The gingiva (gum) is the protective type of skin that is closely adapted to the necks of the teeth and covers the bone holding the roots of the teeth. There is a shallow ditch like space that separates the margin of the normal gingiva from the tooth surface. This space is 2mm in depth and is called gingival sulcus. It is one of the places that a dentist will carefully examine to detect the presence of gum disease.
The gums are firm and pink. The bone is healthy and supports the teeth.
How is the tooth held in the jaws?
Each tooth consists of two parts (a) the crown - that can be seen in the mouth of the person and (b) the root that is enclosed within the bone and the gingiva. The tooth is not directly attached to the bone, for there is a thin, elastic and fibrous tissue between them called the periodontal ligament, which attaches the tooth to the surrounding bone. When the tooth is used for biting or chewing, the periodontal ligament acts like a cushion and prevents the biting or chewing force to be directly transferred to the jaw bone. The gingiva, periodontal ligament and the bone that encloses the roots of the teeth are collectively referred to as periodontal tissue.
What is plaque and how does it form?
In a mouth that is not kept clean by regular oral hygiene practice, a thin, soft, sticky colorless layer is constantly formed on the surface of teeth and it is called dental plaque. Dental plaque is just layers of growing mass of various types of bacteria that are present in the mouth. Dental plaque in small quantities is almost invisible, but in large quantities it can be felt with a tongue as a fuzzy unclean coating. If plaque is not completely removed everyday by tooth brushing and flossing, the remaining plaque becomes a stony crust called calculus/tartar. Calculus clings to the teeth with such force that only a dentist or a hygienist with the help of special instruments can remove it.
What causes Gum Disease?
Gum disease, is an infection of the gums caused by bacteria. These bacteria produce toxins that irritate the gingiva, and also directly infiltrate into the gingiva causing them to become inflamed and bleed easily. If the irritation persists, the gingiva separate from the teeth and form pockets. Plaque then forms within these pockets and eventually destroys the gingiva and the underlying bone. The teeth may then become loose and fall out or need to be removed. There are other factors that may contribute to gum diseases. They are as follows
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Plaque traps-
Decayed teeth, broken or ill fitting dentures, crowded or crooked teeth, improper filled teeth may provide secure areas for plaque to form, from where it cannot be removed by routine oral hygiene methods.
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Systemic factors-
Individuals with diseases such as Diabetes, leukemia or people who are on certain medications may be particularly prone to gum diseases, because their resistance to this disease has been lowered and/or that their gums become increasingly sensitive to any local irritation.
Bacterial Plaque collects on the teeth at the gum line. Eventually the gums become red and inflamed. As the inflamation progress, the gums become red, puffy and bleed easily.
If the Inflammation continues for a long period of time. the gums will eventually pull away from the teeth forming a deep pocket or gum crevice. These pockets become filled with bacterial plaque and hard deposits, and bone is lost. The infection at this stage, is usually painless although puss may be present. The Bone is damage and begins to deteriorate.
The infection over time spreads and becomes more severe. This process results in bone loss, the teeth shift and start to become loose.
Advanced gum disease is one of the leading causes of tooth loss in adults. Bone loss is severe and there are gum abscesses. The infection is severe and painful.
Infected gums with bone loss is known as periodontistis (Pyohrea ) and is a very common form of gum disease.
Without proper home care including brushing and flossing, bacterial plaque accumulates on the teeth. Over time this will eventaully result in inflamation and damage to the gum tissues and bone. In it's advanced stages the gums pull away from the teeth bone is lost, a person will experience pain and the teeth become loose. Periodontitis is the leading cause of tooth loss in adults.