Gum disease (Gingivitis and Periodontitis)
Gum disease is described as swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.
Gingivitis-
Gingivitis-
Gingivitis refers to ‘inflammation of the gums'.Signs and Symptoms:
·
Colour-
red
·
Contour-
loss of stippling
·
Consistency-
swollen (inflamed gums)
Types of Gingivitis
Gingivitis
can be classified according to distribution (localised, generalised, marginal)
or duration (acute or chronic) or causes as follows:
1.
Hormonal gingivitis, which includes pregnancy
gingivitis and pubertal gingivitis
2.
Acute Necrotising Ulcerative
Gingivitis (ANUG),
caused by poor oral hygiene, stress and smoking. It is characterised by painful
papillary, yellowish-white ulcers, which bleed easily.
3.
Drug-induced hyperplastic
gingivitis, from
long term use of anti-epileptics and certain antihypertensives
Periodontitis
Long-standing gingivitis can turn into periodontal disease. Inflammation
of the periodontium, characterised by progressive loss of attachment and
destruction of periodontal ligament and alveolar bone
Types
Periodontitis
can be classified according to distribution (localised or generalised), onset
(pre-pubertal periodontitis and juvenile periodontitis) or severity as:
1. Mild
Periodontitis:
localised alveolar bone loss of 2mm or less, pocket depth of 3-5mm
2. Moderate
Periodontitis:
alveolar bone loss of 3-5mm, pocket depth of 4-6mm, mobile teeth
3. Advanced
Periodontitis: major
destruction of attachment and alveolar bone, with alveolar bone loss of more
than 5mm, pocket depth exceeding 6mm and greater tooth mobility.
The cause of gum disease
The
main aetiological factor in most forms of periodontal disease is plaque, a firmly adherent mass of
bacteria. Persistent plaque accumulation for more than 2 weeks, leads to
formation of calculus (tartar),
which consists mainly of mineralised, dead bacteria and a small amount of mineralised
salivary proteins. Calculus formed above the gingival margin is called supragingival
calculus, while that formed below
the gingival margin is called subgingival calculus. Newly formed calculus is light yellow. It is
easily stained dark by foods, tea and tobacco. Calculus is most frequently
found close to the openings of the major salivary glands (at the lingual
surface of the lower anterior teeth and at the buccal surface of the upper
posterior teeth). Calculus cannot be removed by tooth brushing. Calculus
is not a disease per se.
However, its presence can make cleaning the teeth more difficult.
Effects of smoking on gums and teeth-
People who smoke are more likely to produce bacterial plaque. The gums are affected because smoking causes a reduced supply of oxygen in the bloodstream, so the infected gums don't heal. Smoking causes people to have the gum disease to get worse more quickly than in non-smokers.
Prevention
1.
Effective
oral hygiene: brushing twice a day, after meals, with a fluoridated toothpaste,
or use of chewing sticks in places where toothbrushes and toothpastes are
unavailable or unaffordable.
2.
Avoiding
risk behaviours like smoking
3. Control
of systemic diseases like diabetes
Treatments of gum diseases
Scaling
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