What is Gum Recession (Periodontitis)?
Periodontitis, also called gum recession or gum disease, is a serious gum infection that damages the soft tissue around the teeth and, if left untreated, can destroy the bone that supports an individual’s teeth. Gingival recession (periodontitis) can cause loosening or tooth loss.

Gum recession (periodontitis) is a common but largely preventable condition. It is usually caused by poor oral hygiene and care. Brushing teeth at least twice a day, flossing daily, and having regular dental examinations can both reduce the likelihood of developing gingival recession (periodontitis) and greatly increase the chances of successful treatment.
What Causes Gum Recession (Periodontitis)?
In many cases, the development of gingival recession (periodontitis) begins with the formation of plaque, a sticky film made up of bacteria at its base. If this plaque is left untreated, it can eventually turn into periodontitis.

Plaque forms on the teeth when starches and sugars in food interact with bacteria normally found in an individual’s mouth. Brushing twice a day and flossing once a day can remove plaque buildup, but plaque builds up quickly.

Plaque remaining on the teeth can harden below the gum line and become tartar, that is, tartar. Tartar is more difficult to remove than plaque and is full of bacteria. The longer plaque and tartar remain on your teeth, the more damage it can do. It is not possible to clean calculus by brushing and flossing. A professional dental cleaning is needed to remove it.

Plaque can cause gingivitis, the mildest form of gum disease. Gingivitis is the name given to the irritation and inflammation of the part of the gum tissue around the base of the tooth. Gingivitis can be reversed with professional treatment and good oral care at home.

Ongoing gingivitis can cause periodontitis. This causes pockets to form between your gums and teeth that fill with plaque, tartar, and bacteria. Over time, these pockets deepen and fill with more bacteria. If these deepening infections are left untreated, this results in both tissue and bone loss and can eventually lead to the loss of one or more teeth. Ongoing chronic inflammation can strain an individual’s immune system.

gingivitis, medications that cause dry mouth or gum changes, malnutrition including vitamin C deficiency, certain diseases such as diabetes, rheumatoid arthritis and Crohn’s disease, hormonal changes such as those related to pregnancy or menopause, genetics, poor oral health habits, leukemia, HIV / Factors that cause decreased immunity such as AIDS and cancer treatment, obesity, smoking or chewing tobacco, or drug use can increase the risk of developing gingival recession (periodontitis).
What are the Complications that May Occur with Gingival Recession (Periodontitis)?
Tooth and jaw bone loss is one of the leading complications caused by gingival recession (periodontitis). In addition, the bacteria responsible for gingival recession (periodontitis) can enter the circulatory system from the gum tissue and affect other parts of the body.
It has been observed to be linked to problems controlling blood sugar in gingival recession (periodontitis), respiratory disease, rheumatoid arthritis, coronary artery disease and diabetes.
How to Prevent Gingival Recession (Periodontitis)?
The most effective way to prevent periodontitis is the habit of cleaning teeth, which is started from a young age and maintained continuously throughout life.

Good oral hygiene and dental hygiene means brushing the teeth at least twice a day, in the morning and before bed, and flossing at least once a day. Flossing used before brushing helps to better clean the food particles and bacteria stuck between the teeth. This prevents the development of an environment conducive to certain bacteria that cause periodontal disease around the teeth.

In general, regular visits to the dentist or dental professional for cleanings every 6 to 12 months will be beneficial, especially for individuals with risk factors that increase the likelihood of developing gum recession (periodontitis), such as dry mouth, use of certain medications, or smoking.

What are the Symptoms of Gum Recession (Periodontitis)?
Under normal conditions, healthy gums are hard and pale pink in color and fit snugly around the teeth. In case of gingival recession (Periodontitis), the following signs and symptoms are observed:

swollen or puffy gums
Bright red, dark red, or purplish gums
Bad breath
painful chewing
New spaces developing between teeth
Space between your teeth and gums
Gums that pull down making teeth appear longer than normal
Spitting up blood while brushing or flossing
Gums that are sensitive to touch
Pink toothbrush after brushing
Loose teeth or tooth loss
A change in the way your teeth fit together when you bite
Gums that bleed easily
Individuals should go for dental check-ups regularly. Individuals who notice any signs of gingival recession (periodontitis) should make an appointment with the dentist as soon as possible. Early intervention increases the chances of reversing the damage caused by gingival recession (periodontitis).

Diagnostic Methods
How to Diagnose Gingival Recession (Periodontitis)?
The dentist will first perform an examination to determine if the individual has gingival recession (periodontitis) and, if so, how severe it is. During this exam, the dentist will review the individual’s medical history to identify factors that may be contributing to the symptoms, such as smoking or taking certain medications that cause dry mouth.

He or she will check the individual’s mouth and easy bleeding to control plaque and tartar buildup.

He will measure the pocket depth of the groove between the gums and teeth in various parts of the mouth by placing a dental probe next to the tooth to measure it. Pocket depth in a healthy mouth is usually between 1 and 3 millimeters. Pockets deeper than 4 millimeters may indicate the presence of periodontitis. Pockets deeper than 5 millimeters cannot be cleaned well and may require intervention.

He or she will take a dental X-ray to check for bone loss in areas with deeper pocket depths.

After these stages, the dentist can assign a stage and grade for gingival recession (periodontitis) depending on the severity of the disease, the complexity of the treatment, the existing risk factors and the health of the individual.

Treatment Methods
How to Treat Gingival Recession (Periodontitis)?
Gingival recession (periodontitis) treatment can be done by a dentist or dental hygienist. The goal of treatment is to thoroughly clean the pockets around the teeth and prevent further damage to the surrounding bone. Successful treatment also requires a good daily routine of oral care, managing health conditions that can affect dental health, and stopping tobacco use.
If gingival recession (periodontitis) has not developed, the treatment process can be completed with non-surgical treatments and less invasive procedures. For this, the removal of tartar and bacteria from the tooth surface by scraping can be performed with the help of tools, laser or ultrasonic devices.

Smoothing the root surface can prevent further tartar and bacterial growth and remove bacterial byproducts that delay gingival healing or re-adhesion to the tooth. Topical or oral antibiotics can help control the bacterial infection.

Topical antibiotics may include antibiotic mouthwashes or inserting antibiotic-containing gels into the space between your teeth and gums, or into pockets after deep cleaning. However, oral antibiotics may be necessary to completely eliminate the bacteria causing the infection.

However, if the individual has advanced gingival recession (periodontitis), dental surgery may be required during the treatment process. Accordingly, flap surgery, that is, pocket reduction surgery, can be performed. The dentist makes small incisions in the gum so that some of the gum tissue can be lifted back, exposing the roots for more effective cleaning and root straightening.

Because gingival recession (periodontitis) often causes bone loss, the underlying bone may need to be recontoured before the gingival tissue is sutured into place. After healing, it is easier to clean these areas and preserve healthy gum tissue.
When an individual loses gingival tissue, the gingiva recedes. Some of the damaged soft tissues may need to be strengthened. Soft tissue grafts can be applied for this. This usually happens by removing a small amount of tissue from the individual’s palate or transferring it to the affected area using tissue from another donor source. This can help reduce further gum recession, cover exposed roots, and give your teeth a more pleasant appearance.

The bone grafting procedure is done when gum recession (periodontitis) destroys the bone surrounding the tooth root. The parts used in grafting may consist of small parts of the individual’s own bones, may be made of synthetic bones, or may be donated. The bone graft helps prevent tooth loss by holding the tooth in place. It also acts as a platform for natural bone regrowth.

Guided tissue regeneration therapy allows bone destroyed by bacteria to regrow. In one approach, your dentist places a special piece of biocompatible fabric between the existing bone and your tooth. This material prevents unwanted soft tissue from entering the healing area, instead allowing time for bone to regrow.

Another technique involves applying a special gel, i.e. tissue stimulating proteins, to a diseased tooth root. This gel contains the same proteins found in the development of tooth enamel and allows healthy bone and tissue to grow.

Lifestyle Changes and Home Care for Gingival Recession (Periodontitis)
It is possible to take various simple measures to reduce or prevent periodontitis.

These measures include primarily brushing the individual’s teeth at least twice a day and ideally after every meal or snack.
The individual should use a soft toothbrush, and should replace the brush at least every three months. Electric toothbrushes may be more effective at removing plaque and tartar. Dental floss should be used at least once a day.
In cases recommended by the dentist, mouthwash can be done to help reduce interdental plaque.
A quality toothpaste, interdental brush and tooth stick can be used to supplement normal brushing.
Regular professional dental cleaning should be done according to a schedule recommended by the dentist.
Smoking and tobacco use should be avoided as the second most important factor. These are items that help dry mouth and bacterial growth.

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