Gum Diseases (Periodontology)

Healthy Gums

Healthy gum tissue is slightly rough like orange peel, runs in a straight line at teeth border, and has pale coral pink colour. Healthy gums do not bleed when brushed or probed.

What is Gingivitis?

Healthy gum tissue is slightly rough like orange peel, runs in a straight line at teeth border, and has pale coral pink colour. If you don’t brush your teeth regularly or ensure oral hygiene, microbial dental plates will develop on your teeth’s surface. A plaque is a sticky plate that accumulates on and between teeth, which also contains bacteria. This causes gums to become redder and more oedematous, sensitive, and prone to bleeding.

What is Periodontitis?

Periodontitis almost exclusively starts with gingivitis. If sufficient oral hygiene cannot be provided to contain gingivitis, it will advance and turn into periodontitis.

Accumulated plaque and tartar, when not cleaned properly, may cause gum inflammation. This triggers gum recession and follow-up osteonecrosis. This is called periodontitis.

When bone substance loss occurs, it means tooth has lost support tissue. If said bone loss is not restrained, tooth may be lost as well.

Periodontitis symptoms include:

• Increased pocket depth due to swollen gums and bone loss
• Gum redness, bleeding when brushing or probing
• Decreased bone level around teeth, a.k.a. osteonecrosis
• Distinctive bad breath
• Teeth and gum ache

Untreated periodontological diseases are the leading cause of teeth loss in adult population.

Infected Gum

It looks bright and swollen, with an irregular teeth line. Constant pain may accompany. Bleeding can be observed during eating, brushing, or probing. This inflammation may also cause unpleasant bad breath.

Reasons of Gum Inflammation

• Microbial dental plaque and tartar accumulation
• Lack of mouth care, insufficient oral hygiene
• Lack of vitamins
• Inability to provide oral care due to physical deficiencies
• Certain autoimmune diseases

Reasons of gum recession

• Severe gum inflammation
• Tartar and plaque accumulation
• Incorrect tooth brushing with excessive and/or wrong force

Inappropriately placed fillings and crowns

General Symptoms of Gum Infection

• Spontaneous, or probe or brushing related gum bleeding
• Redness in gums
• Losing orange peel appearance of healthy teeth due to gum swelling
• Mild pain or discomfort in teeth and/or gums
• Gum recession

Bad breath

Levels of Gum Infection:

1. Gingivitis: Redness on gums, disrupted orange peel appearance to a bright oedematous formation, bleeding after brushing.
2. Early Periodontitis: Redness on gums, swelling, mild pain, bleeding spontaneously or after brushing, mild bad breath. These patients also have significant plaque and tartar accumulation.
3. Moderate Periodontitis: Redness on gums, swelling, mild pain, serious bleeding spontaneously or after brushing, disturbing bad breath, gum recession and bone loss. These patients also have serious plaque and tartar accumulation, in addition to loose teeth due to bone loss.

Severe Periodontitis: A purplish-red colour on gums, serious bleeding spontaneously or after brushing, abscess and severe bad breath, gum recession and serious bone loss. These patients also have extreme plaque and tartar accumulation. In addition, teeth are mobile due to bone loss, and may need to be extracted.

Gingivitis Treatment

• Weeping the infection to relax gums
• Completely cleaning surface tartar
• Completely cleaning deep tartar and subgingival curettage
• Providing oral hygiene training and teaching proper tooth brushing methods
• Vitamin and antibiotics use in advanced cases
• Surgically removing infected parts of gums (gingivectomy, papillectomy)
• Surgically applying biomaterials or membrane to areas of bone loss to try and rebuild bone tissue

Attempting to fix gum recession areas with surgical operations such as flap operation