RECESSION OF GUMS

CAUSES, DANGERS AND TREATMENTS

The loss of Gingiva (gum tissue) resulting in the exposure of the roots of the teeth is called Gum recession or receding gums

Periodontal disease also commonly known as Gum Recession refers to an infection of the tissues supporting and surrounding the teeth mainly caused by the accumulation of bacteria from the dental plaque that inflames and damages the gums.

Receding gums affects people over the age of 40, can be present in younger ages as well. It may be generalized or localized depending upon the oral hygiene maintenance and it is generally progressive in most cases.

The first usual sign of gum recession is sensitivity to cold and hot drinks. The affected teeth appear longer and the roots start to get visible, a notch like depression can be felt near the gum line and spaces between teeth seem wider.

Commonly experienced symptoms are:

  • Red, Swollen And Tender Gums
  • Pus And Pockets Between Gums And Teeth
  • Receding Gums
  • Bleeding Gums During Or After Brushing Flossing Or Eating Hard Food,
  • Shifting Or Separating Teeth Creating Gaps
  • Persistent Bad Metallic Taste In Mouth And Bad Breath
  • Mouth Sores
  • Changes In The Fit Of Dentures And The Teeth Fit During Bites.

The Causes May Be:

  • Poor Oral Hygiene
  • Periodontal Or Gum Disease
  • Aggressive Brushing Technique
  • Trauma To The Gums
  • Systemic Illnesses Like Diabetes Or Cancer
  • Faulty Restorations
  • Malposition Of The Teeth
  • Hormonal Imbalances During Pregnancy And Menstruation
  • Regular Or Repetitive Teeth Grinding Or Clenching
  • Smoking And Chewing Tobacco
  • Hereditary Disorders
  • Medications Such As Contraceptives And Anticonvulsants

Why Is It A Serious Condition?

When the gums pull away from teeth, the roots of your teeth which were earlier covered are left bared and exposed and this puts your dental health at risk for decay and damage. If they are left untreated, receding gums will lead to functional and aesthetic problems.

What Are The Treatment Options?

  • Scaling and roots planning, stabilization of the teeth is first line of treatment if the recession is caused by periodontal disease. Oral hygiene maintenance is extremely important to avoid further gum recession and bone loss.
  • In case of overaggressive brushing, visit your dentist and he can help you by demonstrating the proper brushing technique and recommending the best oral hygiene tools according to your requirement.
  • By eating healthy, fibrous food, maintaining a balanced diet, smoking cessation and regular use of dental appliances for your grinding habit can also prevent the gingival recession.
  • In advanced gum recession cases, gum tissue regeneration and gingival grafting can be done by a Periodontist or an Oral surgeon.
  • If you experience hypersensitivity to cold and hot drinks or food, consult your dentist. If the damage to teeth is less, then it can be corrected by desensitizing agents, varnishes and dentine bonding agents. He may recommend specific toothpaste and mouthwash to reduce the sensitivity.

Bleeding Gums: Myths and Facts

1.Is it normal for gums to bleed?

Without proper dental hygiene, the bacteria present in the mouth forms plaque on the teeth surface. These bacteria cause gums to become inflamed, resulting in red, swollen, or bleeding gums. In some cases the inflammation is not so painful. If left untreated, gingivitis can worsen and lead to loss of teeth.

2.     What to do when Gums bleeding during brushing or flossing?

Bleeding gums, also known as gingivitis, is very common condition. People actually stop brushing and flossing after finding out blood, as a matter of fact, they should never cease to brush. Visit your dentist and follow the general oral hygiene practice.

3.     How should I clean my teeth effectively?

Always make sure that you use gentle, circular motions to clean your teeth and gums.

Make sure that you clean not only the teeth, but also the gums. A lot of bacteria are found at the junction of gum meeting the teeth and it needs to be cleaned.

Flossing is also very important, in those areas where your toothbrush alone just can’t get rid of to remove the bacteria, mainly in between the teeth. Many times patient’s gums start bleeding when they floss after not having flossed in a very long time. It’s because the gums are inflamed from bacteria not being removed for a longer period of time. Generally brushing twice a day and flossing once a day will make bleeding gums will go away within a week or so.

Without regular teeth cleanings with your dentist, dental tartar/calculus will harbor even more plaque bacteria, which can push the gum line below and lead to gum disease.

4.     What other health conditions could be related to gum diseases?

The bacteria present on the teeth and gums continuously release toxic substances that harm your healthy gums and can cause redness and swollen gums. If left untreated, the infection and the inflammation can damage your gums and even spread further down to your bone. Gradually it will lead to periodontitis and teeth loss.

In other cases, bleeding gums can be caused by numerous conditions such as severe vitamin deficiency, hormonal changes like pregnancy or menstruation, chemotherapy, some diseases like diabetes, certain medication like blood thinners, antiepileptic drugs.

Smoking also causes damage to your gums and makes the gum disease progress much faster.

5.     Are there any OTC medications that can be taken for bleeding gums?

The best treatment is to remove the sticky transparent film like plaque by brushing twice a day and flossing once a day that causes bleeding gum. When dental plaque builds up, it hardens and turns into tartar, a hard substance that gets attached to your teeth. Without regular teeth cleanings with your dentist, dental tartar or calculus will harbor even more plaque bacteria, which can push the gum line below and lead to gum disease.

6.     What other things I can do to prevent bleeding gums?

Visit your dentist. Your dentist will remove the soft and hard deposits by scaling and root planning treatment, which slows the process of gum disease down. Maintaining the oral hygiene is also important after getting cleaning done by the dentist.

In case of an advanced form of periodontal disease, periodontal therapy as seeing a periodontist, a gum disease specialist is recommended. In those cases, sometimes dental surgery may be needed to control the progression of the gum disease.

7.     Is there any advice for patients with gum disease?

Always brush and floss regularly. Get your teeth cleaned professionally with dentist every 3 to 6 months, depending on the condition of the gums, to prevent any disease in the future.

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Soft Tissue Grafting

This is in preposition of a treatment planning of an appropriate surgical technique for increasing the width of the attached mucosa in order to maintain Peri-implant health.

The soft tissue around gingival being divided into gingival and mobile alveolar mucosa, the gingival width varies individually as 2-9 mm.There is a time-point to distinguish the peri-implant mucosa from the gingival around the teeth:  The peri-implant connective tissue has less number of fibroblasts & more collagen fibers’ as compared to gingiva.  The junctional epithelium is more permeable with scarce number of blood vessels than that of around the tooth. 

The peri-implant connective tissue fibers’ run in a parallel direction to the implant or abutment surface without being attached rather being perpendicular to the root cementum.

It has been concluded that presence of non-elastic collagen fibers’ in the connective tissue is responsible for keratinization. Based on findings, >2 mm of keratinized tissue is required for maintenance of healthy gingival tissues.However,around the dental implants, the crucial role of an adequate width of keratinized /attached mucosa for the clinical success is still controversial.

Recent studies have shown that lack of adequate width of Keratinized alveolar mucosa around dental implants is associated with more plaque accumulation, inflammation, soft tissue recession, attachment loss.

Since implant surgery includes one or two stage bone augmentation procedures, displacement of the mucogingival Junction does occur.hence, in order to regulate the width of keratinized attached mucosa, two different peri-implant soft tissue augmentation procedures can be concluded:

Increase in soft tissue volume using a sub epithelial connective tissue graft or soft tissue replacement graft

Enlargement of keratinized mucosa width by means of an apically repositioned flap/vestibuloplasty.

General Dentistry Clinical Training

COURSE DURATION: 1 MONTH

Every participant will be provided with total no. of 25 patients

MODULE 1: Endodontics

Demonstration and hands on (using hand files, hand protaper files, Rotary endodontics)

– Access cavity preparation of anterior, premolar and molar on extracted tooth.

– Biomechanical preparation of canals using STEP BACK & CROWN DOWN technique

MODULE 2:

– Working length determination using apex locator.

– Clinical diagnosis in endodontics.

– Interpretation & use of RVG in endodontics.

MODULE 3:

-Demonstration and hands on of Different Obturation techniques.

-Clinical knowledge about use of various Intracanal Medicaments, Sealers in endodontics.

-Prevention and Management of fracture of instruments and ledge formation.

– Retreatment in endodontics & Demonstration of GP removal.

MODULE 4:

-Prosthodontics, Aesthetics & Restorative Dentistry

– Diagnosis and treatment planning in fixed partial prosthesis and steps of crown preparation

– Demonstration and hands on of Light cure Class I – V Composite restoration

-Demonstration and hands on of vital tooth Bleaching & Non Vital tooth Bleaching (Walking Bleach)

– Clinical Diastema Closure.

-Tooth Jewellery

MODULE 5:

– Restoration of endodontically treated tooth (Post and core) [hands on] – prefabricated & customized

– Gingival retraction and multiple impression material technique in fixed partial prosthesis

– RPD cast designing

– Pontic design discussion classes

– Tooth Preparation, Impression making and cementation procedure.

MODULE 6: Oral surgery, Periodontics

EXTRACTION

-open & closed

-Local anesthesia – Nerve block

-Flaps

-Management of trauma cases

-Splinting of mobile teeth

-Impactions

-Extraction of grossly carious teeth

MODULE 7:

 Sutures

-Materials

-Techniques

-Hands-on

-Medically compromised patients

-Minor Oral Surgery

MODULE 7: Pedodontics

Direct and Indirect pulp capping

Different materials available including MTA

MODULE 8:

Pulpotomy, Apexogenesis and Apexification