Types, Symptoms, Causes, Diagnosis, Treatment, Surgery and Complications of Gum Diseases
Abstract
Periodontal diseases, also known as gum diseases, start with the buildup of bacterial plaque that causes gingivitis, or inflammation of the gums. If treatment is not received, this condition develops into periodontitis, a destructive infection of the gums, bone, and supporting tissues that can result in tooth loss and is linked to systemic conditions like diabetes, cardiovascular disease, and unfavorable pregnancy outcomes. Poor dental hygiene, tobacco use, diabetes, and heredity are risk factors. The goals of care are to reduce bacterial biofilm, stop the progression of the illness, and replace damaged tissue.
What are Gum Diseases?
Gingivitis: The mildest and most curable type of gum disease is characterized by bacterial plaque-induced gum inflammation.
Periodontitis: A long-term inflammatory condition that spreads past the gum line, damaging the periodontium—the tissues and bone that support teeth—and perhaps resulting in tooth loss.
Causes and Risk Factors
· Bacterial Plaque: The main reason is the development of bacteria biofilms on teeth.
· Poor Oral Hygiene: Plaque buildup results from inadequate brushing and flossing.
· Tobacco Use: An important environmental component.
· Diabetes: Gum disease is more common and more severe in those with diabetes.
· Genetics: Susceptibility is increased by a genetic component.
· Systemic Conditions: Periodontal problems can be a symptom of autoimmune diseases and other ailments.
Health Consequences
Tooth Loss: Teeth that have sustained progressive periodontal disease may become loose and fall out.
Systemic Link: An elevated risk of systemic disorders is associated with periodontal diseases, including:
- 1. Heart-related conditions
- 2. A stroke
- 3. Unfavorable pregnancy outcomes, such as low birth weight or premature delivery
- 4. The pulmonary condition
- 5. Diabetes (perhaps making glycemic control worse due to periodontitis)
- 6. Treatment and Prevention
Oral Hygiene: Plaque control requires thorough and consistent brushing and flossing.
Professional Dental Care: Gum disease must be prevented and managed with routine dental examinations and expert cleanings.
Risk Factor Management: It can be beneficial to manage systemic diseases and control other factors like smoking.
Therapies:
- Professional cleaning and antibacterial rinses are non-surgical options.
- In more advanced situations, surgical procedures including bone grafting and flap surgery are employed to replace missing tissue.
References
Sanz, M., Ceriello, A., Buysschaert, M., et al. (2018). Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. Journal of Clinical Periodontology, 45(2), 138–149.
NHS Digital. (2011). Adult dental health survey 2009: Summary report and thematic series. https://digital.nhs.uk/data-and-information/publications/statistical/adult-dental-health-survey/adult-dental-health-survey-2009-summary-report-and-thematic-series
Bernabe, E., Marcenes, W., Hernandez, C. R., et al. (2020). Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: A systematic analysis for the Global Burden of Disease 2017 Study. Journal of Dental Research, 99(4), 362–373.
World Health Organization. (2022). Global oral health status report: Towards universal health coverage for oral health by 2030. http://www.who.int/team/noncommunicable-diseases/global-status-report-on-oral-health-2022
Forbes, G., Rutherford, S., Stirling, D., Young, L., & Clarkson, J. (2015). Current practice and factors influencing the provision of periodontal healthcare in primary dental care in Scotland: An explorative study. British Dental Journal, 218(7), 387–391.
West, N., Chapple, I., Claydon, N., et al. (2021). BSP implementation of European S3-level evidence-based treatment guidelines for stage I–III periodontitis in UK clinical practice. Journal of Dentistry, 106, 103562.
Department of Health & Social Care, Office for Health Improvement and Disparities, NHS England, & NHS Improvement. (2021). Delivering better oral health: An evidence-based toolkit for prevention. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention
Caton, J. G., Armitage, G., Berglundh, T., et al. (2018). A new classification scheme for periodontal and peri-implant diseases and conditions: Introduction and key changes from the 1999 classification. Journal of Clinical Periodontology, 45(Suppl. 20), S1–S8.
Herrera, D., Sanz, M., Kebschull, M., et al. (2022). Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. Journal of Clinical Periodontology, 49(Suppl. 24), 4–71.
Herrera, D., Berglundh, T., Schwarz, F., et al. (2023). Prevention and treatment of peri-implant diseases: The EFP S3 level clinical practice guideline. Journal of Clinical Periodontology, 50(Suppl. 26), 4–76.
World Dental Federation. (2016). ISO 3950:2016: Dentistry — Designation system for teeth and areas of the oral cavity. International Organization for Standardization.
NHS Wales. (2021). NHS Wales decarbonisation strategic delivery plan 2021–2030. https://www.gov.wales/sites/default/files/publications/2021-03/nhs-wales-decarbonisation-strategic-delivery-plan-2021-2030-summary.pdf
Scottish Government. (2022). NHS Scotland climate emergency and sustainability strategy: 2022–2026. https://www.gov.scot/publications/nhs-scotland-climate-emergency-sustainability-strategy-2022-2026
NHS England. (2023). Greener NHS. https://www.england.nhs.uk/greenernhs/
Scottish Dental Clinical Effectiveness Programme. (2023). Practice support manual. https://www.psm.sdcep.org.uk
Leite, F. R. M., Nascimento, G. G., Scheutz, F., & Lopez, R. (2018). Effect of smoking on periodontitis: A systematic review and meta-regression. American Journal of Preventive Medicine, 54(6), 831–841.
Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Clinical Periodontology, 45(Suppl. 20), S149–S161.
Yang, I., Sandeep, S., & Rodriguez, J. (2020). The oral health impact of electronic cigarette use: A systematic review. Critical Reviews in Toxicology, 50(2), 97–127.
Hartmann-Boyce, J., Lindson, N., Butler, A. R., et al. (2022). Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews, 11(11), CD010216.
Nascimento, G. G., Leite, F. R. M., Vestergaard, P., Scheutz, F., & Lopez, R. (2018). Does diabetes increase the risk of periodontitis? A systematic review and meta-regression analysis of longitudinal prospective studies. Acta Diabetologica, 55(7), 653–667.
Simpson, T. C., Clarkson, J. E., Worthington, H. V., et al. (2022). Treatment of periodontitis for glycaemic control in people with diabetes mellitus. Cochrane Database of Systematic Reviews, 4(4), CD004714.
National Institute for Health and Care Excellence. (2015). Type 1 diabetes in adults: Diagnosis and management (NICE Guideline [NG17]). https://www.nice.org.uk/guidance/ng17
National Institute for Health and Care Excellence. (2015). Type 2 diabetes in adults: Management (NICE Guideline [NG28]). https://www.nice.org.uk/guidance/ng28
Marsh, P. D. (2004). Dental plaque as a microbial biofilm. Caries Research, 38(3), 204–211.
Socransky, S. S., & Haffajee, A. D. (2002). Dental biofilms: Difficult therapeutic targets. Periodontology 2000, 28, 12–55.
British Society of Periodontology. (2019). Basic periodontal examination (BPE) guidelines. https://www.bsperio.org.uk/assets/downloads/BSP_BPE_Guidelines_2019.pdf
British Society of Periodontology and Implant Dentistry & British Society of Paediatric Dentistry. (2021). Guidelines for periodontal screening and management of children and adolescents under 18 years of age. https://www.bsperio.org.uk/assets/downloads/Updated_BSP_BSPD_Perio_Guidelines_for_the_Under_18s_2021_FINAL_270921_vc_PDF_version.pdf
Hamp, S. E., Nyman, S., & Lindhe, J. (1975). Periodontal treatment of multirooted teeth: Results after 5 years. Journal of Clinical Periodontology, 2(3), 126–135.
Miller, S. C. (1950). Textbook of periodontia (3rd ed.). Philadelphia: Blakiston.
Faculty of General Dental Practice (UK). (2018). Selection criteria for dental radiography (3rd ed.).
Lang, N. P., Suvan, J. E., & Tonetti, M. S. (2015). Risk factor assessment tools for the prevention of periodontitis progression: A systematic review. Journal of Clinical Periodontology, 42(Suppl. 16), S59–S70.
Asimakopoulou, K., Nolan, M., McCarthy, C., & Newton, J. T. (2019). The effect of risk communication on periodontal treatment outcomes: A randomized controlled trial. Journal of Periodontology, 90(9), 948–956.
Refbacks
- There are currently no refbacks.