Gingivitis is one of the most common oral problems. It is a mild inflammation of the gums that causes discomfort, bleeding and irritation. In the vast majority of cases, it is caused by not brushing our teeth enough, but, although it is a reversible problem, we must take it seriously because if we let it evolve it can turn into periodontal disease, a problem that is more difficult to solve and that If left untreated, it can sometimes lead to total loss of teeth.

• Inflammation and loss of the light pink color of the gums.
• Bleeding when brushing or flossing
• Bad breath
• Receding gums
• Possibility of the appearance of tooth sensitivity

If we don’t brush our teeth properly, plaque builds up on them. This plaque is a kind of invisible sticky film full of bacteria that must be removed daily. If we don’t, this plaque will eventually harden, turning into tartar that accumulates under the gums. This tartar makes it more difficult to remove plaque and also protects bacteria. As a result, the gums become inflamed and begin to cause discomfort and bleeding. If we do not solve the problem in time and allow the problem to establish itself, the inflammation will cause the loss of those gums and the bone underneath, thus initiating periodontal disease.

• Poor oral hygiene
• Misaligned teeth: they make it difficult to clean them properly and therefore favor the accumulation of plaque and tartar and with it the development of gum diseases.
• Tobacco
• Age
• Dry mouth
• Diet poor in fruits and vitamins
• Diseases that affect immunity such as HIV or leukemia
• Hormonal changes such as those that occur in pregnancy.

• Keep an eye on your dental hygiene. Not only in the amount of brushing but in the quality of them.
• Choose a suitable toothbrush for your gums and change it when the bristles lose efficiency.
• Don’t forget interdental hygiene. Use interproximal brushes and dental floss to reach hard-to-reach areas.
• Treat crowding problems. Poorly aligned teeth can prevent proper oral hygiene.
• Improve the health of your gums with the use of dental irrigators. The use of pressurized water facilitates the elimination of food remains, especially in patients with dental prostheses. It also helps reduce gum bleeding and inflammation.

It is usually easily resolved by performing a professional cleaning in the office and improving hygiene habits, using dental floss and a specific paste and rinse for the gums.

Periodontitis is the most serious disease that affects the gums, and should be treated as soon as it is detected since it can cause serious problems that include tooth loss and complications in other areas of our body, such as heart disease, rheumatoid arthritis or diabetes.

Apart from those of gingivitis, we add

• Very sensitive gums. Pain when chewing
• Teeth that move
• Very receding gums

If we do not treat gingivitis and let it evolve, the continued infection caused by bacteria that were under the gums causes the destruction of the bone that supports the tooth, which is called the alveolar bone, appearing the so-called periodontal pockets. This is the beginning of periodontal disease, which if left untreated can cause teeth to move and even be lost.

Periodontitis is a very common disease but it can be largely prevented as we have said: maintaining good oral hygiene and a mouth free of tartar and plaque. For this, it is very important to brush your teeth after each meal, floss and not allow tartar to accumulate by regularly visiting the clinic for dental cleanings. Other risk factors for periodontitis are:

• Tobacco
• Certain diseases such as diabetes or Crohn’s disease
• Unhealthy diet.
• Unfortunately, there is also a genetic predisposition to periodontal disease that we cannot control.

To treat periodontal diseases, it is essential to perform a professional deep cleaning to remove all the plaque and tartar that are under the gums. This is done through ultrasound cleaning (in case of gingivitis) or curettage, when there is periodontal disease. Although lost bone cannot be recovered, if we keep our teeth clean and healthy, the disease process can be stopped.

PERIODONTAL DIAGNOSIS

In order to make a correct diagnosis and assess the extent of the injury to the gums, it is necessary to perform a series of medical tests, such as a microbiological study to know the type of bacteria causing the disease, probing of the periodontal pockets and a radiological study In most cases. With this information, a forecast is made for each tooth.

DEFLAMMATORY PHASE

Once we have the diagnosis, a deep cleaning is carried out to remove both the superficial tartar and the one that is lodged under the gum. For this, a scaling and root planing or curettage of each tooth is carried out.

Normally, this treatment is performed in quadrants (the mouth is divided into 4 quadrants or parts) and under local anesthesia. It is usually done in 2 or 4 appointments.

REVISION

Once the teeth and gums have been thoroughly cleaned, it is essential to have periodontal disease under control. Therefore, a series of maintenance appointments are scheduled.

SURGICAL PHASE (if applicable)

In cases where the periodontal pockets are very deep and the tartar cannot be removed by scaling and root planing, it is necessary to perform periodontal surgery, reducing the size of the periodontal pockets by cutting off the excess gingiva and thus allowing better hygiene of the the same.

MAINTENANCE

The maintenance phase in periodontal disease is life-long. Review appointments are scheduled every 3 or 6 months. At this stage it is essential that the patient maintain good oral hygiene. The success of the treatment will depend on it.

Is the treatment painful?

Periodontal treatment is not painful since it is performed under local anesthesia, and the improvement in the health of the mouth in general is very significant. It is necessary to think that a deep cleaning of areas that have sometimes remained inflamed for months or years is carried out, leading to a great improvement in the well-being of the patient.

How long does the treatment result last?

The gums will remain healthy as long as we do not allow plaque and tartar to accumulate under them. If we carry out a correct maintenance of our hygiene and avoid the deposits of tartar through periodic professional cleaning, the disease can be stopped for a long time.

Is periodontal disease common?

Periodontal diseases are much more frequent than people can imagine, and in most cases they go unnoticed until the most serious stages and when the prognosis of the teeth is most unfavorable. According to the latest most relevant epidemiological studies:

Spanish adults between 35-44 years old, only 14.8% have healthy gums. 59.8% have gingivitis, and 25.4% periodontitis.

In people older than 65-74 years, only 10.3% have healthy gums; the rest have some type of periodontal disease. 51.6% present gingivitis, and 38% also periodontitis. In those over 35 years of age, more than half the population has gingivitis, and one in three people has periodontitis.

GINGIVECTOMY

This treatment consists of «trimming» or reshaping the gums a bit to improve dental aesthetics when there is excessive gum growth (hyperplasia) or recurrent inflammation.

CORONARY ELONGATION

Technique with which we manage to remove part of the gum tissue to reveal more of the tooth. It is a very effective cosmetic procedure when we find short teeth or smiles where a lot of gum is shown.

GUM GRAFT

It is performed in cases where the loss of the gum has exposed part of the root of the tooth, causing sensitivity or to prevent cavities that are difficult to treat. In this way we can reestablish the lost gingiva. It can also be useful to achieve gingival volume increases in aesthetic areas.

FRENECTOMY

It consists of the intervention on the frenulum of the tongue or the upper lip when its abnormal size or shape hinders the normal functions of the mouth.