Different types of problems affect different parts of the teeth, and there are specialties that deal with the various areas. Periodontics is one such specialty, which primarily deals with the periodontium. This is the structure that supports the teeth by attaching them to surrounding tissue. The periodontium allows the sensations of pressure and touch. The term comes from two Greek words that mean “around” (peri) “tooth” (odons).

Periodontics deals with inflammatory diseases that affect the structures supporting the teeth such as the gums. The dentists who specialize in these problems, who are known as periodontists, receive extensive training on these areas, including the latest methods of diagnosing and treating associated problems as well as performing cosmetic periodontal procedures.

This branch of dentistry concerns four main parts:

• Gingiva, which is commonly known as the gum
• Cementum that covers the root of tooth
• Alveolar bone that contains the sockets of the teeth
• Periodontal ligament that attaches the cementum to the alveolar bone

Causes of Periodontal Diseases

The mouth is full of bacteria that generally combine with mucus and different particles to form a colorless, sticky substance known as plaque. The bacteria in the dental plaque typically cause periodontal diseases. Bacterial infections usually affect the gum first. If the gum infection is not treated, the problem spreads to the periodontal ligaments and eventually reaches the alveolar bone. The problem gradually erodes the bone, leading to loose teeth that finally fall off.

The first stage affecting the gums is known as gingivitis, the second involves gum recession and moderate periodontitis and the third stage involves advanced periodontal disease and bone loss. The conditions range from gum inflammation to serious problems that cause significant damage to both connective tissue and bone, which sometimes lead to loss of teeth.

Risk Factors

• Some diseases and treatments: Treatments of diseases like cancer and AIDS negatively affect gum health. AIDS itself also affects the gums, and diabetes makes it easier to develop different infections like gum disease.
• Medications: Some medicines lead to overgrowth of gum tissue, which makes it difficult to properly clean the teeth and gums.
• Smoking: Smoking does not only lead to the development of gum disease but it also interferes with the treatment process.
• Hormonal changes in females: The hormonal changes that women and girls experience can lead to more sensitive gums that can be easily affected.
• Genetics: Some people are naturally more susceptible to developing gum disease than others.

Signs of gum disease do not usually show until people reach their thirties or forties, with men being at a higher risk than women. Teenagers typically develop gingivitis.

Periodontal Treatments

The treatments include:

• Non-surgical treatments
• Laser treatment
• Gum graft surgery
• Dental crown lengthening
• Regenerative procedures
• Pocket reduction procedures
• Dental implants
• Plastic surgery procedures

Non-surgical treatments include tray delivery systems, scaling and root planing. Scaling and root planing involves the removal of plaque and tartar (hardened plaque). Many patients do not need further treatment after this procedure although some will need ongoing maintenance. Some patients need tray delivery systems that are custom-made from the impressions of a patient’s mouth. The trays help the patients to deliver prescribed medications at home.

Although periodontal treatments should ideally be achieved using the least invasive methods, some cases require different types of surgical treatments. These include flap surgery and grafts of the bone and tissue.

It is important to treat periodontal problems early considering that some studies have associated gum disease with other health problems like poor control of blood sugar, heart complications and birth problems.

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