Gum Diseses-Causes and Prevention

It is a disease of a soft tissue and bone which surrounds the teeth .it occurs due to prolonged exposure of a plaque and calculus .these plaque and calculus have a bacteria which releases toxin products and causes inflammation of a soft tissue .if it is left untreated it leads to severe inflammation of soft tissue and bone loss around the teeth .so that teeth becomes mobile very early in those patients.

Etiology

• Accumulation of plaque and calculus [due to improper oral hygiene habits ]
• Tobacco and betel nut chewers.
• Woman at the time of pregnancy and puberty [due to hormonal changes in body ]
• Genetics [due to mutations in a genes ]
• Medication [use of oral contraceptives and anti depressants ]
• diabetes
• bruxism habit (night grinding habit of teeth)

Smoking: tobacco smokers are increased risk of disease compared to non smokers. Smoking increases the thickness of plaque and calculus at a cervical areas and below the cervical line in a sub gingivally .it is difficult to remove this rigid calculus in a tobacco smokers in a daily brushing techniques .it has to be removed by a professional at a dental office .smoking stains the tooth and causes soreness of mouth .it increases melanosis of oral soft tissue and causes smokers melanosis. puberty and pregnancy in woman's: woman at a time of puberty ,pregnancy and menopause hormonal changes takes place in a body in all the tissues even gums in a oral cavity .women’s at this stage are more susceptible to gum disease. Stress: stress is a main thing it causes many health problems .people those who are feeling stress have a reduced capacity of host fighting against infectious agent’s .so disease may advance in to periodontitis. diabetes: diabetic patients have a reduced production of insulin in a body so there may be increased glucose(sugar) levels in a blood .sugar acts as a media for bacterial growth and multiplication .so disease severity rapidly takes place in those patients. Nutrition: lack of nutrient supplements reduces the host defense mechanism and progress the periodontal disease. Medication: there are many drugs which causes gingival hyperplasia mainly a) Anticonvulsant drug: phenytoin. b) Immunosuppressive agent: cyclosporine. c) Calcium channel blocker: nifidipine Oral contraceptives and antidepressants also causes gingival hyperplasia . gingival hyperplasia associated with wegners granulomatosis ,sarcoidosis ,cron's disease. genetics: inherited disorder from parents to their children’s through genes .so persons with inherited genetic traits from their parents are more prone to disease.

Symptoms:

sign: gingiva becomes red ,swollen and tender on touch often pain. patient experiences bad breath from a mouth.

• bleeding gums while brushing
• Itching sensation in gums
• gingival recession (sensitivity may occurs due to exposure of a root portion of a teeth.)
• Severe bone loss around the teeth (mobility of a teeth)
• Severe bone resorption takes place (results in to difficulty to wear a dentures )

Gum pain: inflammation of gingiva due to pathogenesis of bacteria .it causes pocket formation, and loosening of teeth. so patient experiences pain. Pain can be reduced by reducing the inflammation. Gingival recession: inflammation of gingiva causes apically shift of a gingiva so root portion of teeth exposes and teeth appears bigger in size. If the inflammation is localized only some teeth are affected .if it is generalized complete gingival recession is seen. All teeth appear bigger in size due to exposure of a root portion of teeth. Bone loss: bone loss is an advanced stage of disease if the gingival inflammation if it is untreated diseases progress and severe bone loss takes place. it is not visible clinically but bone loss can be seen in a radiograph .it reduces support to a teeth and teeth becomes mobile. If the inflammation is localized localized bone loss is seen so two are more than two teeth are mobile .if the inflammation is generalized, generalized bone loss around the teeth takes place. so all the teeth in a oral cavity are mobile. Gingival hyperplasia: many systemic conditions like pregnancy puberty and menopause causes gingival hyperplasia .there are many drugs which also causes gingival hyperplasia. Diffuse overgrowth of gingiva it may extends beyond the teeth towards coronally.loss of attachment to teeth. Bleeding gums: patient complaints of bleeding gums while brushing daily .it is a most common sign seen in gingivitis.

Prevention of gum disease:

1 Regular dental check up : patient should visit the dentist of a periodic intervals for every three months and following the precautions which are given by a dentist. 2 Regular brushing: regular brushing with a soft brush in a bass technique twice in a day .it removes the debris and plaque and preventing plaque formation on teeth. Tooth brushes are available as manual and rotary. Rotary tooth brushes are specially designed for handicapped persons. 3 Dental floss: regular dental floss removes the interdentally food lodgment, plaque and calculus deposits .dental floss is made up of a nylon which is soft thread like material .length of the floss is 45 cms (18inches) it should hold between two fore fingers and griped it with a thumb .floss should be pulled in to inter dental spaces very gently. Some amount of bleeding occurs during flossing, if the gingival becomes healthy bleeding stops. 4 oral rinses: salt with water rinses reduces bacterial growth in a oral cavity. It is less economic and available easily .essential oil rinses like thymol, eucaliptol and menthol. Commercially available are chlorehexidine mouth washes it is very effective in reducing plaque and calculus formation. 5 oral prophylaxes: complete oral prophylaxis procedure eliminates supragingival plaque and calculus deposits. Management of gum disease: In a chronic stage it cannot be cured by following preventive procedures but it controls the progression .so it has to be treated by a dentist by giving medication and appropriate surgical procedures. Gum pain : if patient experiencing pain and tender on touch topical application of anesthetic it temporarily relives the pain. Inflammation of gingival is controlled by topical application of ointment (benzocain). Bleeding gums: bleeding gum is controlled by complete oral prophylaxis procedures by ultrasonic scaling. Diabetic patients: Insulin administrations in diabetic patients it controls the blood glucose level and reduces the inflammation of gingiva .in a mild diabetic patient’s topical oral hypoglycemic are given. Gingival hyperplasia: drugs which are causing gingival hyperplasia are nefidipine it is replaced with nemodipine.cyclosporin is replaced with triclosan.stop using the drugs which are causing the gingival hyperplasia (oral contraceptives and anti depressants) .

Procedures at a dental clinic are:

• scaling
• Root planning
• curettage
• Flap surgery

These procedures remove subgingingival infectious agents, creating new attachment and maintaining healthy form of a soft tissue. NOTE: improper oral hygiene habits causes accumulation of plaque and calculus deposits at a cervical areas of a teeth .these plaque and calculus are removed by following regular brushing techniques and dental floss. if oral hygiene procedures are not proper these plaque and calculus containing bacteria extends in to subgingivally.if it is left untreated in advanced stage leads to gum disease .