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Preshaw, Philip M (15 September 2015). "Detection and Diagnosis of Periodontal Conditions Amenable to Prevention". BMC Oral Health. 15 (S1): S5. doi: 10.1186/1472-6831-15-s1-s5. PMC 4580822. PMID 26390822. Periodonditis also needs a professional clean, which includes deep scaling and root planning to clean between the gums and teeth down the roots. In severe cases, surgery may be required to remove all bacteria. Occasionally, soft tissue grafts are required. After treatment, an improved oral hygiene regimen is essential. How do I prevent gum disease? Gum disease happens when the tissue around your teeth gets infected, causing inflammation. Plaque-forming bacteria that build up on your teeth usually cause this swelling as it spreads below the gum line. A periodontist is a gum specialist. They focus on treating conditions that affect the tissues that support your teeth (such as your gums and jawbone). In addition to graduating from a four-year dental school, a periodontist receives three years of additional training before earning their license to practice periodontics in the U.S. Why would you see a periodontist? The non-surgical phase is the initial phase in the sequence of procedures required for periodontal treatment. [41] This phase aims to reduce and eliminate any gingival inflammation by removing dental plaque and calculus, restoration from tooth decay and correction of defective restoration, as these all contribute to gingival inflammation, also known as gingivitis. [41] Phase I consists of treatment of emergencies, antimicrobial therapy, diet control, patient education and motivation, correction of iatrogenic factors, deep caries, hopeless teeth, preliminary scaling, temporary splinting, occlusal adjustment, minor orthodontic tooth movement and debridement. [41] Re-evaluation phase [ edit ]

The main cause of periodontitis is poor oral hygiene. Bacteria cling to plaque and tartar on your teeth surfaces. If you don’t clean your teeth as well or as often as you should, bacteria travel down beneath your gum line, where your toothbrush and floss can’t reach. These harmful bacteria erode the tissues that support your teeth, leading to infection, bone loss and tooth loss. A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease (a chronic inflammatory disease that affects the gums and bone supporting the teeth also known as gum disease), and in the placement of dental implants. Periodontists receive extensive training in both of these areas and more, including three additional years of education beyond dental school.Reversible interaction: there is electrostatic attraction or hydrophobic interaction between microorganisms and the tooth surface. [19]

Multiplication: through continued growth and maturation of existing plaque micro-organisms and the further recruitment of later colonisers. [19] Many periodontists also place dental implants, though the procedure isn’t exclusive to the field of periodontics. Oral surgeons and some general dentists place dental implants as well. Climax community (homeostasis): after a prolonged period of stability, the bacterial community has sufficient nutrients and protection to survive. These complex biofilms are usually found in hard to cleanse areas. Nutrition is provided from dietary consumption of the host for supra-gingival biofilm organisms and from blood and GCF for the sub gingival biofilm organisms. [19] a b c Gurenlian, JoAnn R. (31 December 2007). "The Role of Dental Plaque Biofilm in Oral Health". American Dental Hygienists' Association. 81 (suppl 1): 116. The exact treatments that your dentist or surgeon will choose depends on the severity of the periodontal disease. Nonsurgical treatments

How do you find periodontal treatment?

To become a dentist, you must complete five years of study at a dental school and two years of supervised practice. When applying for dental school, the requirements are achieving A grades at A-level (or equivalent) qualifications. These tests help them create a periodontal treatment plan. Your periodontist, a dentist, or dental hygienist may all be part of your treatment. Antibiotics or a thorough cleaning can often control early stages of gum disease. More advanced cases may require surgery. A periodontist routinely performs gum surgeries. There are several different types of surgical periodontal treatments, including: A periodontist will assess your medical history as a starting point. Issues relating to general health are likely to affect the gums and bone structure of your mouth. Things that can come into consideration are pregnancy, diabetes, heart disease, and many other conditions. The varying nature of each individual case makes it vital for a periodontist to assess your specific needs. Risk characteristics must be considered in conjunction with risk factors as variables that may also contribute to increasing or decreasing one's chances of developing periodontal disease. Numerous studies show that age, gender, race, socioeconomic status, education and genetics also have strong relationships on influencing periodontal disease.

Also acute necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis, it is a type of periodontal disease different than many other periodontal diseases. Clinical characteristics include gingival necrosis (breakdown of the gums), gingival pain, bleeding, halitosis (bad breath), as well as a grey colour to the gingiva and a punched out appearance. [ clarification needed] It is treated through debridement, usually under local anaesthetic due to immense pain. To maintain and treat the condition completely, a chlorhexidine mouthwash should be recommended to the patient to use twice daily, oral health instruction should be provided (using a soft bristle toothbrush or electric toothbrush twice a day) and an interdental cleaning aid, such as floss or interdental brushes, which cleans the areas that the toothbrush cannot reach. The patient should also be educated on proper nutrition and diet and healthy fluid intake. Smoking cessation should occur not only to completely eradicate the disease but also for the health of the patient. Pain control can be done through ibuprofen or paracetamol/acetaminophen. In the case of an immunocompromised patient, antibiotics should be prescribed. Assessment of treatment should be done after 24 hours of treatment and continued every 3–6 months until signs and symptoms are resolved and gingival health and function restored. [55] Chronic periodontitis [ edit ] Gum recession that doesn’t result from too much brushing is usually a sign of later-stage gum disease, however. At this point, a periodontist can examine the issue and advise on appropriate treatment. What to Expect at the Periodontist Tezal, Miné; Grossi, Sara G.; Ho, Alex W.; Genco, Robert J. (February 2001). "The Effect of Alcohol Consumption on Periodontal Disease". Journal of Periodontology. 72 (2): 183–189. doi: 10.1902/jop.2001.72.2.183. PMID 11288791.

Symptoms

Periodontal diseases can be caused by a variety of factors, the most prominent being dental plaque. Dental plaque forms a bacterial biofilm on the tooth surface; if not adequately removed from the tooth surface in close proximity to the gingiva, a host-microbial interaction gets underway. This results in the imbalance between host and bacterial factors which can in turn result in a change from health to disease. Other local or systemic factors can result in or further progress the manifestation of periodontal disease. Other factors can include age, socio-economic status, oral hygiene education and diet. Systemic factors may include uncontrolled diabetes or tobacco smoking. [15] The type of treatment you will have will depend on how serious your gum disease is. The aim of treatment is to control any existing gum disease and prevent further problems arising. Surgical crown lengthening:Sometimes when a tooth breaks off near the gum line, there isn’t enough room to place a dental crown. When this happens, your periodontist can remove a few millimeters of gum and bone tissue around that tooth so the crown can fit properly.

The best way to prevent gum disease is pretty simple – clean your teeth twice a day and floss daily. Brush the teeth for two to three minutes at a time and ensure the head of the toothbrush moves along the gum line pointing towards the gum so that bristles work their way beneath the gums. Also, it’s worth using a mouthwash as a final step in the process. Oshman, Sarah; El Chaar, Edgard; Lee, Yoonjung Nicole; Engebretson, Steven (25 July 2016). "Effect of patient age awareness on diagnostic agreement of chronic or aggressive periodontitis between clinicians; a pilot study". BMC Oral Health. 17 (1): 27. doi: 10.1186/s12903-016-0258-0. PMC 4960759. PMID 27456238.A risk factor is a variable that in health can be defined as "a characteristic associated with an increased rate of a subsequently occurring disease". [23] Risk factors are variables that contribute to disease, rather than being factors that induce disease. Risk factors may be seen as modifiable and non-modifiable. Modifiable risk factors are often behavioural in nature and can be changed by the individual or environmental circumstances, whereas non-modifiable factors are usually intrinsic to an individual's genetics and cannot be changed. To determine risk factors for a disease, evidence-based research and studies are needed for evidence, with longitudinal studies giving the most statistically significant outcomes and the best reliability for determining risk factors. Risk factors often coexist with other variables, rarely acting alone to contribute to a disease. Risk factors can be genetic, environmental, behavioural, psychological, and demographic in nature. [24] The primary aetiological factor for periodontal disease is plaque biofilm of dental biofilm. A dental biofilm is a community of microorganisms attached to a hard, non-shedding surface. In the oral cavity, hard non-shedding surfaces include teeth, dental restorative materials and fixed or removable dental appliance such dentures. [15] It is this adherence to non-shedding surfaces that allows bacteria in a dental biofilm to have unique characteristics of clinical significance. Michalowicz, Bryan S.; Diehl, Scott R.; Gunsolley, John C.; Sparks, Brandon S.; Brooks, Carol N.; Koertge, Thomas E.; Califano, Joseph V.; Burmeister, John A.; Schenkein, Harvey A. (November 2000). "Evidence of a Substantial Genetic Basis for Risk of Adult Periodontitis". Journal of Periodontology. 71 (11): 1699–1707. doi: 10.1902/jop.2000.71.11.1699. PMID 11128917. Smile lift:Some people have excess gum tissue that covers part of their teeth when they smile. People who want to improve the appearance of their smile can have a smile lift. During this procedure, your periodontist removes gum — and usually a small amount of bone — from around the affected teeth. Your periodontist can perform a smile lift as a stand-alone procedure or they may recommend it in combination with veneers. Signs and symptoms of periodontal disease: bleeding gums, gingival recession, halitosis (bad breath), mobile teeth, ill-fitting dentures and buildup of plaque and calculus. [16]