Gum problems (Periodontal problems)

What then causes gum problems and deep pockets in the gums?

When plaque is not brushed off everyday, the plaque( which contains a lot of bacteria), may calcify overtime to become calculus/tartar. Usually, those plaque above the gum line can be removed by brushing. however, plaque in the pocket is usually harder to brush off. Thus leading to formation of subgingival calculus. subgingival calculus requires a dentist to remove.

Thus it is important to brush everyday as it disrupts the plaque and thus disrupts the bacteria biofilm, and hence reduces the chances of us getting gum problems and tooth decay.

The bacteria biofilm is the major culprit causing tooth decay as well as gum problems.

The problematic thing about calculus is that it has a rough surface which accumulates and traps even more plaque. So it ends up like a positive feedbacck loop which leads to aggravation of the gum disease.

These, if not removed, compromise the health of the gums and causes inflammation, attachment loss( of gums to the tooth) and even bone loss. Over time, it can aggravate if left untreated and may lead to tooth mobilty and eventually tooth loss.

Why are gum problems so important?

Gum problems are usually silent strikers, just like caries( name of disease causing tooth decay). Which is why people usually do not notice it until it gets worse.

Fortunately for all of us, there are two stages to gum problems. Gingivitis and periodontitis.

Gingivitis is the reversible process whereby there is no attachment loss. The process may be reversed if the patient maintains good oral hygiene and a good cleaning up of the calculus is done by the dentist.

However, if left untreated, it may aggravate and turn into periodontitis, which is more severe and is accompanied by attachment loss. At this stage, we cannot reverse the process, but we can arrest it and prevent it from aggravating by thorough cleaning and maintainence of oral hygiene by the patient.

Why do we do gum treatment before restorative work?

If the gum problems are left untreated, it may affect the restorations that are done( eg fillings) and also compromise the health of the teeth. it is wiser to ensure good gum problems before more complex work is done, so that the longetivity of the tooth is ensured before we do complex work. This is much better than doing the complex work and then having to extract the tooth later due to poor oral hygiene!