The gum is one of the tissues surrounding the tooth. Tissues surrounding the tooth are known as periodontium (Latin periodontium), lending the branch of dentistry dealing with periodontal diseases the name periodontics.
Structure and physiology of the periodontium is shaped during teething. It is then that we see the formation of the epithelial attachment, the connection between the tooth enamel and cutting of the gingival epithelium around the neck of the tooth. The epithelial attachment constitutes the bottom of the gingival sulcus, commonly called the gingival pocket.
Fusion of the gingival epithelial with the crown enamel is present in the area of the neck of the tooth for about 25-30 years. It then starts to slowly recede to the root apex. As this occurs, there is a loss of bone mass in the alveolar process and waekening of the gums. It is a so-called “senile” loss of periodontium, in the sense that, very slowly though steadily, the necks of teeth become exposed, followed by the roots. This can result in a reduction or absence of sensitivity to stimuli, lack of circulation to the gums and loosening of teeth.
Between the gum and the tooth crown, there is a recess called gingival pocket, which is shallow (about 1 mm deep). Bacteria accumulate in it, which if not removed regularly, can cause inflammation of the gums or tooth decay near the gumline.
Healthy gums are pale pink in colour and never bleed. However, due to failure to clean the teeth properly, one may suffer from gum inflammations. They are then red, painful, and bleed easily.
More than half the world’s population is at risk of gum disease, usually without being aware of the fact. Gum diseases are usually difficult to detect, and are often the main cause of tooth loss after the age of 35. In the very early stage of periodontal disease, gums become inflamed (gingivitis), following which there is a change in the bone of the alveolar process, which is referred to as periodontitis. According to the common idea, this type of disease cannot be helped – they come with age like wrinkles, and one has to learn to live with them. However, progress in the field of dentistry, has proven this not to be true.
Periodontal diseases, similarly to cavities, are caused by bacteria accumulated on the teeth in the form of biofilm (plaque). In their first phase they cause inflammation of the gums, evidenced by slight redness, swelling and bleeding.
A periodontal disease
A periodontal disease causes teeth to gradually loosen, causing then to tilt and move. Spaces are created between teeth which were not present before. A patient with inflammation of the gums may feel discomfort in the form of tingling, numbness or gum pain. Sometimes, periodontal diseases develop unnoticed and can only be detected during an accidental X-ray.
Treatment of periodontal diseases
If you keep having bad breath accompanied by a bad taste in the mouth, your gums are red, swollen and bleed easily, and you tend to notice blood when brushing and chewing hard foods, visit your dentist as soon as possible. A specialist will select a treatment appropriate for the severity of the disease.
Treatment of periodontal disease has to be carried out in several stages – necessarily in cooperation with visit to the dentist. However, the most important role in treating such ailments is played by the patient themself, dutifully performing a doctor’s recommendations. These recommendations are not always easy to meet. Sometimes it happens that a patient has to have a tooth removed or a complex surgery needs to be carried out. In the treatment of periodontium, the patient needs to show a lot of perseverance and belief that all actions taken will lead to combating the disease.
When this form of the disease is acute, appearing suddenly, the healing process takes a few weeks. During this period, the doctor first tries to remove any acute pain and infection, then removes plaque and tartar, and finally instructs the patient in the correct method of brushing (cleaning) teeth. The disease passes, but whether it does forever – again it depends on the patient, their persistence and consistency.
Saving loosened teeth is extremely tedious. If there is no other option, a surgery is performed, during which pathological pockets with purulent exudates are cut. Then, the exposed roots and alveolar process bone are cleaned, and in exceptional cases – when bone loss is significant – the dentist uses materials enabling restoration of the periodontitium. Although surgery removes disease, it does not rule out its recurrence. Moreover, once destroyed gums never grow back.
Therefore, the recipe for healthy gums is systematic monitoring of the state of dentition ensuring accurate removal of these fragments of biofilm and tartar, which – in spite of good oral hygiene – we could not avoid.