Periodontal Treatment | Al Ibtesamah Al Jamilah

What is Gingivitis?

Gingivitis — an inflammation of the gums — is the initial stage of gum disease and the easiest to treat. The direct cause of gingivitis is plaque – the soft, sticky, colorless film of bacteria that forms constantly on the teeth and gums.
If the plaque is not removed by daily brushing and flossing, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected. Left untreated, however, gingivitis can become periodontitis and cause permanent damage to your teeth and jaw.

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How do I Know if I Have Gingivitis?

Classic signs and symptoms of gingivitis include red, swollen, tender gums that may bleed when you brush. Another sign of gum disease is gums that have receded or pulled away from your teeth, giving your teeth an elongated appearance. Gum disease can cause pockets to form between the teeth and gums, where plaque and food debris collect. Some people may experience recurring bad breath or a bad taste in their mouth, even if the disease is not advanced.

How can I Prevent Gingivitis?

Good oral hygiene is essential. Professional cleanings are also extremely important because once plaque has hardened and built up, or become tartar, only a dentist or dental hygienist can remove it.
You can help stop gingivitis before it develops by:
· Proper brushing and flossing to remove plaque and debris and control tartar buildup
· Eating right to ensure proper nutrition for your jawbone and teeth
· Avoiding cigarettes and other forms of tobacco
· Scheduling regular checkups with your dentist

Symptoms of gingivitis

Healthy gums are firm and pale pink. If your gums are puffy, dusky red and bleed easily, you may have gingivitis. Because gingivitis is seldom painful, you can have gingivitis without even knowing it. Signs and symptoms of gingivitis may include:
· Swollen gums
· Soft, puffy gums
· Receding gums
· Occasionally, tender gums
· Gums that bleed easily when you brush or floss, sometimes seen as redness or pinkness on your brush or floss
· A change in the color of your gums from a healthy pink to dusky red
· Bad breath
Causes

The most common cause of gingivitis is poor oral hygiene that encourages plaque to form. Plaque is an invisible, sticky film composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing and flossing your teeth each day removes plaque. Plaque requires daily removal because it re-forms quickly, usually within 24 hours.
Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar makes plaque more difficult to remove and creates a protective shield for bacteria. You usually can’t get rid of tartar by brushing and flossing — you need a professional dental cleaning to remove it.
The longer that plaque and tartar remain on your teeth, the more they irritate the gingiva, the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily.
Risk factors

Gingivitis is very common, and anyone can develop it. Many people first experience gum problems during puberty and then in varying degrees throughout life.
Factors that can increase your risk of gingivitis include:
· Poor oral health habits
· Tobacco use
· Diabetes
· Older age
· Decreased immunity as a result of leukemia, HIV/AIDS or other conditions
· Certain medications
· Certain viral and fungal infections
· Dry mouth
· Hormonal changes, such as those related to pregnancy, your menstrual cycle or use of oral contraceptives
· Poor nutrition
· Substance abuse
· Ill-fitting dental restorations

· Complications

· Untreated gingivitis can progress to gum disease that spreads to underlying tissue and bone (periodontitis), a much more serious condition that can lead to tooth loss. Periodontitis and poor oral health in general may also affect your overall health in ways that aren’t completely understood. Studies link periodontitis to an increased risk of heart attack, stroke or lung disease. And women with periodontitis may be more likely to give birth to premature babies or babies with low birth weight than are women with healthy gums. Although more research is needed, these studies highlight the importance of taking good care of your teeth and gums.

GUM DISEASE

gum disease or periodontal disease, begins with bacterial growth in your mouth and may end — if not properly treated — with tooth loss due to destruction of the tissue that surrounds your teeth.

What’s the Difference Between Gingivitis and Periodontitis?
Gingivitis (gum inflammation) usually precedes periodontitis (gum disease). However, it is important to know that not all gingivitis progresses to periodontitis.
In the early stage of gingivitis, bacteria in plaque build up, causing the gums to become inflamed and to easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.
When gingivitis is left untreated, it can advance to periodontitis. In a person with periodontitis, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gums collect debris and can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.
Toxins or poisons — produced by the bacteria in plaque as well as the body’s “good” enzymes involved in fighting infections — start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose, and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults.
What Causes Gum Disease?
Plaque is the primary cause of gum disease. However, other factors can contribute to periodontal disease. These include:
· Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, which makes it easier for gingivitis to develop.
· Illnesses may affect the condition of your gums. This includes diseases such as cancer or HIV that interfere with the immune system. Because diabetes affects the body’s ability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease and cavities.

· Medications can affect oral health, because some lessen the flow of saliva, which has a protective effect on teeth and gums. Some drugs, such as the anticonvulsant medication Dilantin and the anti-angina drug Procardia and Adalat, can cause abnormal growth of gum tissue.
· Bad habits such as smoking make it harder for gum tissue to repair itself.
· Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.
· Family history of dental disease can be a contributing factor for the development of gingivitis.
What Are the Symptoms of Gum Disease?
Gum disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. The symptoms of gum disease include:
· Gums that bleed during and after tooth brushing
· Red, swollen, or tender gums
· Persistent bad breath or bad taste in the mouth
· Receding gums
· Formation of deep pockets between teeth and gums
· Loose or shifting teeth
· Changes in the way teeth fit together upon biting down, or in the fit of partial dentures.

Even if you don’t notice any symptoms, you may still have some degree of gum disease. In some people, gum disease may affect only certain teeth, such as the molars. Only a dentist or a periodontist can recognize and determine the progression of gum disease.

How Does My Dentist Diagnose Gum Disease?

During a dental exam, your dentist typically checks for these things:
· Gum bleeding, swelling, firmness, and pocket depth (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease)
· Teeth movement and sensitivity and proper teeth alignment
· Your jawbone, to help detect the breakdown of bone surrounding your teeth.

How Is Gum Disease Treated?
The goals of gum disease treatment are to promote reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues. A full description of the various treatment options is provided in Gum Disease Treatments.

How Can Gum Disease Be Prevented?
Gum disease can be reversed in nearly all cases when proper plaque control is practiced. Proper plaque control consists of professional cleanings at least twice a year and daily brushing and flossing. Brushing eliminates plaque from the surfaces of the teeth that can be reached; flossing removes food particles and plaque from in between the teeth and under the gum line. Antibacterial mouth rinses can reduce bacteria that cause plaque and gum disease,
Other health and lifestyle changes that will decrease the risk, severity, and speed of gum disease development include:
· Stop smoking. Tobacco use is a significant risk factor for development of periodontitis. Smokers are seven times more likely to get gum disease than nonsmokers, and smoking can lower the chances of success of some treatments.

· Reduce stress. Stress may make it difficult for your body’s immune system to fight off infection.

· Maintain a well-balanced diet. Proper nutrition helps your immune system fight infection. Eating foods with antioxidant properties — for example, those containing vitamin E ( vegetable oils, nuts, green leafy vegetables) and vitamin C (citrus fruits, broccoli, potatoes) — can help your body repair damaged tissue.

· Avoid clenching and grinding your teeth. These actions may put excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are destroyed.

Despite following good oral hygiene practices and making other healthy lifestyle choices, the American Academy of Periodontology says that up to 30% of Americans may be genetically susceptible to gum disease. And those who are genetically predisposed may be up to six times more likely to develop some form of gum disease. If anyone in your family has gum disease, it may mean that you are at greater risk, as well. If you are more susceptible to gum disease, your dentist or periodontist may recommend more frequent check-ups, cleanings, and treatments to better manage the condition.