Dr. Neeraja

Gum disease begins with the growth of bacteria in your mouth and it may end with loss of teeth. Thus, the severity of gum disease or periodontitis should not be underestimated. Tooth loss mainly happens due to the destruction of the tissue which surrounds the teeth. 

Types of gum disease:

1. Gingivitis: Gingivitis is basically the first stage of periodontitis. It causes bleeding from the gums and also causes immense pain in the teeth.
2. Periodontitis: In periodontitis, the gum and teeth separate. A gap is formed between the two which may cause debris to accumulate in the space and cause other infections.

Causes of gum disease:
The exact cause of gum disease is not known but here are some of the possible causes:

1. Hormonal changes: Hormonal changes during pregnancy, menopause and puberty are just some times the gums become more sensitive and gingivitis develops.
2. Illnesses: Cancer, HIV, diabetes and other illnesses may cause problems with the immune system and damage the gums. This is an example of how gingivitis is caused as a complication of other disorders.
3. Bad habits: Smoking causes gum disease as you may already know.
4. Poor oral hygiene: Not brushing and flossing may lead to accumulation of food materials in the mouth causing gum diseases.
5. Family history: Family history is also a major contributing factor to what may cause gum disease.

Treatment:
The treatment prescribed for gum disease depends how deep it is set and whether it is a case of gingivitis or periodontitis. Here are the possible treatments for gum disease:

1. Professional dental cleaning: This is the most common treatment used in the early stages of gum disease. In fact, dental cleanings are usually used to prevent it and are used as soon as tartar and plaque buildup. 
2. Scaling and root planing: This is also a type of cleaning except that it needs to be done under a local anesthetic as there is a certain degree of pain involved in the procedure.
3. Surgery: Surgery is also sometimes used to remove the infected pockets and put the gums back in their original place.

The treatment will depend on how severely the tooth was damaged.
Breaks can range from small chips to major fractures, so you might need a major procedure, a minor adjustment or no treatment at all. 
A tooth has three layers: the enamel is the hard outer shell, the dentin is found under the enamel, and the pulp, which is the nerve centre, is at the core.
Minor chips are common, and involve loss of some enamel. Usually, little or no pain is felt, 
But if enough tooth enamel is lost the dentin may be exposed which might cause sensitivity to cold.
The most severe breaks expose the pulp, which can cause extreme pain and even bleeding.
If you have a small chip in your tooth, make a routine dental appointment, and try an over the counter pain medicine for sensitivity as long as it is safe for you to take it. 
More serious fractures should be evaluated immediately. Rinse your mouth out with warm water, cover the break with a piece of clean gauze to protect it, and see the dentist as soon as possible. Apply an ice pack to minimize swelling if your mouth or lips were injured, and avoid using aspirin for pain because as it increases the risk of heavy bleeding.

Even if your tooth is only slightly chipped, the dentist is probably going to take an x-ray of the damaged tooth and recommend being gentle with it for a few days.
 A minor chip can often be smoothed out or repaired with white filling material, often without anesthetic. 
Even when a break is severe, a tooth can almost always be saved with a permanent crown if the pulp is not damaged. 
Postponing a crown or replaced filling that has been recommended can place the tooth at risk for a much more serious fracture- perhaps one that cannot be repaired. On those occasions when a tooth must be removed after a fracture, there are several options available for replacing the missing tooth – an implant is often the ideal choice for many people because it provides a permanent solution with a natural appearance.