Periodontology is a branch of dentistry that examines tissues surrounding teeth such as gums and alveolar bone, aiming to diagnose diseases that occur in these tissues, provide treatment, and maintain health after treatment.

Healthy gums are typically pink, matte, with a surface resembling an orange peel texture, and form a knife-edge shape towards the teeth. As gum inflammation progresses, the gums become red, warm, swollen, shiny, and bleed easily.

There are many signs of gum (periodontal) diseases:

• Bleeding gums
• Red, tender gums
• Gums that are prone to detach from the teeth
• Inflammatory discharge from the gums
• Receding gums, losing the knife-edge appearance and flattening
• Loose, spaced-apart teeth
• Bad breath

The primary cause is bacterial plaque. Bacteria accumulate and form plaque on tooth surfaces that are not adequately cleaned. This plaque is soft and can be removed by brushing and flossing. However, areas that cannot be cleaned properly harden due to certain substances and minerals in saliva, forming tartar. Tartar cannot be removed by brushing alone and requires professional intervention.

Tartar can form on visible or hidden parts of your teeth. Proper tartar removal is essential to eliminate these deposits and alleviate discomfort in the area.

If left untreated, tartar continues to cause inflammation and bleeding, leading to gum recession. Over time, advanced tartar can result in bone loss around the teeth, tooth mobility, and eventual tooth loss.

Causes of Gum Diseases

Tartar forms when plaque is not adequately removed. However, the development of gum disease can accelerate due to factors other than plaque.

• Genetic predisposition
• Smoking: Narrows blood vessels, reducing gum blood supply, masking bleeding and disease.
• Medication Use: Birth control pills, antidepressants, and some blood pressure medications affect gum tissue.
• Hormonal Changes: During pregnancy, adolescence, menopause, menstruation, extra care must be taken with oral hygiene. Gums soften, blood vessels widen, bleeding increases, and body resistance decreases.
• Stress: Lowers body resistance.
• Teeth Clenching/Grinding: Reduces the force between teeth and gums, leading to destruction of periodontal tissue.
• Poor Nutrition: Weakens the body and immune system, leading to infections. Vitamin C deficiency is directly related to gum inflammation.
• Diabetes: Diabetics must take extra care of their oral health. Delayed wound healing and increased destruction of surrounding bone may occur.
• Poorly made bridges and fillings can apply pressure to the gums, subjecting the area to trauma.

Gingivitis: The earliest stage of gum disease, characterized by gum inflammation due to plaque at the gum line. Your gums may bleed during brushing and flossing. Damage can be prevented at this stage because the bone and supporting tissues of the tooth have not yet been affected.

Periodontitis: In this stage, irreversible damage has occurred to the supporting bone and fibers that hold your teeth in place. A pocket may start to form below the gum line, trapping food and plaque. Prompt treatment and diligent at-home oral care can often prevent further damage.

Advanced Periodontitis: In this final stage of gum disease, the supporting fibers and bone that hold teeth in place are severely damaged, leading to tooth mobility. This condition can affect your bite, cause gaps between teeth, and if teeth cannot be saved with intensive treatment, tooth extraction may be necessary.

Preventing Periodontitis

Regular and effective brushing of all areas for an optimum two minutes, using dental floss, interdental brushes if there are gaps between teeth, and mouthwashes can help prevent gum diseases.

Treating Periodontitis

If prevention is delayed and bleeding or swelling begins, professional tartar removal by a periodontist is necessary. After all areas are properly cleaned, a polishing procedure called prophylaxis is performed to remove stains from tooth surfaces and eliminate attachment areas.

The optimum interval for tartar removal is every six months.

If the condition is more severe, root planing (scaling) may be performed. In this procedure, bacterial plaque and tartar attached to tooth roots are removed using special instruments, and root surfaces are smoothed to prevent further bacterial attachment.

After treatment, frequent check-ups should be conducted, and oral care should be continued as instructed by the dentist.