Gum Surgeries

Gum is gingival fibers (soft tissue) surrounding neck of the teeth. Inflammation of gums (red and spongy, pain on pressing) / gum disease may lead to loss of bone surrounding the teeth and hence cause tooth-ache.

Causes of Gum Inflammation / Disease
(A) Mainly caused by plaque (bacterial film over soft deposits lodged mostly on inter-dental surfaces). Plaque with course of time gets calcified (tartar) and lacerates gum tissues.
(B) The other causes are-tobacco use, diabetes, certain medications, mal-aligned teeth, pregnancy, defective fillings and poor oral hygiene.

Symptoms of Gum Disease
Early symptoms include bleeding gums while brushing. It maybe without pain. Pain is there in advanced stage when there is bone-loss around the teeth leading to gum (periodontal) pockets. These gum pockets provide room for food lodgment over which the bacteria acts, causing gum inflammation, pain and further loss of supporting bone. With the result, teeth sometimes become shaky (mobile) and can shed-off leading to loss of otherwise healthy teeth.

If early symptoms are ignored or left untreated the condition may further deteriorate leading to destruction of tooth supporting tissues, e.g., periodontal ligament. It reaches a condition known as periodontitis. At this stage teeth are unable to take food (masticatory) pressure. Gums start bleeding with sometimes pus formation (pyorrhoea), resulting in bad breath (foul smell) from the mouth.

1. Non-Surgical Treatment This involves:

(A) Scaling and Polishing of teeth: With this procedure, supra-gingival (above gum margin) plaque / tartar accumulated around the teeth are removed.

(B) Root planning (sub-gingival scaling or deep scaling): After supra-gingival scaling the rough surfaces of the roots are smoothened, allowing gum healing and reattachment to the teeth.

(C) Curettage: Removal of plaque and infected tissue from gum pocket walls.

Surgical Treatment
Flap Surgery
In severe gum inflammation, there will be alveolar bone-loss (on which teeth rests). In Flap surgery, gum is retracted from the teeth to remove the diseased tissue. Bone is contoured, reshaped and allows re-generation of healthy bone and gums.

Latest surgical techniques for the treatment of periodontal pockets and subsequent bone-loss are:
(A) GTR (Guided Tissue Regeneration)
(B) GBR (Guided Bone Regeneration) Grafts

- Proper brushing and flossing.
- Incorrect brushing will miss some spots in mouth leading to bacterial accumulation of high levels which will cause gum inflammation or gum disease.
- One must make a conscious effort to brush every single tooth.

It is usually advised to people prone to food lodgment in inter-dental spaces due to crowding of teeth or irregular (mal-aligned) teeth. Brush cannot reach these surfaces, thus these areas are deprived of good cleaning. Inter-dental flossing is recommended to remove soft deposits from such surfaces, thus stopping bacterial accumulation and preventing gum disease.




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