Studies have shown a strong correlation of many systemic diseases like diabetes,stroke etc. worsening with gum infections, and vice versa.Gum diseases/problems are the most ignored diseases as they are chronic in nature (slow progressing) and do not show symptoms until the infection has reached a considerable depth in the gums.
There are 4 stages of gum disease:
|Stage 1 –
|Mild inflammation (redness) of the gums with little or no bleeding of the gums. This stage can be detected only by the dentist||A minor procedure like Oral Prophylaxis(regular clean up) every 6 months can prevent progression and maintain good oral hygiene|
|Stage 2 –
|Moderate inflammation of the gums along with bleeding while brushing and biting onto hard food. There is marked accumulation of tartar and deposits||A deep cleaning and a procedure called ‘Root Planing’ will help to remove all the deposits and help heal the gums and the surrounding soft and hard tissue. This should be followed by adopting a good oral hygiene regime and a follow up oral prophylaxis(clean up) every 6 months|
|Stage 3 –
|Inflammation and infection of the gums and the surrounding tissue which results in bone loss around the tooth||At this stage a minor surgical procedure called Flap Surgery is recommended|
|Stage 4 –
|Severe infection of the gums with pus formation resulting in severe bone loss causing a few teeth to be mobile||At this stage too, a flap surgery is done followed by removal of the teeth which cannot be saved. However this stage can be prevented with regular dental check-ups|
Flap Procedure for Gum Disease.
You may need surgery for severe gum disease (Periodontitis) if it cannot be cured with antibiotics or root planing and scaling. A flap procedure cleans the roots of a tooth and repairs bone damage caused by gum disease. A gum specialist (periodontist) or an oral surgeon often performs the procedure, using a local anaesthetic.The doctor will pull back a section of your gums to clean the roots of your teeth and repair damaged bone, if needed. The gum flap will be sewn back into place and covered with gauze to stop the bleeding.
Why Is It Done?
The flap procedure is necessary when severe gum disease (periodontitis) has damaged the bones that support your teeth.
What to Think About?
A flap procedure is often needed to save teeth that are supported by a bone damaged by gum disease.
Gum disease usually will come back if you do not brush and floss regularly after surgery.
To promote healing, stop all use of tobacco. Smoking or using chewing tobacco decreases your ability to fight infection of your gums and delays healing. You should see your dentist regularly so your progress can be monitored. If your gum disease spreads, you may lose teeth.
WISDOM TOOTH EXTRACTION
Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth – the four permanent adult teeth located at the back corners of your mouth on the top and bottom.If a wisdom tooth doesn’t have room to grow (impacted wisdom tooth), resulting in pain, infection or other dental problems, you’ll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon. Some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren’t causing problems, as a preventive measure against potential future problems.
Why is it done?
Wisdom teeth are the last of your teeth to come in, or erupt, through the gums. Sometimes a wisdom tooth becomes impacted (or stuck below the surface of your gums) and grows at an odd angle, possibly causing complications.
Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.
Many people, however, develop impacted wisdom teeth — teeth that don’t have enough room to erupt into the mouth or grow normally. Impacted wisdom teeth may erupt only partially or not at all.
An impacted wisdom tooth may:
• Grow at an angle toward the next tooth (second molar)
• Grow at an angle toward the back of the mouth
• Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
• Grow straight up or down like other teeth but stay trapped within the jawbone
You will likely need your impacted wisdom tooth pulled if it results in problems such as:
• Damage to an adjacent tooth
• Development of a fluid-filled sac (cyst) around the wisdom tooth
• Damage to surrounding bone
• Complications with orthodontic treatments to straighten other teeth
Most wisdom tooth extractions don’t result in long-term complications. Problems that can occur include:
• Dry socket, or exposure of bone when the post-surgical blood clot is dislodged from the site of the surgical wound (socket) — a complication that delays healing and causes pain
• Infection in the socket from bacteria or trapped food particles
• Damage to sinuses near the upper wisdom teeth
• Weakening of the lower jawbone
• Damage to nerves that results in altered sensation in the lower lip, tongue or facial muscles.
Preparing for the surgery
A wisdom tooth extraction is almost always performed as an outpatient procedure. This means that you go home the same day.
You’ll receive instructions from the hospital or dental clinic staff on what to do before the surgery and the day of your scheduled surgery.
Your doctor or oral surgeon administers local anaesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to the gums that numbs the site. You’re awake during the tooth extraction. Although you’ll feel some pressure and movement, you shouldn’t experience pain.
During wisdom tooth extraction, your dentist or oral surgeon:
• Makes an incision in the gum, creating flaps to expose the tooth and bone
• Removes any bone that blocks access to the tooth
• Divides the tooth into sections if it’s easier to remove in pieces
• Removes the tooth
• Cleans the site of the removed tooth of any debris from the tooth or bone
• Stitches the wound closed to promote healing, though this isn’t always necessary
• Places gauze over the extraction site to control bleeding and to help a blood clot form
After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in dislodging the blood clot from the socket.
Drink lots of water after the surgery. Don’t drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don’t drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.
Eat only soft foods, such as yogurt or bread for the first 24 hours. Start eating semi soft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.
You may be able to manage pain with a prescription pain medication — given by your doctor or oral surgeon — or an over-the-counter pain reliever, such as acetaminophen (Tylenol, others). Holding a cold pack against your jaw also may relieve pain.
Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don’t dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.
Swelling and bruising:
Swelling and bruising of your cheeks usually improves in two or three days. Use an ice pack as directed by your dentist or surgeon.
Cleaning your mouth:
Don’t brush your teeth, rinse your mouth, spit or use a mouthwash during the first 24 hours after the surgery. After that time, gently rinse your mouth with warm salt water every two hours and after meals for a week after your surgery. Mix 1/2 teaspoon (2.5 millilitres) of table salt in 8 ounces (237 millilitres) of water. After the first 24 hours, resume brushing your teeth, being particularly gentle near the surgical wound to avoid disrupting any stitches.
If you smoke, don’t do so for at least 24 hours after surgery — and wait longer than that if possible. If you chew tobacco, don’t use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.
You may have stitches that dissolve within a few weeks or if your stitches need to be removed, schedule an appointment to have them taken out.
If complications develop, your dentist or oral surgeon will discuss appropriate treatment options with you.