Periodontics

 Gum diseases, also known as periodontal diseases, are infections that affect the gums and bone that hold teeth in place. There are several types of gum diseases, including:

1. Gingivitis: The mildest form of gum disease, causing red, swollen, and bleeding gums.
2. Periodontitis: A more advanced stage of gum disease, causing inflammation and infection of the gums, bone, and surrounding tissues.
3. Aggressive periodontitis: A rapid and severe progression of periodontitis, often seen in younger individuals.
4. Chronic periodontitis: A slow and gradual progression of periodontitis, often seen in adults.
5. Necrotizing periodontal disease: A severe and painful gum disease, often seen in individuals with weakened immune systems.
6. Periodontal abscess: A pocket of pus that forms in the gums, often painful and accompanied by swelling and fever.
7. Systemic periodontitis: A gum disease that affects the entire body, often linked to systemic conditions like diabetes or heart disease.

Gum diseases are caused by:

• Poor oral hygiene
• Bacteria in plaque and tartar
• Smoking and tobacco use
• Genetics
• Hormonal changes
• Medications
• Poor diet
• Stress

Symptoms include:

• Red, swollen, or bleeding gums
• Bad breath
• Loose teeth
• Painful chewing
• Sensitive teeth
• Gums pulling away from teeth

If left untreated, gum diseases can lead to tooth loss, bone loss, and increased risk of systemic diseases like heart disease and diabetes.

The treatment of gingivitis typically involves a combination of professional dental cleaning, good oral hygiene practices, and lifestyle changes. 

A few of the common treatment options:

1. Professional dental cleaning (prophylaxis): A thorough cleaning of the teeth and gums to remove plaque, tartar, and bacteria.
2. Scaling and root planing: A deeper cleaning procedure to remove tartar and bacteria from the roots of the teeth.
3. Antibacterial mouthwash: Prescription mouthwash to reduce bacteria and inflammation.
4. Antibiotics: In severe cases, antibiotics may be prescribed to treat bacterial infections.
5. Improved oral hygiene: Brushing twice a day with fluoride toothpaste, flossing once a day, and regular dental check-ups.
6. Lifestyle changes: Quitting smoking, reducing stress, and improving diet.
7. Desensitizing toothpaste: For sensitive teeth.
8. Saltwater rinse: Rinsing with warm saltwater to reduce inflammation.
9. Hydrogen peroxide mouthwash: To reduce plaque and gingivitis.
10. Topical antiseptics: Applied to the gums to reduce bacteria and inflammation.

It's important to note that gingivitis can be reversed with proper treatment and good oral hygiene practices. If left untreated, it can lead to periodontitis, a more severe gum disease. 

The treatment protocol for periodontitis include the following:

1. Deep cleaning: This is a non-surgical treatment that involves scaling and root planning to remove tartar and bacteria from the teeth.
2. Medications: Medications such as antimicrobial mouth rinse, antiseptic chip, and enzyme suppressant can be prescribed to prevent periodontitis.
3. Surgical pocket reductions: This surgical procedure involves cleaning the pocket carefully, removing tartar deposits after lifting up the gums to clean underneath them.
4. Bone and tissue grafts: This procedure is done to regenerate lost bone or gum tissue.
5. Scaling and cleaning: Scaling and debridement can help restore periodontal health by cleaning the surfaces of the teeth.
6. Gingivectomy: This is the removal of gum tissue.
7. Lip repositioning surgery: This procedure repositions the upper lip to reduce its movement.
8. Orthodontic treatment: This type of treatment can treat misalignment that causes a gummy smile.
9. Crown lengthening: This procedure reshapes gum and bone tissue to expose more of the tooth.

Acute Necrotizing Ulcerative Gingivitis (ANUG) is a severe and painful gum infection. 

Treatment typically involves a combination of:

1. Antibiotics: To combat bacterial infection.
2. Pain management: To alleviate severe pain.
3. Debridement: Removing dead tissue and bacteria from the gums.
4. Scaling and root planing: Deep cleaning to remove tartar and bacteria.
5. Hydrogen peroxide mouthwash: To reduce bacteria and inflammation.
6. Saltwater rinse: To reduce inflammation and clean the gums.
7. Antibacterial mouthwash: To reduce bacteria and prevent further infection.
8. Surgical intervention: In severe cases, surgical intervention may be necessary to remove damaged tissue.
9. Supportive care: Rest, hydration, and nutritional support to manage symptoms.
10. Follow-up care: Regular dental check-ups to monitor healing and prevent recurrence.

It's essential to seek immediate dental attention if you suspect you have ANUG, as prompt treatment can help prevent further tissue damage and reduce the risk of complications.

A Gummy Smile, also known as excessive gingival display, is a condition in which a person shows a significant amount of their gum line when smiling. Gummy smile treatments include:

• Botox: Temporarily reduces the appearance of a gummy smile by limiting the movement of the upper lip
• Orthodontic treatment: Treats misalignment that causes a gummy smile
• Gingivectomy: A surgical procedure that removes excess gum tissue
• Crown lengthening: Reshapes gum and bone tissue to expose more of the tooth
• Lip repositioning surgery: Repositions the upper lip to reduce its movement
• Dermal fillers: Used to support the upper lip and reduce the appearance of a gummy smile

The Crown Lengthening Procedure is a surgical procedure that aims to expose more of the tooth by removing some of the gum and the supporting bone. The procedure is usually performed by a periodontist or a dentist. The goals of this procedure can be functional or aesthetic. Here are some of the reasons a crown lengthening procedure is performed:

• Increase retention and resistance when placing a dental crown
• Access subgingival caries
• Access accidental tooth perforations
• Access external root resorption
• Alter gum and tooth proportions, such as in a gummy smile
• The procedure can be done in one of two ways:
• Apically repositioned flap with osseous recontouring (resection)
• Forced tooth eruption

Gum depigmentation, also known as gum bleaching, is a cosmetic dentistry procedure used to lighten or remove black spots or patches on the gums.

Some of the factors that contribute to the development of gum discoloration include:

• Genetics
• Ethnicity
• Hormonal changes
• Medications
• Smoking
• Systemic diseases
• Poor oral hygiene

There are multiple ways for treating gum depigmentation include:

1. Dental lasers: A specialized laser target and removes the melanin pigments responsible for the darkened appearance of the gums.
2. Scalpel: A surgical instrument used to remove pigmented layers of gum tissue.
3. Electrocautery: A device that uses heat to remove pigmented areas.
4. Cryotherapy: A technique that uses extreme cold to destroy pigmented cells.
5. Chemical depigmentation agents: Solutions applied to the gums to lighten or remove pigmentation, such as hydrogen peroxide or kojic acid.
6. Diamond bur: A rotary instrument used to gently remove surface pigmentation.
7. Sandpaper strips: Used to smooth out the gum surface and remove pigmentation.
8. Gingival mask: A specialized instrument used to apply a depigmentation agent to the gums.
9. Micro-ablative lasers: Used to remove thin layers of gum tissue and reduce pigmentation.
10. Radiofrequency ablation: A device that uses heat energy to reduce pigmentation.

These instruments may be used alone or in combination with lasers, depending on the severity and extent of gum depigmentation. 

Pericoronitis is inflammation of the tissues surrounding the crown of a partially erupted tooth, including the gums and dental follicle. This condition is usually associated with wisdom teeth and can be acute or chronic. 

Symptoms of pericoronitis include:

• Pain, often severe, which can radiate to the ear, throat and nearby areas
• Tenderness, redness and swelling of the tissues around the tooth
• Bad taste and halitosis
• Formation of pus under the operculum
• Difficulty opening the mouth and swallowing
• Fever and swollen lymph nodes

Pericoronitis can be treated with pain management and inflammation reduction, and in some cases, removal of the tooth or doing operculectomy  might be necessary.

Gum Enlargement, also known as gingival enlargement or hypertrophic gingivitis, is a condition where the gums become abnormally large and swollen. It can impact oral health and aesthetics. 

This can be caused by:

• Hormonal changes (e.g., pregnancy, puberty)
• Certain medications (e.g., phenytoin, cyclosporine)
• Poor oral hygiene
• Gum disease (gingivitis or periodontitis)
• Genetic predisposition
• Vitamin deficiencies (e.g., vitamin C)
• Mouth breathing

Symptoms include:

• Swollen and tender gums
• Redness and inflammation
• Bleeding or pus between teeth and gums
• Difficulty chewing or speaking
• Bad breath

Treatment options include:

1. Professional dental cleaning
2. Medications to reduce inflammation
3. Improved oral hygiene practices
4. Surgical reduction of excess gum tissue (gingivectomy)
5. Addressing underlying medical conditions or medications

Gum recession, a form of gum disease, occurs when the gum tissue pulls away from the teeth, exposing roots underneath. This condition can be caused by a variety of factors, including aggressive brushing and genetics.

Warning signs of gum recession include:

• Tooth root exposure
• Sensitivity to cold and heat
• Changing appearance of the teeth
• Bad breath
• Bleeding gums

Gum recession cannot be reversed, but there are various treatment options available, such as antibiotics, antimicrobial mouth rinses, and surgery.

Gum recession treatment depends on the severity and underlying cause of the recession. 

Common treatment options:

1. Deep cleaning: Scaling and root planing to remove plaque and tartar.
2. Gum grafting: Transplanting healthy gum tissue to cover exposed roots.
3. Pinhole surgery: A minimally invasive procedure to reposition gum tissue.
4. Laser treatment: Using a laser to recontour the gum line and reduce inflammation.
5. Tissue regeneration: Stimulating new tissue growth to replace receded gums.
6. Pocket reduction surgery: Reducing the depth of gum pockets to prevent further recession.
7. Orthodontic treatment: Straightening teeth to reduce gum stress and recession.
8. Pinhole technique: A minimally invasive procedure to reposition gum tissue.
9. Gum veneers: Porcelain veneers to cover exposed roots and improve aesthetics.
10. Surgical exposure: Exposing the roots to place a crown or bridge.