Gum Disease Treatments

Gingivitis is inflammation of the gums. It is usually a result of dental plaque on the surfaces of the teeth, and it is reversible and is not destructive. With treatment, which focuses primarily on effective oral hygiene, gingivitis can be reversed. Without treatment, however, gingivitis is likely to progress to periodontitis, which can lead to destruction of gum and bone tissue and possibly the loss of the teeth. Gingivitis manifests as any other inflammatory disease would, causing swelling, redness, and pain or tenderness in the gum tissue. Gingivitis may also cause the gums to bleed, especially after brushing or flossing, and it often causes bad breath. When the gums are healthy, in many people, they have a stippled appearance, resembling the texture of an orange peel. When gingivitis is present, this stippling may disappear and the appearance of the gums becomes stretched and shiny. For a plain-language overview, see what gum disease is, and gum disease symptoms lists the signs to watch for between visits.

The tissue of the gums, or gingiva, surrounds the bones in the oral cavity and the teeth. When gum disease is present, it is characterized by a periodontal pocket. Sometimes, gingival pockets are present; these are not indicative of gum disease and are usually reversible by removing or addressing their cause. To understand what gingival pockets and periodontal pockets are, it’s helpful to have a basic understanding of the dynamic anatomy of the periodontium and its associated vocabulary. Two terms that explain location in the mouth are coronal and apical. Coronal refers to the direction of the crown of the tooth, and apical refers to the direction of the base of the root of the tooth. These terms are helpful when referring to teeth in either the upper or lower jaws, since “top” and “bottom” would change depending on the jaw in which the tooth is located. The crescent-shaped crevice of tissue that immediately surrounds the base of each tooth is called the gingival sulcus. The gingival sulcus contains different, and constantly changing, types of cells, food debris, chemicals, and fluid, each of which affects and is affected by the oral cavity, creating a synergistic relationship. The depth of the gingival sulcus is in a constant state of flux, affected by cycles of bacterial invasion in the oral cavity and. Bleeding is often the first thing patients notice — what causes bleeding gums explains the common causes, and what puffy gums can mean covers when swelling is worth a call.

A periodontal pocket is characterized by a probing depth of 4 mm or more. This occurs when the gingival fibers that once attached the gum tissue to the tooth have been irredeemably damaged and are destroyed. The gingival sulcus is the crescent of gum tissue that forms the gumline; between the gum tissue and the tooth, there is a small crevice that contains bacteria, debris, cells, and fluids. The depth of the gingival sulcus is measured and this probing depth is recorded during a basic periodontal exam and must be noted so that the progress of periodontal disease can be monitored. Periodontal pockets are particularly susceptible to infection, which may result in abscess, and it is also possible for the roots of the tooth to sustain damage when they are no longer protected by the sulcular epithelium. When abscess occurs, this usually requires drainage and both systemic and local antibiotic treatment. The periodontal pocket is defined as either supra bony or infra bony, depending on its location in relation to the alveolar bone. If the periodontal pocket is not treated, it can damage the soft tissues beyond the gingiva, becoming a mucogingival defect. Dental scaling and root planing, also known as a dental deep cleaning, is the preferred treatment for periodontal disease; in this treatment, a dental health professional will. Once pocketing is established, treatment is the only way to reverse it; how gum disease is treated outlines the options, and when to be concerned with bleeding gums explains when bleeding warrants prompt attention.