Who is a periodontist?
A dentist who has specialized in the treatment of gum-related diseases.

What is the importance of gums in maintaining the health of the teeth?
The part of the tooth visible outside is the crown. The part that is inside the gums is the root. Just like a good building needs a strong foundation, the root of a healthy tooth must be strongly anchored within the tooth socket, which is a part of the jaw bones. Healthy gums form a tight covering over the root and the surrounding bone.

What are the most common causes of gum diseases?
• Gum diseases are caused by improper oral hygiene.
• Improper/inadequate brushing will lead to the formation of tooth deposits, which are mainly of two types.
• The initially formed deposits are thin, soft, yellowish-white in color, and cannot easily be seen with the naked eye. This is called dental plaque.
• Dental plaque will harden over time to form another type of deposit known as tartar or dental calculus.
• Even though dental plaque forms very rapidly, proper brushing on a regular basis (twice a day) can remove most of it.
• However, Calculus cannot be removed by brushing, and requires professional removal.
• Plaque and calculus are initially formed on the tooth surface outside the gums. Subsequently, these will extend under the gums.
• The action of the harmful bacteria present in these deposits will lead to infection of the gums.
• Other conditions that can aggravate gum diseases are chronic smoking, diabetes, hormonal variations, pregnancy and certain medicines like Amilodipine (for hypertension) and Phenytoin (for epilepsy).
• Although gum diseases usually manifest after the age of 35, a hereditary type of severe gum disease is sometimes seen in people less than 30 years of age. If untreated, this can lead to early tooth loss.

What are the symptoms and signs of gum diseases?
• The initial signs of gum diseases are:
1. bleeding from the gums especially while brushing or biting on hard food,
2. bright red color of the gums, and
3. mild swelling of the gums

• This is called gingivitis. At this stage the disease is confined only to the gums without affecting the underlying bone.
• If gingivitis is not treated in time, it will lead to detachment of the gums from the tooth, creating a space between the gums and the tooth known as a pocket.
• A pocket can be detected only by your doctor with the help of special instruments.
• This stage of the disease is called periodontitis.
• The common symptoms of periodontitis are
1. shaking teeth,
2. pus discharge from the gums,
3. foul taste in the mouth,
4. foul smell of the mouth,
5. itching sensation in the gums,
6. food getting stuck between the gums and the teeth,
7. sudden appearance of gaps between the teeth
8. Change in the normal position of the teeth.
9. increase in the length of the tooth due to gum recession
10. sensitivity of the teeth especially while taking cold food or drinks.
11. frequent occurrence of painful swellings on the gums (abscess formation).
If not treated, the disease can progress to such an extent that the tooth will fall off. Dental X-rays or Panoramic radiographs are often required to assess the extent of the disease.

How can gum diseases be treated?
• The basic treatment for any type of gum disease starts with professional tooth cleaning called scaling. Multiple visits may be required depending on the amount of deposits on the teeth. Initial stages of gum disease (gingivitis) can most often be treated by proper scaling alone.
• In more advanced cases, scaling has to be followed by deep scaling and root planing (scaling under the gums on the root). This may require the use of local anesthesia.
• In case of deeper pockets and considerable loss of tooth supporting bone, flap surgery may be required. During this procedure, under local anesthesia, the gums are surgically reflected from the teeth, the infected tissues inside are removed and the root surfaces are thoroughly cleaned. In certain situations, artificial bone graft materials and GTR (Guided Tissue Regeneration) procedures are used in areas where natural bone has been destroyed due to disease. Afterwards, the gums are stitched back in place. The stitches can be removed within 10 – 14 days after surgery.
• In the case of shaking teeth, a procedure called splinting can be done. Here, the loose teeth are attached to the adjacent firm teeth using certain materials.
No medicine can completely cure gum disease as long as the deposits are present on the tooth surface. In acute stages of the disease and following surgical treatment, certain antibiotics and antiseptic mouthwashes may be required to control the disease and prevent infection

What is esthetic gum surgery?
• These are surgical procedures of the gums done for improvement of the esthetic appearance of the patients. • These are usually indicated for people with gummy smile (excessive display of gums while smiling) and also for teeth with receded gums.

How far is treatment of gum diseases successful?
• Treatment of gum diseases is quite predictable and good results are obtained most of the time. • However, long-term success of the treatment depends on co-operation of the patient. • Following treatment, the patient has to maintain his/her oral hygiene properly. Along with this regular dental check ups once in 3-4 months is also required.

Is there any consequence of gum diseases other than loss of teeth?
• Recent studies have shown that chronic gum infections can aggravate many other diseases such as diabetes, heart diseases, respiratory diseases and gastro-intestinal diseases.
• A significant finding is that severe gum infections in pregnant women can result in premature delivery and birth of underweight babies.

How can gum diseases be prevented?
• The only effective way to prevent gum disease is to maintain good oral hygiene.
• For this, the teeth must be proper brushed using the correct technique at least twice a day.
• A dental check-up once every six months is also mandatory. Only a thorough dental examination by a dentist can identify gum problems at the initial stages.
• Remember, there is minimal pain or discomfort for treatment of the initial stages of gum disease.