GUMS

What is Gingivitis?

Symptoms of Gingivitis

Gingivitis, also known as gum disease, is inflammation of the gums. It is often the first stage of periodontal disease.

Some of the warning symptoms of gingivitis include:

  • Bleeding when brushing or flossing.
  • Redness where the gums and tooth meet.
  • Swollen gums.
  • Bad breath.
Causes of Gum Disease

Gingivitis usually begins when plaque, the sticky, colorless film of bacteria and food particles that constantly forms on your teeth, is not cleaned away every day.

It is hard to see plaque, but in the image below, a harmless dye stains it red. When plaque stays on your teeth for two or three days, it can harden into tartar. Tartar, which is stained blue in the image, can irritate your gums and lead to gingivitis.

Gum disease can also be caused by certain medical conditions, some medications, trauma, smoking or chewing tobacco. During pregnancy, hormonal changes can contribute to gum disease.

Causes of Gum Disease

Gingivitis usually begins when plaque, the sticky, colorless film of bacteria and food particles that constantly forms on your teeth, is not cleaned away every day.

It is hard to see plaque, but in the image below, a harmless dye stains it red. When plaque stays on your teeth for two or three days, it can harden into tartar. Tartar, which is stained blue in the image, can irritate your gums and lead to gingivitis.

Gum disease can also be caused by certain medical conditions, some medications, trauma, smoking or chewing tobacco. During pregnancy, hormonal changes can contribute to gum disease.

Examination

To determine if you have gingivitis, we examine your mouth and look for red, swollen, or bleeding gums.

Because gingivitis can advance to periodontal disease, we may take x-rays to check your bone levels.

We may also check the depth of the sulcus around each tooth. A sulcus is the tiny groove between the base of the visible part of your tooth and the gum.

Treatment

If you have gingivitis, we thoroughly clean your teeth and may schedule you for more frequent cleanings. We may also suggest a special mouthwash or rinse and discuss your homecare technique.

The good news is that gingivitis is reversible. The sooner we catch it, the better chance.

What is Periodontitis?

What is Periodontal Disease?

Periodontal disease is a serious infection and the number one reason adults lose teeth. As periodontal disease advances, the infection can destroy the ligaments and bone that support your teeth.

What are the Symptoms?

If you have periodontal disease:

  • Your gums may bleed when you brush or floss.
  • Your gums may be soft, swollen, or tender.
  • Your gums may start to pull away from your teeth.
  • Your teeth may become loose.
  • You may have persistent bad breath.

It is also possible to have no noticeable symptoms. In fact, most people who have periodontal disease are not even aware of it.

What Causes Periodontal Disease?

The main cause of periodontal disease is the long term build-up of plaque, the sticky, colorless film of food and bacteria that constantly forms on your teeth.

It is hard to see plaque, but plaque can clearly be seen after it is stained with a disclosing tablet. When plaque stays on your teeth for two or three days, it hardens into calculus, or tartar.

The bacteria in plaque invade the spaces between your teeth and gums and produce toxins. These toxins, combined with your body’s reaction to them, destroy the bone around your teeth. And once lost, bone never grows back on its own.

If there is not enough support for the teeth and they become loose, they might have to be removed.

Diagnosis And Treatment

To determine if you have periodontal disease, we perform a thorough examination which includes taking x-rays to determine how much bone has been lost.

We measure the depth of the sulcus (a tiny groove between the tooth and gum) with a probe. A reading of more than 3 millimeters could be a sign of periodontal disease, and we pay careful attention to those areas.

If we find periodontal disease, we discuss your treatment options and proper homecare. We want to help you maintain the health of your teeth, gums and bone and restore your healthy smile.

What is a Periodontal Abscess?

Immediate Treatment Necessary

A periodontal abscess is a pocket of pus that typically forms in the tiny space between the gums and the tooth. This space is called the sulcus.

A periodontal abscess should be treated as soon as possible to eliminate pain, stop the spread of infection, prevent tooth loss, and restore the health of your mouth.

Symptoms of a Periodontal Abscess

You may realize that you have a periodontal abscess if:

  • The affected tooth hurts when you tap or bite on it.
  • The tooth is slightly loose.
  • The gums bleed, and they are swollen, shiny and red, or deep red-blue.
  • You have a nasty taste in your mouth.

It is also possible that you can have a periodontal abscess and experience no symptoms at all.

The Causes of a Periodontal Abscess

There are several conditions that can cause a periodontal abscess. Many abscesses are caused when periodontal infection flares up in a gum pocket and quickly grows, forming a ball of pus. Injured gums can sometimes form an abscess when they are infected by bacteria that live naturally in your mouth, especially if the gums are already affected by periodontal disease.

Impacted food, often a seed or popcorn hull, can sometimes cause an abscess because the food particle prevents your saliva from flushing out the bacteria and provides fuel for bacterial growth.

Once formed, an abscess might drain through the gums, creating what is commonly called a gumboil. A periodontal abscess can cause pain and swelling and, if left untreated, can cause damage to supporting bone and ligaments in a short period of time. It can also lead to the loss of the affected tooth and sometimes even neighboring teeth.

Diagnosis and Treatment

If we suspect that you have a periodontal abscess, we perform a thorough examination. We use a periodontal probe around the teeth and take x-rays to check bone levels. We also look for any pus or discharge.

To treat a periodontal abscess, we must drain it and remove the source of infection. A root planing procedure will drain the abscess, as well as clean plaque and tartar from the root surface. In some cases, we may numb the area and then lance the abscess at its base. Although antibiotics cannot cure an abscess by themselves, they may also be prescribed.

Homecare may include rinsing your mouth with warm salt water or an antimicrobial mouthwash.

Diabetes and Periodontal Disease

Periodontal Disease and Diabetes

If you have diabetes, you have an increased risk of developing periodontal disease. Diabetes contributes to periodontal disease in several ways. It can:

  • Lower your body’s ability to fight infection.
  • Slow healing.
  • Cause dry mouth.
  • Often result in high blood sugar levels.

Your blood vessels bring oxygen and nutrients to your tissues, including your mouth, and remove wastes. Diabetes causes the blood vessels to thicken and become less elastic, making you less resistant to infections, like periodontal disease. Diabetics often experience a decrease in the flow of saliva. This can lead to a condition called dry mouth, or xerostomia. A lack of saliva allows plaque, the sticky film of food and bacteria, to build up easily on teeth. This accumulation of plaque is the main cause of periodontal disease, which can result in bone loss. Having poorly controlled diabetes also means that there is often an excess level of glucose in the blood and saliva. Some think a higher glucose level may encourage the growth of the bacteria that live in plaque and are responsible for periodontal disease. We will work with your physician to monitor your diabetes and keep you in good health. You have to do your part by maintaining a meticulous oral homecare routine. Together, we can help keep you healthy and free of periodontal disease.

Pregnancy and Periodontal Disease

Periodontal Disease and Pregnancy

If you have periodontal disease and you are pregnant, periodontal disease may be putting your baby’s health at risk.

There is some evidence that expectant mothers who have periodontal disease are more likely to deliver a premature, low birth weight baby.

Gums infected with advanced periodontal disease can be compared to a large open wound around your teeth that allows harmful bacteria to enter your bloodstream and travel throughout your body.

Infection Harmful

One theory suggests that as the body fights the infection caused by periodontal disease, it produces prostaglandin, the same hormone that signals the body to begin labor, which may result in a premature delivery. This is serious because pre-term babies have a higher risk for disease and disabilities such as respiratory problems and developmental issues. The good news is that early periodontal disease is preventable and treatable, starting with brushing at least twice a day and, ideally, after every meal.We will gladly show you proper brushing and flossing techniques.

We will gladly show you proper brushing and flossing techniques. We also want to monitor the health of your gums. In some advanced cases, we may want to perform a scaling and root planing procedure. Pregnancy is a time when every aspect of your health is especially important. Let us help you and your baby to make it safely through this wonderful event.

Respiratory Infections and Periodontal Disease

Periodontal Disease and Respiratory Infections

If you have periodontal disease, you should know that it can contribute to respiratory infections. Evidence suggests that the bacteria that cause periodontal disease can contribute to, or worsen, infections such as pneumonia, chronic bronchitis, emphysema, and chronic obstructive pulmonary disease. These bacteria enter your lungs through normal breathing and swallowing, where they can multiply and inflame lung tissues. This is especially true if you smoke, have a weakened immune system, or if you already have a respiratory condition.

If we determine that you have periodontal disease, we will recommend an appropriate treatment plan. We will review your home care and schedule you for regular cleanings. We may recommend other procedures to remove the source of bacteria and allow your gums to heal. By caring for your dental health, you will reduce your risk of respiratory infection and increase your overall health.

Smoking and Periodontal Disease

Periodontal Disease Linked to Tobacco

By now almost everyone knows that smoking has been linked with lung disease, cancer, and heart disease. But most people are not aware that smokers are three to six times more likely to have periodontal disease, and two times more likely to lose teeth.

Periodontal Disease

Periodontal disease is an infection of the teeth, gums, and the bone that surrounds your teeth. It is caused by the bacteria that live in plaque, the sticky film of food and bacteria that forms constantly on your teeth. The bacteria infect the tooth roots and cause pockets of infection to form in the gums. The bacteria also produce toxins, and these toxins, combined with your body’s reaction to them, destroy the bone around your teeth.

Periodontal Disease and Smoking

Smoking helps cause periodontal disease in two ways: It reduces the production of saliva, and it damages the body’s ability to fight off infection. Saliva is necessary for oral health because it helps wash bacteria from the teeth, so less saliva means more plaque. Saliva also contains disease-fighting antibodies that help fight destructive bacteria in the mouth. Smoking damages your immune system by causing blood vessels to constrict throughout your entire body. This constriction reduces the flow of infection-fighting white blood cells, oxygen, and nutrients to the gums, making them more susceptible to infection. Besides contributing to the onset of periodontal disease, continuing to smoke after periodontal treatment makes it much harder for your gums to heal. So, if you have not yet thought about quitting smoking, you should consider it now. By becoming a nonsmoker you can strengthen the fight against periodontal disease and keep your teeth.

Cardiovascular Health and Periodontal Disease

Periodontal Disease and Heart Disease

Some studies show that people with periodontal disease have a higher probability of being diagnosed with heart disease than those without periodontal disease. Researchers suspect that is because inflammation is a characteristic of both periodontal and heart disease. Bleeding gums, a sign of periodontal disease, are open wounds that allow the bacteria to enter your bloodstream.

Plaque Restricts Blood Flow

One cause of heart disease is a build-up of plaque in the arteries that, over time, can restrict the flow of blood. Periodontal bacteria have been found in that plaque, which leads many researchers to believe there might be a relationship. In addition to building up, the plaque in the arteries can rupture, forming a clot. The clot can block blood flow and trigger a heart attack.

The same thing can happen in your brain. If the bacteria settle in your carotid artery, the inflammation may lead to the build-up of fatty deposits. If these deposits break apart and are carried in your bloodstream, they can lodge in your brain, block a blood vessel, and cause a stroke.

Risk Factors

You may also be at risk if you have damage to your heart or heart valve, certain congenital defects, a history of endocarditis, an artificial heart or heart valve, or you have had a heart transplant.

We want to work with you and your physician to keep you in optimal health. And a healthy mouth is key to a healthy life.

Gingival Grafting

Gums Protect Tooth Root

When gums recede and expose the roots of the teeth, a gingival graft can repair the damage.

The loss of protective gum tissue can lead to significant decay in the roots and painful sensitivity. It can also age your smile.

Procedure

We begin the procedure once we are sure you are completely numb.

At the damaged area, we gently separate the gums from the tooth. We then carefully remove any plaque and tartar from the root surfaces.

Next, we take a small tissue graft from another area in your mouth.

That site may heal on its own, or we may place a stitch or two.

Lastly, the donor tissue graft is seated to fill in the missing gum and stitched into place.

As the gum tissue heals, it tightens more closely around the tooth. After a few weeks, the gum tissues should blend in beautifully.

Benefits

Gingival grafting:

  • Helps protect root surfaces from decay.
  • Keeps roots cleaner.
  • May reduce tooth sensitivity.
  • Can improve your periodontal health.

Gingival grafting is a safe way to restore your gums and keep your smile beautiful.

Crown Lengthening Procedure

Gum Lift

An esthetic crown lengthening, sometimes called a gum lift, is a safe and predictable procedure for reshaping bone and gum tissues when teeth seem to be too short or when the gumline is uneven.

Procedure

We begin the procedure when we are sure the area is completely numb.

Then, we make small incisions in the gums and gently lift them away from the tooth.

We reshape the bone and gum tissue to reveal more of the natural tooth and to maintain a healthy distance between the bone and gumline.

A couple of stitches are placed in the gums to speed healing. After a few weeks, the gums will heal completely.

If necessary, we can bond a crown, veneer, or composite resin restoration to improve the shape of the tooth.

An esthetic crown lengthening can make a dramatic improvement in the look of your teeth and help you have the smile of your dreams.

Gingivectomy

Excess Gum Tissue

A gingivectomy is a procedure in which we remove excess gum tissue. We may recommend it for a variety of reasons.

A person with periodontal disease may need a gingivectomy to:

  • Reduce pockets that trap bacteria.
  • Remove diseased gum tissue.

Gum tissue can need to be reshaped because certain medications caused it to thicken and grow.

A gingivectomy reshapes gum tissue to give someone an esthetically pleasing smile.

Procedure

Once the area is numb, a special instrument gently removes the excess or diseased gum tissue.

Next, we shape and contour the gums to enhance your smile’s natural beauty.

The procedure usually only takes about an hour and can be done in our office. You gums should be completely healed in just a couple of weeks.

A gingivectomy is a safe and predictable procedure that can dramatically improve your smile.

Pocket Reduction Surgery

Pocket Reduction Necessary

If you have deep gum pockets infected with periodontal disease, we may perform flap surgery to help the area heal.

The procedure, sometimes called a pocket reduction, may be necessary when gum pockets are so deep that scaling and root planing cannot remove the infection.

Procedure

To begin the procedure, we first make sure all the areas are completely numb. Then, we gently separate the gums from the tooth. This creates a flap and gives us access to the bone and tooth root.

We remove plaque, tartar, bacteria, and infected tissue from the area.

We may then smooth the bone around the tooth. This will limit the areas where bacteria can hide and will help the gums reattach to the tooth.

In some cases, we may also apply special proteins or other treatments that help reattachment.

The gums are secured with a few stitches. As the gum tissue heals, it tightens more closely around the tooth.

Periodontal flap surgery:

  • Removes the source of infection.
  • Reduces the size of the gum pockets.
  • Helps the gum tissue heal and reattach to the bone.
  • Makes it easier to keep the area plaque-free.

It is an effective method for treating deep-seated periodontal disease and restoring your health.

Periodontal Bone Grafting

Periodontal Disease Destroys Bone

When periodontal disease has destroyed the bone around your teeth, a bone grafting procedure can often be used to replace the missing bone.

Before we begin, we prepare the replacement material, which may be your own bone, bone from another source, or artificial bone.

Procedure

Once the area is numb, we make small incisions in the gum and lift it away from the tooth.

Next, we remove any plaque and bacteria from the root surface of the tooth.

Then, we place the grafting material into the areas where the bone has been destroyed.

Depending on the circumstances, additional treatments, such as special proteins or platelet-rich plasma may be applied to encourage bone growth and help your gums reattach to the tooth.

We may also place a special membrane over the graft to prevent unwanted tissue from growing into the graft site.

The last step is to reposition the gum and close the grafting site.

Over the next several months, the bone will heal around the tooth.

Bone replacement has several benefits. It can:

  • Fill in areas of bone loss.
  • Stimulate new bone growth.
  • Stimulate soft tissue growth.
  • Significantly reduce gum pockets.

Periodontal Surgery Post-op Instructions

Surgery Aftercare Recommendations

Now that you have had surgery on your gums, it is important to make sure you are as comfortable as possible to maximize the chance for success.

Relax and avoid all strenuous activities for the first 24 hours following surgery.

If we used an anesthetic during the procedure, do not eat anything for 2 hours after surgery. When you do feel comfortable enough to eat, but you still have numbness, be careful not to bite your cheeks or tongue.

For the first week, restrict your diet to soft foods, such as yogurt, scrambled eggs, and soup, until you can comfortably chew. Chew on the side of your mouth opposite the surgery site.

Avoid alcoholic drinks and hot or spicy foods for at least a week after surgery.

To control discomfort, take pain medication before the anesthetic has worn off, or as recommended. It is normal to have some discomfort for several days after surgery. Generally, do not take pain medication on an empty stomach, or you may experience nausea. Make sure you follow the directions.

For the first 6 hours after surgery, apply an ice pack 20 minutes on and 20 minutes off, to decrease pain and swelling.

After 24 hours, reduce discomfort or swelling by rinsing your mouth very gently with warm salt water 3 times each day. Use about 1 teaspoon of salt in a glass of warm water.

Some slight bleeding is normal for a day or two following surgery. If bleeding persists, apply firm pressure with a gauze pad, or bite on a clean, moist tea bag for 20 minutes. Call us if this does not control bleeding or if bleeding increases.

Clean the treated areas by gently rinsing with warm water or mouthwash. Avoid frequent or vigorous rinsing or brushing until the area has healed.

Brush and floss the non-treated areas of your mouth as you normally would.

If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.

Call us if discomfort is not diminishing day-by-day or if swelling increases or continues beyond 3 or 4 days.



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