Gum care and Periodontics

• Recover the good health of the gums
• Eliminate bacterial plaque, the main cause of the appearance of gum disease
• Carry out a complete and thorough dental cleaning that serves to prevent the appearance of future infections that can lead to periodontitis
• Avoid the destruction of bone tissue caused by periodontitis
• Eliminate bad breath.

Gum or periodontal diseases are a leading cause of tooth loss in adults. Unfortunately, periodontitis often shows no symptoms until it has advanced considerably, earning it the nickname “silent killer of teeth.” Regular dental visits are crucial for maintaining healthy gums and for the early detection and treatment of any issues.

The initial stage of gum disease is known as gingivitis. As periodontal disease progresses, it leads to more serious issues, including symptoms like a persistent bad taste, loose permanent teeth, or teeth that are nearly falling out, as well as changes in how your teeth align when you bite. Inflammation and bleeding gums are common and caused by bacteria, but in chronic cases, the prolonged presence of bacteria and gum inflammation can result in bone loss. This causes the gums to recede, exposing the root and making prompt treatment crucial. In such cases, only a specialist can halt the progression, potentially stabilizing the loose teeth and preventing further loss.

Gingivitis is a mild form of gum disease in which inflammation is limited to the gums.

Periodontitis is a bacterial infection affecting the gums and the bone that supports your teeth (the periodontium). It typically develops when gingivitis is left untreated, allowing the infection and inflammation caused by plaque buildup to spread from the gums to the ligaments and bone beneath the gums that hold the teeth in place.

Periodontitis can cause pain, sensitivity, and significant discomfort, but often there are no noticeable symptoms. Unfortunately, if left untreated, it can damage the bone surrounding your teeth, leading to looseness and mobility of the teeth. In severe cases, periodontitis can result in tooth loss.

• Red or swollen gums
• Bleeding when brushing and flossing
• Sore or tender gums
• Gum recession
• Bad breath

Before addressing any periodontal issues, it is essential to have a complete understanding of the situation. A thorough examination is necessary, during which we will assess all areas around your teeth.

The most common and effective treatment for periodontal disease is Dental Scaling and Root Planing. Dental Scaling involves removing hard build-up, known as calculus, from the surfaces of the teeth and roots. These areas are difficult to clean with regular brushing.

There are three primary classifications of periodontal surgeries: gingival flap surgery, mucogingival surgery, and osseous surgery.

The first type of periodontal surgery is gingival flap surgery, commonly known as gum lift surgery. This procedure recontours the gums to enhance the appearance of the smile and includes both gingivoplasty and gingivectomy. Dentists often use these terms interchangeably, as they involve similar techniques but serve different purposes.

Gingivoplasty is performed to reshape the gum tissue and remove diseased soft tissue from the periodontal pocket walls. Gingivectomy, on the other hand, is used to reshape gums that have lost their normal structure, involving the removal of not only the diseased tissue but also the entire affected portion. This procedure is often done to correct a gummy smile, remove excess tissue due to enlarged gums (gingival hyperplasia), or lengthen the crown of a tooth in preparation for a restoration.

Mucogingival surgery is a more complex type of periodontal surgery, typically used for advanced gum disease, especially when exposed root surfaces require coverage. This procedure is also recommended for patients with removable dentures, primarily to deepen the oral vestibule and reposition the frena. The oral vestibule is the space between the lip/cheeks and teeth, while frena (singular: frenum) are small bands of tissue in the lip and cheek area.

Mucogingival surgery includes several techniques, such as the apically-repositioned flap, replaced flap, laterally-repositioned flap, free gingival graft, and frenum repositioning.

Osseous surgery, like mucogingival surgery, is a treatment for advanced periodontal disease that focuses on managing the damage caused by gum disease. As the name implies, it involves manipulating bone tissue, particularly reshaping or restoring it to its ideal form. The underlying principle is that resolving periodontal disease is possible if the bone and gums have matching contours.

Osseous surgery includes subtypes, such as bone reshaping/resectioning procedures and bone stimulative procedures. Bone reshaping procedures, including osteotomy and ostectomy, are used to correct bone defects and restore normal bone contours. Osteotomy reshapes the bone without removing it, while ostectomy involves the removal of some bone.

Undergoing periodontal surgery can help restore gum health and prevent the spread of infection throughout the body. Without treatment, gum disease can lead to serious health issues. Restoring gum health can prevent tooth loss and make you a good candidate for dental implants. If the surgery is for cosmetic purposes, it can enhance your smile and boost your confidence.