivectomy and Gingivoplasty
In some cases, gingival enlargement, drug-related or inherited gingival enlargement is observed. If these gingival growths are not accompanied by osteoporosis, we can remove gingival growths by cutting the soft tissue wall of the pocket between the tooth and the gum. This procedure is called Gingivectomy. After this procedure, Gingivoplasty is applied to correct the gum by surgical methods and restore normal physiognomy.
Flap operation
If periodontal pockets cannot be shallow by curettage and straightening the root surface, the gingiva that forms the pocket is removed surgically. In very deep pockets, the gingiva is removed as a whole and the required root surface straightening is done under it, closed and fixed in place with sutures. If the molten bone needs to be supported at this stage, or if it is thought that bone can be formed in that area, hard tissue grafts or bone particles obtained from the patient's own tissue are placed in the defect region to recover the lost tissue.
Crown lengthening operation
It is a simple procedure to lengthen the parts of the teeth (visible in the mouth) above the level of the gums. In some cases, the caries or fractures go below the gum level or the teeth are too short. In such cases, prosthetic (crown, bridge, etc.) treatments should be extended to the root of the gingiva level for conservancy and gum health.
Smile with gums: (Gummy Smile) In cases where the gums are more visible when they smile, a more pleasant smile can be obtained by removing the excess gums with a small operation whether or not any aesthetic dentistry procedure will be performed.