- January 13
Gingival disease includes a group of inflammatory diseases caused by bacteria, which is capable of superficially damaging gingival tissues (Gingivitis) or penetrating deeper to include osseous tissues and ligaments (Periodontitis) and can potentially lead to tooth loss if left untreated.
The accumulation of plaque and calculus caused by inadequate oral home hygiene, or the absence of or infrequent professional cleanings, are the leading cause for gingival disease. Smoking is also included as an important risk factor for disease development.
A few systemic diseases, first and foremost, Diabetes, are able to significantly increase the risk of developing gingival disease.
The genetic make up of a patient may also be a determining factor and make him or her more vulnerable to gingival disease. Patients with a family history of tooth loss or gingival problems are potentially at greater risk for disease development.
In the presence of Gingival Disease the gum tissues may appear swollen, red, and may by more prone to bleeding. In some cases the patient may also present with halitosis (bad breath) and repeated episodes of gingival abscesses. In advanced stages of the disease the teeth become mobile and can migrate from their original position leaving open gaps between teeth or extruded teeth, which can create esthetic problems. Pain is usually not associated with the disease, if not in the terminal stages, and this characteristic renders the disease even more detrimental because it is often left untreated.
Having identified the accumulation of plaque and calculus as the primary cause of gingival disease, initial therapy begins with a scrupulous deep cleaning of the crown and root surfaces of the teeth.
During this non-surgical therapeutic phase, otherwise known as Initial Therapy, the goal of treatment is the elimination of the causes of gingival disease. The patient is instructed in home oral hygiene and is given cleaning strategies and instrumentation recommendations most suitable to his/her situation. Lifestyle modifications may also be suggested at this time in order to maintain a healthy mouth.
In more advanced cases, following Initial Therapy, Surgical Therapy may be indicated and finalized at obtaining a more harmonious form and position of hard and soft tissues in order to render them less vulnerable to further bacterial attack. This phase of therapy, defined as Corrective Therapy, is a correction of osseous and gingival lesions previously caused by the disease.
The key to obtaining long-term success following therapy is the patient’s commitment to periodicalfollow up care. Patients are encouraged to strictly follow regular check ups and professional dental cleaning at specified and individualized recall intervals by both the dental hygienist and the gum specialist (Periodontist). This phase of therapy is defined as Maintenance Therapy.
When the retraction of the gingival tissues uncovers the roots of one or more teeth it can create esthetic problems able to compromise a patients smile. These recessions are also able to create areas of increased tooth sensibility and in severe cases put the tooth/teeth at risk for being lost. Another common problem in patients with gingival recession is an increased difficulty in their ability to properly clean these areas rendering them more susceptible to plaque and calculus accumulation and thus more vulnerable to the progression of gingival disease.
These gingival lesions more or less localized, may be the result of infection or trauma or both, and can be resolved in office through Periodontal Plastic Surgery.
These surgical procedures have evolved over the years and are continually becoming less and less invasive (meaning less patient discomfort), and have increasingly improved results (better outcomes more frequently).