What is Gum-disease
The Gum disease is a common terminology used by our people. The gum is only a small portion covering one third portion of the exposed part of crown of a tooth. A tooth is supported and surrounded by the tissues. These tissues are the cementum and cover outermost of the root of tooth. The next is a periodontal tissue. Perio mean around and dontia is tooth, hence a tissue that surrounds tooth is known as periodontal tissue. Still next to periodontal tissue is the bone known as the alveolar bone. This is the portion of jaw-bones. This bone provides a fitting for tooth. One socket, a bone space, for one tooth.
A very common or famous word is “pyorrhoea”. The major cause of loss of tooth in India is pyorrhoea-gum disease-periodontal disease. In fact, out of 10 individuals 9 are affected by this disease.
The genetic factor
The gum disease (periodontal) may be regarded as a range of different diseases for which certain individuals are at high risk. In high risk patients host factor appears to play an important role in susceptibility to gum disease and this risk may be partly under genetic control.
How can I find out gum disease?
• When you touch your teeth and the gum with brush, there is stain of blood seen on the brush.
• When you spit, there is a stain of blood seen in the saliva; of course at this hour you should have not taken anything in the mouth, pan or betel nut.
• With the help of toothpick, you can separate the gum from the teeth. Normally it is not.
How Gum Disease Starts?
A stickly material has the property to stick to the surface of tooth known as plaque. The plaque is flooded with tiny germs (Bacteria). This plaque is deposited around the tooth surface at the margin of gum. The gum surrounds the neck of the tooth. The \ th part of the crown is exposed to the mouth cavity. The \ rd portion of the crown is covered by the gum. This gum helps the plaque to get colonised. The plaque gradually gets toughened so as not to be dislodged by the flow of saliva. You cannot remove it by brush. This is the formation of tartar. A hard calcified mass of plaque which is the first stage of tartar.
Stage of gum disease
Utilizing a special dental probe by the dentist with marking of ‘mm’ on probe.
Stage 1.
Normal or just beginning but not bleeding from mouth. Insertion of probe causes bleeding.
Stage 2.
Blood is either in spit or on the brush. Insertion of probe is easy. Foul breath is observed.
Stage 3.
Foul smell, severe pus discharge, tooth is loose, insertion of probe easiest. No bleeding. The tooth is either painless or moderately painful.
Stage 4.
Painful with discharge of pus, a very loose tooth.
Causes of Gum Disease DNA
The cause of the gum disease is not known. But one research has been in progess to find out any link between DNA and periodontal or gum disease commonly known as pyorrhoea. Since all organisms have their own unique genetic structure, these new DNA probes will be able to identify the bacteria in the pockets around teeth and confirm the presence or absence of gum disease, opines Dr. Roy page, professor at the university of Washington.
The periodontal tissue that binds the teeth to the bone gets damaged somehow. Can this tissue be generated like nail or hair?
Until now there is no concrete proof but research is going on. Despite nearly decades of research this periodontal tissue is a mystery.
Local factors :
The local factors responsible for gum disease are
• Deposits of tartar and stain or any material on teeth.
• Food materials that are collected on gum margin are not washed away by saliva and are not removed by brush.
• Crowding of teeth abnormally so that the food remains are not identified. Sometimes the space is created due to removal of teeth or due to other causes.
• Habits like putting a pin, buttons, betel nuts and pipe wires in the mouth. These materials injure gum and cause infection.
• Irritants like alcohol, smoking or even hard brush.
General factors :
Improper food and malnutrition. The under-nourished persons have general weakness. This unattended symptom due to socio-economic factor, plays the most important role in India.
What are the Risk Factors?
• Age—As the age advances the general resistance is gradually reduced.
• Sex—In majority of cases males have a higher status of gum disease due to various habits.
Other factors
Education, income and cultural background plays a tremendous role in India. The Low income group cannot provide even a general health check-up. How can a person afford dental check-up? A vegetarian diet without a fibrous element in it is also a contributing factor. The fruits that clean the teeth are out of reach of common man. Using a tooth brush with paste is unaffordable for them. The cleaning of teeth is done with a mixture of clay and salt by the villagers of India.
A Mystery?
Periodontal health can be considered to be a state of balance in which the bacterial population coexists with the host, and no irreparable damage occurs to either the host or bacteria and there is a balance. Disruption in both the host and biofilm bacteria causes the reaction from both the side. The strong person is winner. This happens because there is a reduction in the the defence capacity of host.
The role of antibiotics is to kill the sensitive organism and to control secondary infections. The responsible microbes for gum disease are a complex community of microorganisms, many of which are still difficult or impossible to isolate in the laboratory. This is because the disease progresses at different rates. Sometimes it is having rapid tissue destruction alternating with periods of remission or recovery. The saliva exerts a major defence activity against gum disease.
But the decreased salivary flow cause gum disease by allowing the biofilm of bacteria to adhere & stay on the tooth surface. In the second stage the bacteria invades the tissue by destroying the barrier by producing enzymes. The third stage is tissue destruction. Hence, a complete answer to the question of what causes gum disease is not known.
Precaution to be Taken in Disease of Gum
Recently new techniques, new machinary & latest materials in dentistry are allowing more people to keep their teeth almost for a lifetime. We must bless ourselves that we live in such advanced times. It is necessary to know your present condition of teeth and gum. May be you don’t believe but nine out of ten people, specially Indians suffer from either tooth decay or gum disease. It is surprising but it is true that more teeth are lost through gum diseases than through tooth decay. This suggests that you will have to choose the best treatment and to have latest information, without wasting time, effort and money.
Sir William Osier recognized and stressed the significance of the oral cavity as a “Mirror” of the rest of the body. Staying smart with spakling teeth takes time. You have to be cautions throughout your life.
At the youngest (20 years)
You were provided with all the amenities of life and taught oral hygiene by your loving parents. But don’t be sure about the past—the bad habits that you pick up being young and free make you susceptible to tooth decay in your youthful days. As such, there is no definite cause that why alcohol, smoking and tobacco chewing make you prone to cavities. Moreover fast food in fast lane, chocolate and cake, rest on your teeth creating a place for decay causing bacteria and plaque to flourish.
Rinsing mouth
When you eat cake, there are lot of crumbs left in your mouth and the bacteria are going to get easy feed. If you drink water and rinse the mouth, this will wash away the remaining soft, stickly material.
Tooth paste with fluoride can remineralize the enamel of your teeth and may prevent tooth decay.
A sealent (plastic) can be painted by your dentist to protect from the caries.
The shackle of time
Time casts a shadow on teeth too. Your teeth get older as you advance in the age. The reason for this is that the protective enamel of your crown of teeth is affected every day with pressure of chewing, hard biting of hard foods, tea, coffee, and tobacco. The enamel wears off in due course of time allowing the dentin, the yellow in colour, next to enamel to show off its presence. The next pray of time is the gum. It recedes and shows the dentin part too.
The supporting structures of the tooth have to withstand pressures of chewing, biting hard food, betel nut and tobacco chewing. In older people the teeth get loose because of the recession of gum, root caries develop and colour of the tooth becomes brownish yellow.
In your adult age (40 years) :
You will be surprised that caries of teeth is rare but another mischievious friend of caries is gum (Periodontal) disease. The marginal gum is involved in the beginning due to accumulation of tartar, then it deepens and affects the supporting structures of the teeth. The tooth gets loosened and ultimately has to be pulled out. Luckily these days all these diseases can be prevented and tooth is preserved.
Taking care of teeth
• Proper oral hygiene.
• Be careful of your brushing technique and flossing to remove the food between the teeth. You must brush twice a day. It should take not more than three minutes.
• Be alert to changes of gum colour, bad breath & bleeding.
• A visit to dentist is a must.
You are unable to rinse thoroughally with water after your meals. There is a less secretion of saliva (dry-mouth) due to heavy smoking stress and alcohol guzzling; the result is bad-odour. Your mouth is the gateway of your body. The bad-breath makes the difference between a smart and shy individual.
The Dental Cause
In ninety percent of the cases the cause is dental,
(a) Teeth decay
(b) Spongy & swollen Gum.
(c) Ill-fitting denture or filling of tooth.
(d) Deposits, tartar.
(e) Deposits on tongue.
Treatment
Home-made
• Regular brushing twice a day and flossing twice or thrice a week.
• Cleaning of tongue with tongue cleaner.
• Cleaning artificial denture.
• A mouth wash.
By the dentist
• Cleaning hard deposits on tooth surface with gum curettage and polishing of teeth.
• Filling of cavities and repair of ill-fitting dentures.
• Teaching a proper way of brushing teeth to the patient.
Bleeding from Oral Cavity
Bleeding from the mouth could be due to so many factors. Gum disease is the most common cause of bleeding from the oral cavity and is often neglected or missed. In fact it would be better to eliminate local cause before thinking of general disease somewhere in the body. Severe illness also causes bleeding from the oral cavity. Bleeding problem can be avoided only with proper oral hygiene.
Bleeding Due to Local Causes :
• Rough and broken edges of tooth.
• Improper fitting of denture.
• Tooth bursh, tooth pick trauma.
• Gum Disease.
Treatment: Antiseptic mouth wash and oral hygiene procedure by the patients will reduce mild bleeding. Dentist will remove the irritants in teeth & gums.If the local measures are not enough then consult a physician.
Twin Brothers
The gum disease and the caries of teeth are two most common diseases in India. The reason for this is the ignorance on the part of the individual and the indifference of professional dental care. Both the diseases are prevalent. The dental caries mostly affect the young population and the gum diseases are common in adults. Dental caries destroy the tooth structure whereas gum disease cripples the surrounding structures. Both cause infection, pain and inability to chew food. Both are twin brothers.
But there is a common factor which gets friendly with twin brothers. That is a soft food material containing tiny germs which adhere to the tooth. It is known as plaque. There is a difference in the prevention and control in caries & gum disease. In caries treatment the help of dentist is a must. In case of gum disease 9% of cases can usually be controlled by the individual home treatment following the rules of oral-hygiene.