Local Dental Care - Periodontal Disease Symptoms

Receding Gums Fixed With Periodontal Procedures

Not even the most beautiful teeth can look attractive if healthy and pleasing-looking gums do not surround them. That's because the gums frame the teeth like a picture frame frames a picture. To have a pleasing smile, the shape, color, and texture of the gums are just as important as that of the teeth they frame. Although tooth development, periodontal disease, trauma, or tooth loss can create esthetic gum deformities like receding gums, modern periodontal procedures can give individuals a smile to smile about.

Common Cosmetic Gum Problems

Unhealthy Gums

As a result of periodontal disease, a person may have red, shiny, or swollen gums. If an individual has gingivitis or periodontitis, the gums have to be periodontally treated prior to cosmetic dental procedures.

"Gummy Smile"

Teeth that appear too short may be normal-sized teeth hiding under too much gum. This can be the result of normal tooth development, or the use of certain medications that may cause gums to overgrow. Either way, a crown lengthening (see article "Crown Lengthening") procedure can help reveal the normal tooth structure.

Recession

If the teeth appear to be too long or if the root surfaces are exposed, it may be due to receding gums (see article "Recession"). Soft tissue grafting (see article "Soft Tissue Grafts") is very successful in correcting this problem.

Uneven Gum Margins

If the gum margins appear to be higher on some teeth and lower on others, this may be due to receding gums, altered eruption, or gum defects that resulted from tooth loss. The treatment of uneven gum margins may require crown lengthening, soft tissue grafting, ridge augmentation or a combination of these procedures.

Gum Indentations

After a tooth is lost, the bone that encased it disintegrates and the gum around it may collapse, creating an indentation where the tooth used to be. Ridge augmentation procedures can help correct this problem.

Uneven Pigmentation

Changes in the color of the gums may be part of normal gum development, or the result of scarring. Soft tissue grafts can predictably correct this problem.

Spaces In Between the Teeth

Periodontal disease can result in spaces in between the teeth that may appear like black triangles. These spaces can be very difficult to treat. They can be made less unattractive by a combination of procedures that include orthodontics (braces), crowns (caps), and/or periodontal (gum) surgery. The best way to avoid these spaces is to seek periodontal treatment in its early stages.

Missing Teeth

One or more missing teeth can be predictably replaced with the aid of dental implants. Dental implants can look and feel like natural teeth.

Changes in the appearance of the gums like receding gums can occur as a result of normal tooth development, periodontal disease, trauma, or tooth loss. By working with a restorative dentist who has expertise in cosmetic dentistry and through the aid of modern periodontal techniques, individuals can design a smile that is both aesthetic and youthful in appearance.

By Laura Minsk, DMD

Periodontitis, The Leading Cause of Gum Disease

According to information from the American Dental Association, three out of four Americans over age 35 have some form of periodontal disease, the major cause of tooth loss and bad breath (halitosis) in adults. Gingivitis is the mildest form of periodontal disease that, if left untreated, can progress to periodontitis, the loss of bone and tissues that support the tooth.

Periodontal disease has three stages, categorized by the extent of bone loss: mild moderate, and advanced. If only one or a few teeth are effected, it is localized. If all the teeth are involved, it is generalized.

Bacteria that accumulate at and below the gum line cause periodontitis. The bacteria release toxic substances that trigger the breakdown of the gum and bone. The body responds with an inflammatory response in which it essentially turns on itself and destructs the bone and tissues around the teeth. This is the body's way of warding off infectious agents.

When this happens the gum separates from the teeth, forming a gap called a periodontal pocket. If left untreated, periodontitis can lead not only to tooth loss but can also aggravate systemic illnesses. The signs of periodontitis may include:

• Bleeding gums when brushing or flossing
• Red, tender or swollen gums
• Bad breath (halitosis) or bad taste
• Receding gums (gums that have pulled away from the teeth)
• Loose teeth
• Teeth that have migrated from their original positions
• Tooth loss

Very often, however, people are not aware that they should see a periodontics professional because gum disease can progress without pain. It is possible to not exhibit warning signs and still have periodontitis. That is why it is very important to have routine periodontal screenings so that the early signs of the disease can be detected and treated before it becomes a major problem.

Periodontal Treatment

Periodontitis is treated in three phases. The first phase involves stopping the disease activity and progression of bone loss. The bacterial deposits (plaque and tartar) that formed above and underneath the gums need to be removed and the root surfaces of the teeth smoothed to enhance healing and deter future plaque retention.

This periodontal treatment is called scaling and root planing. During this phase, a dentist will review the patient's oral hygiene techniques, and give them advice on how to modify certain risk factors associated with periodontal disease.

If the periodontal disease is more advanced, surgical treatment may be needed. The purpose of this phase of periodontal treatment is to create an environment that is more amenable to health and, if possible, bring back some of the bone that was lost to the disease. In some forms of periodontitis, antibiotic treatment may be used. If this is the case, a bacterial culture may be required to test for harmful bacteria and to establish what antibiotics they are susceptible to.

Periodontal disease is a chronic condition that, like many others, has to be closely monitored, even after active treatment.

The third (maintenance) phase is crucial to the success of any periodontal treatment. Daily brushing and flossing is essential in controlling ever-developing plaque and bad breath, as is periodic periodontal maintenance care with a professional scaling of the teeth. Periodontal status will be closely monitored, so that changes can be identified and treated as early as possible.

Everyone should be routinely screened for periodontitis. All dentists are qualified in detecting and treating the early stages of periodontitis, but if an individual suspects that they are at risk, or they know they have gingivitis, they may want to see a periodontist who has advanced training in the diagnosis and treatment of periodontal conditions.

By Laura Minsk, DMD