Dr. Pallavi

The gums are also called the periodontium which means perio for around and dontium for tooth as the gums are literally present "around the tooth."  There is a softer mucosal portion that runs along the tooth in a curved manner and a stronger fibrous portion that connects the tooth to the jaw bone.  Together, they provide the structural support for the tooth to be held in place. In addition they also have an aesthetic value with the healthy pink color.

The mouth has the largest number of bacteria in the body, which act on the food debris that is present on the tooth and the gums. This causes infection in both the gums and the tooth. 

Types: Periodontal disease can be localized or general.

1. Localized disease happens when a tooth is not accessible for thorough cleaning.  The inside surface of lower incisors and outer surfaces of the upper last molars are common areas of localized periodontal disease. 
2. Generalized periodontal disease can be due to conditions like pregnancy, puberty, diabetes problem where gums around all the teeth are affected.

Symptoms: In both the cases, the following symptoms ensue: 

1. The gums are of a healthy pink color and if they turn darker hue of pink
2. Swollen and/or painful gums
3. Spontaneous bleeding: This may be localized or generalized 
4. Chronic bad breath: Due to food accumulation in the infected gums
5. If it continues to form an abscess, pressure on the gums can produce pus
6. Bad taste in the mouth (arising from pus in the gums)
7. Gingival recession, producing an effect of having longer tooth 
8. Dentin is exposed leading sensitivity to hot or cold foods
9. Loosening of the tooth
10. Painful chewing, as it puts pressure on the inflamed periodontium
11. Dentist will identify what are called pockets, which is an indication of severity - the deeper the pockets, the severe the disease.

Management and Prevention: Gum disease is very easy to identify and can be completely cured.

1. Regular brushing and flossing can help maintain regular oral hygiene 
2. With each brushing session, plain finger massage of the gums improves blood circulation and their overall health
3. Regular use of mouth rinse is a good way to improve gum health
4. Regular visits to the dentist can help keep a check on the health of the teeth and the gums - early identification of disease and early treatment
5. Once it has set in, deep scaling followed by root planing may be required to thoroughly clear out the infection
6. More surgical options like gingival grafts, flap surgery, bone grafting in case of severe bone loss may be required. 
7. Management of conditions like diabetes

The best way to avoid periodontal disease is to know its symptoms, follow oral hygiene practices, and consult a dentist regularly.

How scared are you of root canals? what if we tell you. You no longer need to be?
Root canals are easily one of the most dreaded treatments in the world. I have seen patients compare the anxiety they feel before a root canal to things like open heart surgery and labour. The last thing you want to hear on a dental chair is the diagnosis that you need a root canal. The horror stories surrounding this dental treatment range from gruesome to excruciating.

This article is an attempt to dispel the mystery and pain associated with root canals and show you how far we have come from the horrors to the sophistication of the latest technology.

From painful to pleasing

What are root canals really?
In its simplest sense a root canal is a deep filling done by cleaning the infection from the third and innermost layer of the tooth which is made up of nerves and blood vessels.

Our tooth is made up of 3 layers the first 2 are hard and confined layers called enamel and dentin when decay affects these it is very slow to spread and easy to remove and fill within one short session.

The third layer may take 1-3 sessions to clean as the infection may have spread or collected in the supporting tooth structures.

Why are root canals considered painful?

The 3rd layer of our tooth is a nerve chamber containing soft nerves and blood vessels in communication with the rest of our body.

This is the place that communicates pain to our brain and this is why when decay or bacteria hit this soft deeper layer we experience sharp shooting pain.

Top 3 reasons why root canals used to be painful

    Improper or inadequate anesthesia to numb the inflamed nerve
    Mechanical instrumentation to manually pull out the nerve which we now dissolve and clean with automated machines
    Lack of the right medications to use within the tooth.

What happens to root canal infections if left untreated?
If this pain is suppressed with medication and not treated it can lead to an infection spreading within the bone which may later lead to a swelling with pus etc.

If this infection is left within it can eat into the supporting bone and eventually infect or affect the adjacent teeth as well.