Believe it or not, gum problems are the most common diseases affecting the human population. Most of the people think that teeth are the only element of a beautiful smile. However, the fact is that the size, shape, integrity and health of gum tissue greatly influence the aesthetic appearance of even the most perfect teeth. Too much gum tissue can lead to teeth that look short and wide while too little gum tissue can lead to exposure of root surfaces of teeth that look way too long.

Periodontics is an area of expertise that deals with treatment of the gum and bone supporting the teeth.

In health, the gums firmly grip the neck of the tooth. If food is allowed to accumulate between the tooth and the gum margin, it forms plaque along with the microbes. The resultant irritation of the gum margins produces a condition called as GINGIVITIS characterized by redness, bleeding and swelling of the gums. If proper attention is paid at this stage the condition is perfectly reversible. However in untreated cases the condition further deteriorates leading to the destruction of the tooth-supporting tissues. The condition is then called PERIODONTITIS or PYORRHOEA. At this stage the teeth start shaking, they are unable to withstand chewing forces, pus forms in the gums and foul smell starts from the mouth.

Treatment

1. Non-surgical treatment involves scaling and polishing of teeth. The procedure aims to remove food particles, plaque and calculus accumulating around the tooth. The effectiveness of the procedure depends largely on the stage of the disease, the efficiency of instrumentation and the maintenance on the part of the patient.

No matter how good we are at brushing, we cannot achieve 100% efficiency in cleaning. So, small depositions continue to occur on a daily basis. For long term maintenance of teeth, it is therefore advisable to go in for a professional cleaning once in six months even if you do not have an evident gum problem.

2. The Surgical approach to treatment is usually recommended for resistant cases where complete removal of the irritants from root surface of the tooth is not possible by scaling alone due to the deep penetration of the deposits. The procedure also called as flap surgery or flap operation involves reflection of the gums by 1-1 1/2 mm and debriding the area under local anesthesia with direct visualization of the deposits. The procedure is completely painless and involves minimum post-operative pain or discomfort.

In certain cases however it is possible to regrow the lost bone by use of certain bone substitutes called Bone grafts. Such cases provide the ideal outcome of therapy by regenerating the lost tissues.

Gum Recession

Another commonly encountered problem with respect to gums is the recession of gum margins. The etiology of the condition is related to faulty tooth brushing technique or the use of hard-bristle brush. The significance of the condition to the patient lies in the fact that the exposed root surfaces left by the receding gums are sensitive to hot and cold and that the exposed root surfaces are prone to decay. Also, receded gums can make your teeth look unnaturally long robbing you of your beautiful smile.

Treatment of gingival recession:

The treatment of gingival recession involves coverage of the exposed root surface. This is achieved either by

1. Pulling the gum margin coronally

2. by covering the recessed area by a transplanted tissue. The tissue may be derived either from one's own body (palate) or some commercially available substitutes (alloderm) may be used. In the past this procedure required that a piece of tissue be harvested from the roof of your mouth to serve as the graft material. Unfortunately, not everyone has enough tissue available or wants to have tissue taken from this sensitive area. Now, however, you have a choice: AlloDerm. Every patient is different and patient results may vary. Only a trained clinician can determine the best treatment plan for you.

What is AlloDerm ?

AlloDerm is donated human tissue that has been processed to remove all cells,leaving behind a regenerative collagen matrix. The matrix is preserved with a patented freeze-drying process.

How safe is AlloDerm?

The donor tissue undergoes the same stringent screening criteria as any other implantable tissue or organ (heart, lungs &kidneys;,etc.). AlloDerm is a processed tissue that comes from donors who are extensively screened and tested for presence of diseases including HIV and hepatitis Since its introduction in 1994,there have been more than 750,000 AlloDerm grafts placed with no incidence of disease transmission.

Why choose AlloDerm for my procedure?

1. AlloDerm allows you to receive the necessary grafting treatment without the concern and discomfort associated with palatal tissue harvesting.

Alloderm is available in unlimited quantities allowing treatment of all necessary areas in fewer visits than would be possible with palatal harvesting.

AlloDerm results are equivalent to those with palatal tissue.

How does AlloDerm work?

AlloDerm repairs damaged tissue by providing a foundation for new tissue regeneration. The components preserved in AlloDerm contain the information that will help your own tissue to grow into the graft after placement. Soon after placement, blood flows from your tissue into the AlloDerm. Next, your own cells move into AlloDerm and begin the process of tissue regeneration. This is the way your body replaces cells during its regular maintenance cycle.

As the healing progresses, more of your cells move into the AlloDerm and transform it into tissue that looks and functions naturally.

What happens after the healing process?

Over time, AlloDerm allows regrowth of your own healthy gum tissue. Once recovery is complete, you won it be able to tell the AlloDerm was ever there.

Splinting- Managing mobile teeth

Splinting refers to "the joining of two or more teeth into a rigid unit by means of fixed or removable restorations or devices. The overall objective is to create an environment where tooth movement can be limited within physiologic limits with simultaneous restoration of function and patient comfort. The splint may be indicated because of individual tooth mobility or mobility of the entire dentition. Splinting may be a way to gain stability, reduce or eliminate the mobility, and relieve the pain and discomfort. Splints may be classified as provisional and definitive. The type of splint depends on the intended goal of therapy.

Temporary splints may be worn for less than 6 months and may not be followed by additional splint therapy. They provide an insight into whether or not stabilization of the teeth provides any benefit before any irreversible definitive treatment is even initiated. These splints typically are fabricated using thin stainless steel wires, and tooth colored composite resin restorative materials. The splint can also be reinforced in several ways using one of the following materials: ligature wire, glass fiber, or a polyethylene fiber reinforced polymer( Ribbond Fiber). When anterior teeth require splinting, tooth colored restorative resin reinforced with polyethylene fiber is the material of choice. Such an interim restoration not only can improve esthetics, it can restore the occlusal scheme to be incorporated into any definitive prostheses. Only after the interim restoration has been worn by the patient can the design and occlusal form of the final prosthesis be evaluated and incorporated. in the definitive restoration. In patients with a history of bruxism and clenching, special occlusal splints are recommended to help stabilize teeth following selective occlusal adjustment.

Permanent splints maintain long term stability of the dentition. Definitive splints are placed only after stability has been achieved in order to increase functional stability, and improve esthetics on a long-term basis. Such treatment includes conventional fixed prostheses (Dental Bridges) because they provide definitive rigidity and are better able to control and direct occlusal forces than removable splints.

However, the mere presence of tooth mobility does not justify the need to splint teeth. Splinting is best viewed as a preventive treatment measure for teeth that have minimal or no bone loss, yet are clinically mobile. Therefore before treatment is started, the cause of any mobility must be identified. Extraction is an appropriate treatment for extremely mobile teeth.