By Dr Valerie Anithra Pereira
It starts simply. You are at a wedding, excited about all the food on offer – the succulent chicken, the fragrant rice, the spicy mutton falling apart from the bone… yum!
But later, as you dance, you notice some fibres stuck between your teeth. Or is it a “jeera” (cumin seed)? You keep your mouth firmly shut and try to dislodge it with your tongue, hoping your dance partner doesn’t notice. You wish you had a toothpick. After a long struggle – success! It finally comes out.
Days go by, and it happens more frequently, post-lunch and post-dinner. You learn to carry floss or discreetly use the toothpick in the bathroom. In a couple of months, it feels like there Is a hole that sucks in food, especially between the areas of your premolars and molars. Your gums feel tender. Your breath smells bad if you don’t floss. And sometimes, you notice your toothbrush stained pink.
It doesn’t hurt, so you don’t worry!
After a few years, you notice spaces between teeth in your mouth. Also, your gums pull away from your teeth, making them appear longer. All of this continues until one day, you feel your teeth shaking.
That’s when you panic!
Diagnosis
All of the above are symptoms of a disease called Periodontitis, which in simple words means inflammation of the periodontium. The periodontium consists of the tissues that surround the tooth, namely the periodontal ligament, bone, gums and cementum.
Deposition of plaque and tartar (calculus) leads to infection which in turn results in Periodontitis.
The most common sequelae are bone loss, followed by mobile teeth and finally, loss of teeth.Other symptoms may include bleeding and painful gums, pus from the gums, difficulty chewing, foul breath, abscesses and receding gums. Teeth should normally be held snuggly by the gums and underlying bone, but in case of periodontitis, it becomes loose.
The dentist will usually probe under the tooth and look for ‘periodontal pockets’, which are gums that have become thick and have receded, causing a space under the gum line.
Causes
Periodontitis is mainly caused due to the accumulation of plaque and calculus on teeth.
Plaque is a sticky, slimy film composed of microorganisms and food debris. Plaque can be removed by daily brushing and flossing. But in case regular brushing is neglected, plaque builds up, leading to infection. Plaque that is hardened is called Calculus.
Other risk factors for periodontitis are smoking and tobacco, stress, ageing, diet (sticky, sweet foods), diabetes, Vitamin C deficiency, hormonal fluctuations (pregnancy), cardiovascular and respiratory problems, leukaemia, rheumatoid arthritis and HIV, to name a few.
Treatment
A dentist measures Periodontal pockets with a periodontal probe. Pockets which measure above 4 mm in depth indicate the onset of periodontitis. They require a professional cleaning done using ultrasonic scalers and curettes. Pockets ranging from 6-15 mm are deep and involve the bone. These cannot be cleaned without exposing the bone. The dentist will then take an X-ray to check the level of bone loss.
A gum specialist called a Periodontist will perform the next step which is a Flap surgery to arrest the spread of the infection, stop more bone from being lost and reconstruct lost bone and tissue as much as possible.The periodontist may use bone graft and collagen, for the regeneration of bone and tissue depending on the bone loss.
The thing to note about Periodontitis is that it silently creeps up on you, as it is mostly painless. Hence, it becomes mandatory to check one’s gums at the Dentist, every 6 months for signs of inflammation. A simple dental visit can prevent a lifetime of problems. As the adage goes “Prevention is better than Cure.”
Starfish can easily regenerate lost body parts but it takes a lot of time, effort and money to regenerate lost bone and tissue in humans. So, go ahead and get that stitch in time, so you can save nine!
About the Author:
Dr. Valerie Anithra Pereira is a consultant dentist who specialises in Peridontics (gums). She completed her BDS from AJ Institute of Dental Sciences, Mangalore. She then practiced at Narayana Hrudayalaya in Bangalore before going on to do her Masters in Periodontics and Implantology at Rajiv Gandhi University of Health Sciences in Coorg. She has worked as an Assistant Professor in Periodontology at Bhopal University and Maharashtra University of Health Sciences, Nashik She is available for consultation in Panjim. She can be contacted via WhatsApp on: 8208007184.
