A healthy mouth is host to a complex and dynamic community of bacteria
In fact, the presence of oral bacteria is generally beneficial to the well-being of the mouth. Problems begin when there is a change in the balance of the bacteria in the mouth. Oral bacteria are able to adhere to teeth and gums in the form of dental plaque, which is the soft, sticky film that forms on teeth every day. If dental plaque remains for a prolonged period of time, it turns into a hardened calcified deposit called tartar that sticks to teeth near the gums. Tartar cannot be brushed or flossed away. Furthermore, tartar creates an environment for more dental plaque to accumulate. With the overgrowth of dental plaque and buildup of tartar, the balance of oral bacteria in the mouth shifts to unhealthy proportions.
With the presence of dental plaque, the gums respond with inflammation. Our body's immune response through inflammation is the process that can ultimately lead to loss of gum attachment, or "periodontal ligament" and jawbone deterioration.
Treatment For: Bleeding Gums, Shaky Teeth and Bad Breath
Scaling- Even when we brush/ floss regularly, plaque build up occurs in a few nooks and corners that are not reacheable to the cleaning aids. This plaque collection hoards bacteria that is the very cause of decay and gum disease. Studies show that this bacteria also spreads to the heart, reproductive organs etc. In diabetics, it may even cause tooth loss. It is advisable to go for an ultrasonic tooth cleaning once in six months
Deep scaling- When plaque build up has affected the gum health, causing pockets, then the cleaning has to be deep, often done in multiple sittings
Root planing- Cleaning and smoothening the root surface of the tooth to prevent further accumulation of plaque on the root surface - that can cause more bone support loss for the tooth
Curettage- Cleaning and sterilising the infected gums that may be bleeding or causing bad breath using special instruments
Flap Surgery- Reaching within the gums to remove the disease causing germs and infection. This can be performed with and without lasers
Flap surgery with Bone Grafting- Gum infection almost always progresses to the bones, which being delicate, almost always dissolves resulting in a loss of tooth support - this is the reason for shaky tooth and migration of the teeth causing spaces in between the teeth. When the gum disease has progressed to this level, it may also have pus build up in the gums and pockets causing bad breath. In such a situation, it may be necessary to augment the bone support that is lost by adding calcium particles to the tooth surroundings. This will strengthen the tooth further. and prolong the life of the natural tooth
Flap surgery with Biogenic Material (PRF)- When bone loss cannot be just compensated with calcium particles, we use special bone growth inducing growth factors to enhance and ensure healing. These special proteins are sometimes derived from the individuals own body (platelets) .
Depigmentation- Removal of the black pigmentation of the gums to make the gums pink is called gingival depigmentation
Root coverage / Recession Coverage- When the bone around the tooth is lost, the gum sags and gradually recedes exposing the roots of the teeth. This causes sensitivity . This cannot be cured by desensitising tooth pastes, it has to be "covered" by streatching the gums and placing them back in their original position.
Splinting- A procedure to stabilise shaky teeth till the bone healing occurs
PERIODONTAL FLAP SURGERY
Gum Diseases Management
Periodontal plastic surgery is designed to restore form and function to the gum tissue, periodontal ligament, and the bone that supports your teeth or an individual tooth. The real long-term goal of any periodontal surgery is to increase the life expectancy of the teeth and their usefulness. Basically, periodontal surgery removes UNHEALTHY tissue that has been transformed by the disease and then reconstructs the gums and surrounding tissues to better support the teeth and to recreate a normal appearance.
Periodontal disease is diagnosed when gingival or gum tissue attachment to the teeth is abnormal and bone changes may be evident through x-rays. A PERIODONTIST will determine the degree of periodontal disease by examining "pockets" between the gum and tooth to see how much ATTACHMENT LOSS exists and then will thoroughly examine the x-rays.
When periodontal disease is detected, first recommendation are a few behavioral changes including an enhanced oral hygiene program, quitting smoking, and possibly some additional lifestyle changes.
A regular and thorough professional tartar or calcified plaque removal program will become an essential part of your oral hygiene routine. Typically this is a painless procedure but, in some extreme cases, pain medication may be required for a few days.
Surgical Therapy /Regenerative Procedures
In cases of severe periodontal disease, surgery will be necessary to repair and regenerate the soft and hard tissues and replace any missing teeth. The goal of surgery is to eliminate pockets between the gum and tooth and attempt to encourage reattachment and normal function and esthetics to the patient. Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.
Preventing Periodontal Disease
While steps can be taken to alleviate the ravages of periodontal disease, the best step is prevention. Remove plaque and bacteria through daily brushing, flossing, and regular oral hygiene. Routine visits to a dental professional for cleanings are also essential. Quitting smoking has proven to be very helpful in preventing the onset of periodontal disease.
PERIODONTAL PLASTIC SURGERY
Periodontal Plastic Surgery Procedures- Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, a periodontist may be able to help.
Gummy Smile or Uneven Gum Line- Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gumline is sculpted to give your new smile just the right look.
Exposed Roots- Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases.
Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay.
Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.