Periodontists focus entirely on evaluation, diagnosis, and treatment of disease of the gum and bone surrounding the teeth. In advanced cases of Gingivitis or Periodontitis, a general dentist may recommend a gross debridement of superficial plaque and tartar and such cases will, then, be referred to a periodontist for evaluation. Periodontists may recommend a variety of non-surgical or surgical procedures to help stabilize the gum condition. Periodontists are also highly skilled at performing treatments of other conditions of the gums and bone including gum and bone grafts, functional and esthetic Gingivectomy, Gingivoplasty, implants, and crown lengthening. Because gum disease in its advanced stages is the primary cause of tooth loss today, periodontists are especially important in working to treat a difficult disease.

Chlorhexidine Gluconate (Chlohex-ad) is an antiseptic mouthwash that can be used under the direction of a dentist to help reduce the bacteria that cause gum disease. Additionally, antibiotic therapy can be combined in various ways to help treat Periodontitis. Pellets or gels like PerioChip that contain Chlorhexidine or Doxycycline can be placed in deep gum pockets, after completion of Deep Scaling and Root Planing, to kill stubborn bacteria and reduce the size of periodontal pockets. These modes of delivering medications are very effective because the agent is released slowly over the course of about seven days. Additional medications such as Xylocaine and NSAIDs may be needed for pain control during and after treatment.

There has been evidence to suggest the effectiveness of the following over-the-counter and natural treatments for gum disease:

• Green Tea has antioxidants that reduce inflammation in the body.
• Hydrogen Peroxide helps kill bacteria when used as a mouthwash or as a gel in a custom fitted tray, but it must not be swallowed at all.
• Rinsing using warm salt water can help soothe sore mouth tissue.
• Baking Soda diluted in water can be used to rinse and brush the teeth and gum-line to help neutralize the acids that irritate the gum tissue.
• Oil Pulling (swishing or rinsing): There has been little evidence to prove that sesame oil or coconut oil can help reduce bacteria that cause gum disease, but, it has been become a recent trend. On a case by case basis, people have noticed improvement with this treatment though we do not recommend it due to lack of clinical proof.

The most important step in treating a disease of any kind is early and proper identification. The same stands true for early stage gum disease (Gingivitis). And, if the patient religiously maintains his oral hygiene along with the necessary treatment, gum disease can be reversed. If identified at this stage, a professional dental cleaning and more thorough brushing and flossing is all that a patient needs to reverse the disease. Once the bacterial infection spreads to the bones in Periodontitis, irreversible changes start taking place with decreased attachment of the gums and bone loss. Therefore, it is very important to catch and treat gum disease as early as possible.

There have been many attempts to understand the link between gum disease and other systemic health problems such as heart disease, stroke, and Alzheimer’s disease. Comparing the bacteria that cause dental plaque with the bacteria involved in heart disease suggests a correlation between gum disease and heart disease, but researchers have been unable to establish a cause and effect relationship. According to the American Academy of Periodontology, recent studies have shown that the bacteria involved in periodontal disease may play a role in the pathology of Alzheimer’s disease too. Even though it is difficult to prove or disprove such types of relationships, it is fair to assume that not having gum disease will remove any chances of such relationships coming into play.

A child should start having his or her teeth brushed with a pea-sized amount of toothpaste beginning at 12 months of age. Emphasis should be placed on brushing all surfaces of the teeth including the gum line. As soon as the gaps between the teeth start to close, it is important to start flossing. At the beginning, the parents should establish a routine to brush the teeth so the child can get used to it. As soon as the child is able, the brushing and flossing should be passed over to him or her and monitored by the parent to ensure a good and thorough technique and consistency. According to the American Dental Association (ADA), a child should get regular dental visits starting at about one year of age. Abiding by these guidelines will help prevent and treat gum disease in most children.

An increase in instances of Gingivitis is noticed during puberty due to the hormonal changes that occur throughout the body during that period. Adolescents should be monitored for good oral hygiene habits and taken to the dentist regularly to treat gum disease with professional dental cleanings.

Many pregnant women think that they should avoid visiting the dentist to keep their pregnancy safe, but they shouldn’t miss their professional cleanings as long as they feel strong and comfortable enough to manage that. During pregnancy, women are at a risk of developing pregnancy gingivitis as an increase in hormones, caused by pregnancy, makes the gum tissues more susceptible to attack from bacteria and other pathogens. An increase in swollen, bleeding gums is noticed quite often in pregnant women even if they have remained consistent with their oral hygiene. This heightened risk can be countered successfully by getting dental cleanings more often than usual during pregnancy.

In most cases, it is very simple to prevent instances of Gingivitis and Periodontitis by ensuring proper plaque control. This can be done by brushing, to remove plaque from the outer surfaces of the teeth, and flossing, to remove food particles and plaque from in-between the teeth. Electronic toothbrushes sometimes prove to be more effective in removing plaque from some of the harder to reach areas of the mouth. And, rinsing the mouth with a mouthwash after brushing and flossing can help reduce the concentration of bacteria that causes gingivitis.

There are certain other factors that have a direct impact on the health of gums and managing them can supplement the oral hygiene practices for a greater impact:

• Sleep/stress:Our body’s immune system has the biggest role in preventing any kind of disease. Getting adequate sleep and reduction in stress gives tremendous boost to our body’s immunity thereby helping the body fight gum disease too.
• Smoking and Chewing Tobacco: Smokers and those who chew tobacco are much more prone to Gingivitis and Periodontitis than those who avoid tobacco.
• Therapy or Braces:It is much easier to remove plaque from straight teeth than crowded, overlapped, and crooked teeth. Braces can make a big difference in having healthier gums by reducing these problems.
• Diet:Limiting the usage of plaque-causing sugars and carbohydrates will help limit its presence. Eating a well-balanced diet will help keep the body’s immune system healthy and ready to fight infection.

The main purpose of using a toothbrush is to remove plaque on the teeth that harbours bacteria and causes gum disease and tooth decay. We can use any toothpaste, along with consistent and thorough brushing habits, to accomplish this goal. Fluoride, a common ingredient in toothpaste, particularly stannous fluoride, helps kill bacteria present in mouth. There are other ingredients in toothpastes that help remove plaque more effectively and help keep plaque off the teeth after they have been brushed. The abrasive agents in toothpaste such as silicates and calcium carbonates help remove sticky plaque. Sodium Lauryl Sulfate (SLS) is a detergent in toothpaste that causes the foaming effect of toothpastes. Toothpastes vary in the amount of SLS they contain; a high concentration of SLS can cause problems for patients who have dry mouth or low saliva flow. Some toothpaste includes plaque-control agents such as pyrophosphates and zinc citrate that prevent plaque from sticking to the teeth after they’ve been brushed. Using toothpaste that contains any combination of these ingredients will increase the effectiveness of oral hygiene.

While most of the factors that lead to Gingivitis and Periodontal disease are dependent on the individual, there is limited scientific evidence to affirm that Gingivitis and Periodontitis-causing bacteria can be passed down from parents to children and between couples.