What do healthy gums look like?

Gums which are healthy are mostly light pink, not very soft, opaque, have a stippling appearance (orange peel-like) and end with a pivot similar to a knife edge.

How is gum disease diagnosed?

The disease is diagnosed by the dentist through clinic and radiographic inspection.

What are the gingival diseases?

Gingival diseases cover a broad range of diseases from basic gingival infection (gingivitis) to strong infections (periodontitis) when the jawbones that surround the teeth deteriorate and the teeth are lost.

What are the oral symptoms of periodontal disease ?
  • Bleeding spontaneously or while brushing,
  • Healthy light pink color turns to red or even purple,
  • Gingiva (gums) gets swollen,
  • Oral malodor,
  • Feeling of food stuck between teeth,
  • Increased amount of tartar,
  • Itching feeling on gingiva,
  • Gingival recession,
  • In advanced stages of the disease, the distance between teeth increases due to bone deterioration of the jawbone and teeth become longer and they start to come loose.

The initial cause of the disease is the microbial dental plaque that occurs when no effective mouth-cleaning prosedure is applied after meals. In this plaque, various types of microorganisms survive. The harmful particles produced by these microorganisms cause gingival diseases. Microbial dental plaque is soft at first and can be removed from the teeth with the help of toothbrush and dental floss. However, if not removed, it turns hard with the help of salvia, creating tartar. Since tartar creates a crinkly, rough area on the tooth, it enables increasing amount of plaque accumulation. This is why, the plaque must be cleaned periodically and it must be removed from the mouth through a proper tooth-brush and dental floss regimen while it is still soft. Although microbial dental plaque is the initial cause of the disease, gingival disease is a multi-factorial disease. Systematic, environmental and genetic factors play an important role in the course of the disease.

Gingival disease plays a role as a risk factor in cardiac and lung diseases, diabetes and premature birth/miscarriage. Cardiac diseases and gingival diseases have similar development mechanisms in accordance with the scientific researches. Both are more observed in older ages, men, smokers, patients of hypertension and stressed individuals. Researches show that the individuals with mouth infection carry 30% more heart attack risk than the ones with no mouth infections. Microorganisms that cause gingival diseases and the substance produced by them plays an important role in diabetes. It has been scientifically proven that non-controlled diabetes patients are more likely to have gingival diseases than controlled diabetes patients with the same level of mouth hygiene. Breathing of the microorganisms that cause gingival diseases and their accumulation in respiratory track may cause the lung diseases to appear. Likewise, these microorganisms constitute the risk of premature birth and birth of lower birth-weight in pregnant women.


Is there a relationship between gingival diseases and medication ?

Some medication prescribed in epilepsy treatment, hypertension treatment and some immunosuppressive medication given after transplantation surgeries may result in enlargements in the gingiva.

Treatment of the disease aims to fix the distortion of the soft (gum) and tough (bone) tissues that surround the teeth. In the initial phase of the treatment, mouth hygiene training, a.k.a. tartar removal, (regular brushing, floss/interface brush usage) is aimed to be provided. This treatment, called initial periodontal treatment, can be the single-used treatment in basic gingival infections as well as a preparation for periodontal operations in advanced stages of the disease. Pariodontal operation can differ according to the severity and type of the disease. In cases where the disease is limited only with the gingival, the aim is to eliminate the gingival groove. If the jawbone is affected by the disease, the treatment aims to cure the jawbone in addition to gingival groove elimination. The bone is fixed and if necessary, biomaterials such as bone powder or membrane are applied. The operation starts with local anesthesia and goes on with the lifting of the gingival. After the lift, infected tissues are cleaned, the bone is fixed, bone powder is applied and the wound is stitched, then the tissue is left to heal. Stitches are taken out in 7 to 14 days regarding the type of the treatment. In the first 2 years, 4 times a year, and then twice a year the patient is called out for inspection. If necessary, the dentist can increase the number of inspections.


How often should tartar cleaning be applied ?

If sufficient mouth cleaning is done, tartar cleaning is normally not necessary. However, it is advisable to visit a dentist once every six months (twice a year). During these visits, tartar cleaning can be conducted if deemed necessary.


What may happen after gingival operations or flap operations (open curettage) ?

On the first day, bleeding, pain and swelling in the surgical area can be observed. In the first 3-4 weeks after surgery, dental sensitivity may be observed. For success of the treatment, medication, ice application and efficient oral care can be applied.


What is a ‘gummy smile ?

Normally, gums are not seen in a normal smile. If there is a case that the gums are visible too mych during smiling, it is called a gummy smile.


Is gummy smile curable ?

Yes, it is. With cosmetic gingival reorganization, the parts where the gingiva is too visible are removed. A new shape is given to the gingiva area, therefore one can have a more beautiful smile where teeth and gingiva are esthetically visible.


Can gingival diseases reoccur after treatment ?

Yes, they may. If no proper oral care is applied for an uncontrolled amount of time, periodontal disease can reoccur. Proper oral care is very important after periodontal treatment. Furthermore, periodical inspections or check-ups should not be skipped. In cases of proper oral care and periodical inspections, gingival diseases do not reoccur.


What should be done to avoid the reoccurrence of gingival diseases ?

Oral care must be maintained very well. Teeth must be regularly and efficiently brushed. Along with tooth-brushing, interface cleaning with dental floss, interface cleaning brushes or oral showering is also very important. Moreover, regular check-ups every 3 or 6 months must not be skipped.


What is the suitable time to change a toothbrush ?

A toothbrush can be used for 3-4 months in general. It can be understood that the toothbrush must be replaced if the brush hair starts to separate and bend. Brushes with rough hair may harm your teeth. Children should change brushes in shorter periods since they are not experienced in toothbrushing.


Would the teeth be harmed if no suitable brushing technique is adopted ?

Yes. Even though the teeth are covered with a very rough layer called enamel, they can be drastically damaged by a toothbrush with a wrong brushing technique. Both upper sides of the teeth and the layer that covers the root can be abraded and the gums may receed. In these kinds of situations, the teeth become more vulnerable to decay or cavities. Toothbrushing with a force that could abrade the teeth should be avoided and the brush must be moved with soft gestures.


Is sucess guaranteed for implants ?

In the scientific researches, the success of implants is estimated to be between 90 and 100%. However, it is not possible to provide a %100 guarantee for implants, like in every other medical intervention.


What can I eat after surgery ?

Soft food and a liquid diet is advised. Relevant warnings will be made by your dentist accoring to your own personal situation.


Is toothbrushing sufficient on its own ?

Even a proper brushing technique, toothbrush, and toothpaste with a brushing duration of 2-3 minutes cannot guarantee to clean the area that the teeth are interconnected, and most of the time the starting point of decays are these closed, hard-to-access areas. For a healthy cleaning, at least once a day, dental floss or interface brush must be used after toothbrushing. After each meal, ensure that the food particles are removed by using dental floss.


Is there a relationship between smoking and gingival diseases ?

The fact that smoking increases the bone loss in gingival diseases has been scientifically approved. Likewise, smoking decreases the oral hygiene and makes the microbial dental plaque accumulation easier. After gingival disease treatment, healing is observed to be slower for smoking patients.


How does family factors affect the gingival diseases ?

In some types of the diseases, genetic heritage is known to be effective. As well as not being the primary reason, some people have genetic tendency to have gingival diseases more than the others.




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