The gums are also called the gingiva. These are firm fibrous tissue connected to the jawbone. They are considered healthy when they are at least 1 mm thick with a good blood supply. Along with age, they decrease slightly and expose more surface of the tooth. Inflammation of gums is known as gingivitis. This condition is caused due to bacterial infection in the gums. Gingivitis is the first stage which may further lead to periodontal disease or gum disease. If not treated in time it may result in tooth loss.
The term implies bacterial growth and generation of conditions that, with time, destroys the tissue around the teeth. "Periodontal disease" is another term for this state. Plaque keeps forming on the surface of teeth due to the presence of bacteria which further causes gum disease. If plaque remains on the surface of the tooth for more than 24 hours, it is transformed into tartar or calculus. Tartar is strongly bonded with the teeth and can be removed only by professional cleaning. Gum disease occurs in two stages: gingivitis and periodontitis. Generally, the former precedes the latter.
Gingivitis is the first stage of gum disease. Food debris, mucus and bacteria form a sticky material which gets deposited on the exposed parts of the tooth. If this material is not cleared from the tooth, it may lead to tooth decay. If adequate plaque control is done, gingivitis can be reversed. By proper treatment from a dentist, coupled with adequate brushing and flossing at home, gingivitis can be cured.
If gingivitis is not treated properly, it may lead to periodontitis. The word "Periodontitis" means diseased condition surrounding the tooth. "Peri" means surrounding or around and "odontos" means tooth. Moderate periodontitis can be considered as the first level of periodontitis which in worse condition enters the advance level.
● Moderate Periodontitis
This is a low-grade gum infection. A superior grade toothbrush cannot control this disease due to the large quantity of calculus. Bacteria in this calculus creates waste products. These products have toxins and volatile sulfur compounds. The toxins destroy the bones and gums surrounding the teeth. The inner layer of the gum and bone move away from the tooth surface. A pocket is formed between the teeth and gums. In this space, debris may get stored. The plaque spreads. It grows below the gum line. The space in healthy gums is up to 3 mm deep. If this increases to 5 mm, it is called "moderate periodontal disease". As the disease increases, the pockets become more deep. Due to this, more gum tissue and bone are affected. As a result, the teeth become loose gradually and finally there is loss of the affected tooth.
The volatile sulfur compounds caused by bacteria leads to bad breath. Sometimes teeth look healthy, but pockets might be present. These can be detected by x-rays and periodontal probing. The periodontal probe measures the pocket depth around every tooth. Generally, periodontal disease is not limited to one tooth. It affects several teeth simultaneously. If the dentist finds that the depth of the pockets has decreased to 1-3 mm after some treatment, it is concluded that the Periodontitis is under control.
● Advanced Periodontitis
This condition is said to occur if the depth of the pockets becomes more than 6 mm. Then, surgery is unavoidable. The surgery can be performed by a dentist or a periodontist. During the surgery, the diseased tissue is removed and the tooth structure is completely cleaned. This makes it difficult for plaque and calculus to gather. In case the disease has led to a defect in the bone, the area has to be reshaped or a bone graft procedure is necessary. The gums have to be stitched around the teeth in a proper place and generally lower than before. Further, if daily brushing and flossing is done, the region can be freed from plaque.
This is also called "periodontal abscess". It usually occurs amongst people who have periodontal disease that has already caused bone loss around the root of the tooth. The gum is separated from the base of the tooth which allows the bacteria to enter deep root from where they are very difficult to clean. The bacteria in the periodontal pocket alter with time and more destructive species may replace the earlier ones. The byproducts of these bacteria can dissolve more bone. The gum abscess can become worse, if there is pus formation and this pus is trapped under the gum. This infection can spread towards the ear or neck or below the lower jaw. Even opening the mouth may become difficult due to the swelling and inflammation.
Sometimes, there is a conspicuous swelling around the tooth. If the gum is pushed by a finger, there is a pain. If the region is probed, blood and pus ooze out. At times this abscess can burst and cause pus to drain. This causes some relief. There are two types of gum abscess. An acute one is accompanied by pain, swelling and fever. A chronic one can be painless and the person is unaware of its formation in the jawbone. The area of infection is surrounded by a fibrous sac (granuloma) that does not contain pus, but has non-infectious sterile tissue. Such abscesses are detected by X-rays.
Symptoms of Gum Disease
Though gum disease has been divided into various stages, symptoms of all the stages are almost same. Following are some of the signs and symptoms which will help you to identify the disease better and faster.
- Discoloration of gums. Gums may appear red or reddish purple
- Bleeding gums, generally while eating something hard like apple, brushing, using dental floss, etc.
- Swollen gums. Swelling may subside on its own but is recurring
- Bad breath and metallic taste in mouth
- Receding gums, which make the teeth look longer or larger
- Extra space between the teeth
- Gums may become tender to touch
- Formation of deep pockets between the gums and the tooth (not found in the gingivitis stage)
- Tooth loss may be one of the major symptom or concern in the advanced periodontitis stage
Treatment of gum disease totally depends upon the seriousness of the infection. Antibiotic treatment can be given if there is a minor infection. It can be non-surgical or surgical treatment.
Non-Surgical Treatment: After going through the tests to find out the exact cause of the infection, first and foremost thing is dental cleaning. Dentist will remove the plaque from the tooth. Deep-cleaning may also be done which will include scaling and smoothing of the surface. This will give your gums a clean and smooth surface to bind again with the tooth.
Surgical Treatment: Surgical method will be used only in case of serious conditions where the roots and tooth are severely infected. Flap surgery or pocket reduction, soft tissue grafts, bone surgery, bone grafts, guided tissue generation, etc. are some of the surgeries which may be recommended according to the severity of the condition. Some drugs may also be prescribed along with surgery to reduce pain and to stop the regrowth of bacteria.
Hope this Buzzle article helped you to understand about various stages of gum diseases. Brush your teeth with soft bristle toothbrush, twice a day. Flossing before brushing will help you to clean all the food particles stuck in between the teeth. Good oral hygiene and regular dental check-up will help you to avoid gum disease and other infections.