Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care. Some of the factors that may contribute to gingivitis include:
- genetic predisposition
- systemic diseases and conditions
- inadequate nutrition
- hormonal fluctuations
- substance abuse
- HIV infection
- certain medications
Gingivitis can advance to periodontitis, and if left untreated can eventually lead to tooth loss and other health problems. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. If the condition is left untreated the disease process can worsen causing several teeth to become loose and may have to be removed.
There are many forms of periodontitis. The most common ones include the following:
- Aggressive Periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
- Chronic Periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid
progression can occur.
- Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
- Necrotizing Periodontal Disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.
TYPES OF TREATMENT
1) NON-SURGICAL THERAPY
Scaling and Root Planing / SRP / Deep Cleaning
A careful & thorough removal of plaque and calculus [tartar] from the root surfaces treating deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing will often be followed by adjunctive therapy such as local delivery antimicrobials, as needed on a case-by-case basis. Many patients do not require any further advanced surgical procedure, however, the majority of patients will require ongoing maintenance therapy to sustain optimal periodontal health.
This is very important aspect of periodontal treatment. This requires team work between the dental team and the patient. After the initial treatment, perio maintenance is imperative to maintain oral condition in good health to prevent the gum disease from recurring.
2) SURGICAL THERAPY
The advanced periodontal condition may further require advanced surgical procedure and depending on the complication of the condition may require treatment by specialist.