Dental problems are not limited to teeth alone but can also involve the surrounding tissues. Improper maintenance of oral hygiene can begin a sequence of events that are mostly reversible with timely intervention but can exacerbate and cause irreparable damage at times. Gum disease can worsen due to:
These factors may contribute to worsening of gum disease or gingivitis. So it’s important to maintain your gum health and visit for appointments regularly to ensure the optimum maintenance of your oral hygiene.
Causes of gum disease:
Gum disease is often the result of accumulated microbial dental plaque (residual food) and calculus (tartar) accumulation. Calculus forms when dental plaque becomes mineralized with saliva, trapping harmful bacteria. Even a small amount of plaque and calculus can lead to gum infection and cause healthy gum tissues (Figure A – top right) to develop into Gingivitis (Figure B). This commonly leads to symptoms like bad breath (halitosis), gum bleeding, and an unpleasant taste in the mouth. However, when there is a significant buildup of gum irritants (calculus), the symptoms worsen. These irritants not only cause bad breath, gum bleeding, and a bad taste but also infect the bone surrounding the teeth, resulting in Periodontitis or periodontal disease (PD) (Figure C and D).
PD is a chronic and progressive disease that can significantly impact daily quality of life, even though its symptoms may not be immediately apparent to patients. PD is a silent “”bone eater”” that takes several years to reach a severe stage of bone loss, eventually leading to tooth loss. The loss of teeth has a profound impact on quality of life. People without teeth experience a lower quality of life compared to those who have their teeth intact, regardless of age. The sooner teeth are lost, the greater the impact on quality of life. Apart from tooth loss and gingivitis symptoms, common PD symptoms include gingival recession, sensitivity of exposed root surfaces, root decay, tooth mobility, and drifting of teeth before final tooth loss.
Management options:
In addition to the traditional surgical approaches for treating gum diseases, there have been significant advancements in our understanding of the underlying causes and the impact of various factors on the prognosis of these conditions. Over the past decade, research in oral microbiology and immunology has greatly contributed to our knowledge in this field. This expanded knowledge has led to the development of innovative treatment strategies, such as LASER THERAPY, which specifically target the harmful bacteria associated with periodontitis. Moreover, there has been a notable shift towards the development of the “next generation” of minimally invasive treatment options. These approaches not only reduce postoperative discomfort and the risk of infections but also promote faster wound healing. This paradigm shift is gaining traction in the field as it offers patients improved outcomes and enhanced post-treatment comfort.
Tooth loss has been associated with changes in food preferences, reduced intake of essential nutrients (such as energy, protein, vitamins, and minerals), dietary fiber, and impaired chewing ability. Research has consistently demonstrated a strong link between the number of natural teeth remaining and chewing ability.
PD can also impact quality of life through its association with systemic conditions such as diabetes, cardiovascular disease (CVD), kidney disease, atherosclerosis, pneumonia, rheumatoid arthritis, and adverse pregnancy outcomes. Given the high prevalence of PD in the US population, with nearly 80 percent of individuals over sixty-five years of age affected, there is a need for increased attention to the potential relationship between oral and systemic diseases. Unfortunately, PD is often underdiagnosed and not referred for proper management at an early stage.
To maintain periodontal health, it is crucial to practice effective home self-care, including regular tooth brushing, the use of interdental aids such as dental floss, and mouthwash for plaque control. Oral hygiene advice and removal of risk factors, such as calculus, which requires professional periodontal instrumentation (PI), are necessary for the prevention and treatment of periodontal disease. In some cases of PD, when tissue regeneration is desired, laser therapy and gum surgery may be considered as treatment options.
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