Periodontology (Gum) Treatments

Periodontal Diseases

Periodontology is the dental specialty that focuses on the diagnosis and treatment of diseases affecting the gums, connective tissues, and jawbone surrounding the teeth. The term “periodontal” means “around the tooth,” while “gingiva” refers to the gums.

Gum diseases are mainly classified as gingivitis and periodontitis. According to the 2017 World Workshop on the Classification of Periodontal Diseases, these conditions are defined based on their severity, extent, and rate of progression using scientific criteria.

 

1. What is Gingivitis?

Gingivitis is the early and reversible stage of gum disease. At this stage, the gums may become:

·         red and swollen

·         sensitive

·         prone to bleeding during brushing or chewing

At this point, there is no bone loss.

Gingivitis is most commonly caused by bacterial plaque accumulation and inadequate oral hygiene. With proper treatment and regular oral care, the gums can return to a healthy state.

Smoking may mask bleeding symptoms by affecting blood circulation; therefore, gum disease may go unnoticed for a long time in smokers.

 

 

 

 

 

Factors that increase the risk of gingivitis include:

·         diabetes

·         tobacco use

·         hormonal changes (e.g., pregnancy)

·         stress

·         nutritional deficiencies

·         weakened immune system

·         certain medications

·         genetic predisposition

 

2. What is Periodontitis?

If gingivitis is left untreated, it may progress to periodontitis. In this stage:

·         gum and connective tissues are damaged

·         destruction of the supporting bone begins

·         the gum detaches from the tooth, forming periodontal pockets

As pocket depth increases, teeth may become loose and, in advanced stages, tooth loss may occur.

 

Periodontitis: Stage–Grade System

Stage describes disease severity and extent of bone loss. Grade indicates the rate of progression and risk factors.

Risk-enhancing factors include:

·         smoking

·         uncontrolled diabetes

·         significant bone loss at a young age

·         history of periodontal disease

This system helps evaluate both the current condition and future risks.

 

Periodontitis Associated with Systemic Diseases

In some individuals, periodontitis may be associated with:

·         diabetes

·         immune system disorders

·         certain cardiovascular and respiratory diseases

In such cases, the disease may appear at an earlier age. This condition is classified as periodontitis associated with systemic diseases.

Necrotizing Periodontal Diseases

These conditions are characterized by tissue necrosis, severe pain, bleeding, and bad odor. They are more commonly observed in immunocompromised individuals, patients with nutritional deficiencies, and HIV-positive patients, and they require urgent treatment.

 

3. Risk Factors for Gum Diseases

Although bacterial plaque is the primary cause, the following factors may accelerate disease progression:

·         smoking and tobacco use

·         diabetes

·         genetic predisposition

·         stress

·         certain medications

·         teeth grinding or clenching

·         poor nutrition and obesity

·         immune system disorders

·         advanced age

 

4. Symptoms of Gum Diseases

·         gum bleeding

·         redness, swelling, tenderness

·          recession

·         spacing and mobility of teeth

·         bad breath

·         pus discharge from the gums

·         ill-fitting dental prostheses

The presence of even one of these symptoms requires a periodontal examination.

 

5. Prevention of Gum Diseases

·         regular tooth brushing

·         interdental cleaning (dental floss/interdental brushes)

·         use of mouth rinses recommended by the dentist

·         control of risk factors

·         dental check-ups every 6 months

Untreated gum diseases may lead to bone and tooth loss and can negatively affect systemic conditions such as diabetes and cardiovascular health.

 

6. Gum Diseases and Systemic Health

Scientific studies show that periodontal inflammation may be associated with:

·         diabetes

·         cardiovascular diseases

·         respiratory infections

·         osteoporosis

·         certain types of cancer

Maintaining gum health is therefore essential for overall health.

 

7. Treatment Methods

Non-Surgical Periodontal Treatment

 

·         removal of dental calculus and bacterial plaque

·         root surface debridement (scaling and root planing)

·         local or systemic adjunctive therapies when necessary

 

Surgical Periodontal Treatments

·         access flap surgery and removal of infected tissues

·         correction of irregular bone contours

·         regenerative procedures

Long-term success of treatment requires the patient to maintain consistent oral hygiene.