DISEASES OF THE GUM AND BONE

The presence of calculus and plaque close to the teeth is a source of continuous release of irritating and harmful bacterial substances for the tissues of the mouth. Certainly the gum also has defense possibilities: they are supplied by capillaries that carry the immune system cells. However, there is a physical - anatomical problem: plaque and calculus are in fact pathological structures external to the gum and cannot be reached by the defense cells of our organism. This is ultimately why plaque cannot be spontaneously removed from the body.

The prolonged presence of plaque and calculus above and below gingival margins, results in gum disease.

 

a) GINGIVITIS

The gum shows a more or less acccentuated and continuous state of irritation. Depending on the age of the patient, the quality of the plaque, the quality of capillary blood supply to the gingiva, this irritation or inflammation can manifest itself with different intensity.

Gingivitis is recognized by the widespread redness, by a certain sense of soreness or burning, by the (rather frequent) presence of bleeding. Of course, in some individuals a minimal amount of plaque is enough to cause it, while others will need a larger amount.

 

b) PERIODONTITIS

It is often an evolution of gingivitis. The organic defenses of the tissues (gum and bone) begin to yield, and the bacterial plaque opens its way downwards, along the root of the tooth. The gum detaches from the collar and puts plaque bacteria in contact with the underlying bone. At this point the true supporting tissue of the tooth is affected as it begins to recede downwards (apex of the root) and reabsorbing itself. The gum can also remain in place, so that what happens underneath can be overlooked by an external eye. This creates a gum pocket: a situation in which bacterial plaque continues to creep under the gum and consume the bone.

Symptoms and signs of this condition vary extremely. In particularly resistant people, the pockets may even be free from symptoms, but generally there should be widespread bleeding of the gums, some pain (even acute), heavy redness, bad odor, pus discharge, and sometimes the formation of real abscesses.

Not all of these signs and symptoms are present at the same time, but they still outline an ongoing disease. When the amount of bone that has been consumed reaches a sufficient level, the tooth has lost so much support that it begins to be unstable and it starts wobbling. At this point the situation can degenerate up to the total loss of the supporting bone, which will lead to the loss of the tooth itself.

 

c) GINGIVAL RECESSION

It is the spontaneous withdrawal of the gingival collar towards the root of the tooth. It is not necessarily a disease: within certain limits it can be considered physiological with age, a bit like graying hair or vision problems. Usually it alarms the patient much more than gingivitis, because it occurs preferably on teeth that have an aesthetic value and is therefore evident in its effect of lengthening the visible crown.

Patients themselves do not have on average a continuous view of their teeth and, when they discover a recession, they get very worried thinking that it has happened very quickly. Of course, the process is actually extremely slow and takes years. It is favored by not very resistant and thin gums, incorrect and too aggressive brushing, traumatic occlusion, presence of frenula (fibrous formations similar to tendons contained in the mucosa that covers the roots and which exert a "traction" on the gum collar).

The direct consequence on the tooth is that the root is uncovered, and the relative increase in the thermal or mechanical sensitivity of the tooth itself, or even the formation of abrasions on the uncovered root that have the appearance of a "axe blow": these problems can be treated with desensitizing substances or with the filling of the collar lesion.

In all cases in which the situation is judged dangerous, it is possible to stop the process or at least slow it down with a gingival graft surgery taken from the palate (or from other areas where a more rigid gum may be found). According to some operators it is even possible to cover the root by recovering the lost gum: in this case, however, the graft is placed on the bare root, without the possibility of regenerating the bone also, so the result has a more uncertain stability over time. .