| Gum disease or Periodontal disease is an infection of the  tissues that support your teeth. Your gum tissue is not attached to the teeth  as high as it may seem. There is a very shallow v-shaped crevice called a  sulcus between the tooth and gums. Periodontal diseases attack just below the  gum line in the sulcus, where they cause the attachment of the tooth and its  supporting tissues to break down. As the tissues are damaged, the sulcus  develops into a pocket: generally, the more severe the disease, the greater the  depth of the pocket.Periodontal diseases are classified according to the  severity of the disease. The two major stages are gingivitis and periodontitis.  Gingivitis is a milder and reversible form of periodontal disease that only  affects the gums. Gingivitis may lead to more serious, destructive forms of  periodontal disease called periodontitis.
 Some factors increase the risk of developing  periodontal disease: 
                              
                                Tobacco       smoking or chewing Systemic       diseases such as diabetes Some       types of medication such as steroids, some types of anti-epilepsy drugs,       cancer therapy drugs, some calcium channel blockers and oral       contraceptives Bridges       that no longer fit properly Crooked       teeth Fillings       that have become defective Pregnancy       or use of oral contraceptives  Several warning signs that can signal a problem: 
                              
                                Gums       that bleed easily Red,       swollen, tender gums Gums       that have pulled away from the teeth Persistent       bad breath or bad taste Permanent       teeth that are loose or separating Any       change in the way your teeth fit together when you bite Any       change in the fit of partial dentures 
 Types of gum disease There are many forms and stages of periodontal disease. The  most common are:1. Gingivitis. The first stage of periodontal disease, gingivitis, is  the mild inflammation of the gingival caused by plaque build up. Gingivitis is  an inflammatory condition of the gingiva caused by factors including smoking,  certain drugs and hormonal changes that occur in puberty and pregnancy. Your  gingival will be red, swollen, and tender. You may also notice bleeding while you brush and floss. This stage of gingivitis is reversible.
 2. Mild Periodontitis. Inflammation will spread to the supporting  alveolar bone. Minor bone loss and the formation of periodontal pockets, or  food traps, may occur. Periodontitis follows with the destruction of the  supporting structure of the teeth and is influenced by factors including the  individual's immune and inflammatory response. It is initiated by microbial  plaque. Periodontitis, if left untreated, can causes tooth loss, mouth odor,  bad breath or halitosis.
 3. Moderate Periodontitis. In this stage, there will be increased  gingival recession, moderate to deep pockets, moderate to severe bone loss,  and mobility of teeth due to the bone loss.
 4. Severe Periodontitis. This is the most serious stage of  periodontitis. Deep pockets, increased mobility of teeth, movement of teeth out  of position, and visible fistulas (boils) will be present in this stage. Pus  may develop; bone loss continues, and your teeth may loosen or fall  out.
 
 How is Periodontal (Gum) Disease Treated?In the event you are diagnosed with gum disease, your gum  dentist / periodontist may recommend non-surgical periodontal treatment. For  advanced cases, gum surgery may be required. The biggest factor in the  treatment options available to you will be how quickly your gum disease is  detected and how rapidly it advances.
 Treatment will depend upon the type of periodontal disease and how far the  condition has progressed.
 1. Non-Surgical Treatment. It will be applied if the patient is still in  the early stages of gum disease.
 2. Scaling or Cleaning. It is a treatment procedure which involves the  instrumentation of the crown and root surfaces of the teeth. Plaque, calculus,  and stains will be removed from these surfaces. It is performed on patients  with periodontal disease and is therapeutic, as apposed to prophylactic and may  precede root planning. It is a definitive, meticulous treatment procedure aimed  at the removal of cementum and/or dentin that is rough and is possibly  permeated by calculus, or even contaminated with toxins or microorganisms. This  procedure can be used as a definitive treatment or as part of pre-surgical  therapy ("tissue preparation") depending on how far the periodontal disease  has advanced.
 3. Bone or Gingival Augmentation. This is a surgical procedure which  uses a barrier membrane and or bone graft replacement material placed under the  gum and over the remaining bone support (ridge or jaw bone) to aid the  regeneration of new bone in an area where teeth are being extracted or have  already been removed. The graft material may be taken from the patient's own  body. If not, an artificial, synthetic, or natural substitute may be used. This  prevents the surrounding bone from collapsing into the extraction socket after  the removal of a tooth. If this procedure is not carried out, the ridge will  become narrow and sharp and it will not be possible to insert an implant or a  comfortable-fitting denture.
 4. Post-Op care. In most cases, the gums are too tender to brush  post-operatively. We will provide you with an antibacterial mouth rinse called  Chlorhexidine which will chemically reach those areas that the tooth brush will  be too sensitive to debride. Warm salt water will help to reduce gum inflammation  and an antibiotic is usually prescribed to prevent infection. Analgesics  (pain medication) can be used if the pain becomes severe.
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