Periodontal or Gum disease
Periodontal disease is more commonly known as gum disease and was referred to as pyorrhoea in the old days. It is a progressive inflammatory disease of the gingival and the surrounding tissue (bone) around the teeth. Periodontal disease is the number one cause of tooth loss after the age of 30 and it is believed that around 80% of the population above the age of 30 may suffer from this disease, with varying degrees of severity.
It is usually painless and is mainly caused by plaque although pregnancy, diabetes, epilepsy, and such medications as chemotherapy, medication prescribed for heart problems, birth control pills, and antidepressants can all make you more susceptible to gingivitis which is one of the more common forms of periodontal disease.
Gingivitis Gum Disease
The first stage of periodontal disease, gingivitis, is the mild inflammation of the gingival caused by plaque build up. Your gingival will be red, swollen, and tender. You may also notice bleeding while you brush and floss. This stage of periodontitis is reversible.
Inflammation will spread to the supporting alveolar bone. Minor bone loss and the formation of periodontal pockets, or food traps, may occur.
In this stage, there will be increased gingival recession, moderate to deep pockets, moderate to severe bone loss, and mobility of teeth due to the bone loss.
This is the most serious stage of periodontitis. Deep pockets, increased mobility of teeth, movement of teeth out of position, and visible fistulas (boils) will be present in this stage. Pus may develop; bone loss continues, and your teeth may loosen or fall out.
Flap surgery can be described as the loosening of the gum from bone to expose and clean underlying tooth structures. In advanced periodontal disease, when scaling and root planning have been unsuccessful in eliminating the entire pocket of decay, or when there has been bone loss that needs to be surgically corrected, then a dentist may perform periodontal flap surgery. In flap surgery, under local anaesthesia, small incisions are made in the gum, so that it can be lifted back to expose the tooth and bone. The entire area is carefully cleaned and all tarter and infected granulation tissue are removed and the bone is examined. Because periodontal disease causes bone loss, often the bone will need to be re-contoured in order for the gum to heal properly.
When the procedure is done, the gums are sutured in to place on top of the bone. The entire flap procedure typically requires from 1 to 3 hours to perform with only two quadrants of the mouth being addressed in a single visit. The sutures will remain in place for approximately one week, and a patient will likely be given a prescription for pain medication and antibiotics.
The lost bone in severe Periodontitis can be replaced using artificial bone material. The lost bone support of the tooth are replaced by this procedure and the strength of the teeth to withstand chewing forces are increased.