Treatment of the gums

Treatment of the gums

What is gum disease?

Gum disease is the second most common dental issue after caries (cavities). Gum disease can generally be categorised into two types: gingivitis, i.e. gum inflammation; and periodontitis, i.e. inflammation that damages the bottom structure of a tooth.

What is the cause of gingivitis?

Gingivitis is usually caused by dental plaque with bacteria that accumulates along the gum line. In rarer cases, the gum disease can be caused by viruses, fungi, general diseases and traumas. The development and progress of gingivitis can be complicated by factors such as smoking, taking certain medicines and hormonal changes in the body during puberty or pregnancy.

The first symptom of a gum inflammation is the presence of blood during brushing. As the dental plaque accumulates further, the symptoms will increase, while the gums will swell, becoming red and sensitive. The symptoms are modest during the starting phase and will progress in a moderate fashion.

An exception is acute gingivitis with lesions, which is characterised by strong pain accompanied by generally feeling unwell and a fever, as well as a gum line that is covered with a greyish layer. The disease mostly occurs in younger people as a result of general stress, inadequate dental hygiene and smoking.

Timely treatment will enable us to stop the disease, and the tissue of the gums can be restored to its original form. The treatment is based on the principle of removing the dental plaque that has caused the disease, as well as correcting the other supporting factors (tartar, faulty fillings, broken teeth) and implementing proper dental hygiene. At home, the treatment is based on thorough and regular brushing with a soft and thick toothbrush, and additional cleaning with dental floss or an interdental brush. Additional means include using a toothpaste and a mouthwash with chlorhexidine or ether oils. Specific dental care products and their uses will be defined by the dentist based on the individual needs of the patient.

Untreated gingivitis can progress to an inflammation that will damage the bottom structure of the teeth or periodontitis.

What is the cause of periodontitis?

Periodontitis is a chronic inflammation that damages the bottom structure of the tooth. It can completely destroy the supporting foundation of a tooth, making the tooth loose and in later stages causing dental loss. Lighter and more moderate chronic forms of the disease are common; while aggressive and difficult periodontitis is rarer.

Periodontitis is caused by a specific aggregate of bacteria (biofilm) that accumulates between the tooth and the gums in so-called periodontal pockets. The disease forms as a result of a general decrease of the immune system, as well as the presence of the supporting factors that include smoking, certain general diseases (diabetes, coronary heart disease), genetic liability and stress.

Periodontitis usually does not cause significant symptoms during its starting phase. Typical symptoms include bleeding gums, redness, swelling and sensitivity during brushing. It can also result in a bad taste in the mouth and vague tingling in the gums. The disease is already advanced once the tooth starts moving, excretes pus and becomes painful.

The foundation of periodontitis treatment involves gaining control over the inflammation. First of all, the patient is presented with guidance for proper dental hygiene, and the dental plaque consisting of bacteria is removed from the surface of the tooth as well as from the periodontal pockets. The factors supporting the accumulation of bacteria are also removed, including tartar, faulty dentures and fillings. Broken teeth are fixed and hopeless teeth are removed. In some cases, it is necessary to apply a surgical treatment to remove the bacteria and tartar from deeper periodontal pockets. Moving teeth can be fixed in place by using various casts, or they can be removed and replaced with implants or dentures. It is recommended to follow general healthy procedures, including having a healthy attitude, while giving up smoking and other unhealthy habits. A thorough dental hygiene regime at home is the main factor for the success of the treatment in the long-term.

Periodontitis is an irreversible process. Modern dental care can stop the progress of the disease; however, there are no methods for fully restoring the gum tissue. A successful treatment therefore depends on detecting the disease as early as possible and applying the proper dental care.

What should I keep in mind after gum treatments?

The teeth and gums can be sensitive after a treatment. It is recommended to avoid cold or hot food/drinks during that time. The sensitivity usually subsides in one or two weeks.

Regardless of the sensitivity, it is important to follow the guidelines for hygiene that have been presented by your doctor. Clean the interdental areas using an interdental brush or dental floss, unless your doctor recommends otherwise.

If the doctor or the dental hygienist has recommended using mouthwash, rinse your mouth twice a day during the two weeks with a chlorhexidine solution for approximately one minute. Proceed with this rinsing 30 minutes after brushing. The wound can be rinsed for up to two weeks, unless the doctor has said otherwise. The solution can cause some pigmentation, but it is not permanent and it is easy to remove after the treatment.