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Gum Disease Stages

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Gum disease overview, gum disease etiology, gum disease symptoms

Stages of gum disease characterized by the progression of the disease. It starts with the inflammation of the gum - gingivitis -and progresses to the next stage  -periodontiis. Depending on the bone loss the periodontitis divided in stages. Click here to read more about stages of gum disease.

The most important step in prevention and treatment of gum disease is home oral hygiene. As the bacteria and its byproducts, contained in dental plaque is the cause of the gum disease, the home care evolves as the most important weapon in gum disease treatment. Click here for more information on home care.


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Gum disease or periodontal disease is the inflammation of the tissue supporting and surrounding the tooth. It affects the connective tissue and bone thattoothdiagram.gif supports the tooth in its socket. In order to successfully treat periodontal disease or gum disease we have to understand the normal anatomy and the causes of the disease.
 

Normal anatomy

The teeth are held in the mouth by the root, which is embedded in your jawbone. Teeth are supported  by hundreds of thin “elastic threads” called periodontal ligament. One end of ligament is connected to the side of the tooth root, another to the  the bone inside the tooth socket. The tooth "hangs" in the bone, suported by hundreds of these ligaments. The bone is covered by the gum, also called gingiva, which is attached to the bone thru periosteum. The top part of the gum (gingival crest) next to the tooth is not attached forming a little pocket, which should measure aboit 1 mm in the healthy individual and tightly hug the tooth. The color of the healthy gum is light pink, it is firm, doesn't bleed 


 Causes of gum disease ( etiology )
 
Our mouth is always populated by bacteria, even in the healthy individuals.  It takes a 24-hour period for these harmless bacteria to turn pathogenic and cause periodontal inflammation.  This inflammtion will lead to gum disease.

 If the teeth and gums are not properly cleansed, then the remaining bacteria along with the food remnants will build on the tooth and below the gum. This bacterial build up is called plague. Bacterial plaque, a sticky, colorless film that constantly forms on your teeth, is the main cause of gum inflammation and periodontal disease. Plaque is not just food debris. it contains millions of bacteria and very toxic in its nature. As plaque builds, it becomes calcified and hard and dental calculus (tartar) appears, depositing on the teeth. Tartar build up spreads below the gum, destroying bone and ligaments supporting the tooth.
Dental pockets (periodontal pockets )start to develop.

probe1.jpgThe pockets (empty space defined by the root of the tooth, the level of the bone and the top edge of the gum) appear. These pockets trap the bacteria and plaque, and are the perfect incubators for it, leading to the progression of gum  disease and gum disease.


The deeper the pockets, the harder for you to clean out the food debris. More plaque builds up, leading to more tartar and calculus, the bacterial count in hundreds of millions, gum inflammation progresses.

As a responce to gum inflammation your body starts to produce special enzymes in response to the bacteria to combat the onset of gum disease. These enzymes are trying to fight the bacteria, but along with bacteria it also starts to destroy the bone surrounding the teeth.

X-ray showing calculus and bone lose on both left and right sides of the mouth

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Gum disease symptoms

Gum disease symptoms include

  • Bleeding gums during brushing
  • Red, swollen or tender gums
  • Bad breath or bad taste in the mouth
  • Tartar or calculus build up on the teeth
  • Receded gums, teeth may look elongated
  • Discharge from the pockets around the teeth
  • Teeth that seem loose or have changed position
  • Teeth that are sensitive to cold or hot
  • Changes in your bite or the way they fit

Please view gum disease stages for more information


Gum pockets serve as a trap and incubator for the bacteria. Dentist's goal in treatment of gum disease is the elimination of dental pockets. The Scaling and root planing procedure, followed by periodontal maintenance, is used as the the most important and first step in office treatment. Along with deep cleaning the use of different medicaments help to achieve the desired goal. In more advanced stages of the periodontal disease surgical approach may be needed and gum surgerymay be recommended. None of these will help unless proper home care and home oral hygiene is maintained by you.  

Ask your dentist or hygienist for customized oral hygiene instructions. Oral home care is the most important step in prevention and treatment of gum disease. Your dentist would not be able to help you if you don't help yourself