a substance called cementum, and is attached to the jawbone by bone fibers. The gum covers the jaw bone and fits snugly
ENGELSK TANNKJØTTSSYKDOMMER
Gum Disease
This brochure provides information about the two of the commonest diseases of the gum: gingivitis and periodontal disease Healthy Teeth
A tooth consists of a crown and root. The crown is the visible part, while the root is not normally visible. The root is covered by a substance called cementum, and is attached to the jawbone by bone fibers. The gum covers the jaw bone and fits snugly against the teeth. Between the gum and each tooth is the gingival sulcus, a pocket-like space which is normally a couple of millimeters deep. The surface of healthy gums is pink and slightly stippled.
How to Prevent Diseases of the Gum
To prevent permanent damage to your gums and loosening of your teeth, you must clean your teeth daily to remove the bacterial coating (plaque) that builds up naturally on your teeth. An ordinary toothbrush does not reach the gaps between teeth. To clean the gaps, you will also need to use toothpicks or an interdental brush, depending on the size of the gaps. Note: it is not enough to remove food debris; you also need to remove the bacterial plaque coating your teeth. Your dentist/ hygienist will give you basic instructions on daily cleaning. Gum disease does not usually cause pain, so you may not realize that your teeth are at risk. This is why you should see a dentist/ hygienist regularly for checkups.
Gingivitis
Healthy gums are pink and fit snugly around the teeth.
Gingival sulcus (gum pocket)
Gum Bone fiber Jawbone
If you fail to clean your teeth every day, plaque along the gumline will cause inflammation of the gums, a condition called gingivitis. The gum becomes red and swollen and bleeds easily when you brush your teeth. The bleeding may be a symptom of gingivitis. If the plaque is left undisturbed for a few days, it turns into a hard deposit called tartar. The rough surface of the tartar traps more bacteria and accelerates the formation of more tartar. Tartar is pale yellow at first, but is soon stained darker by coffee, tea, mustard, red wine etc.
Treating Gingivitis
If plaque and tartar are removed on a regular basis, the gingivitis will recede and your gum will become healthy again. Above the gumline, you can remove the plaque yourself, while tartar and plaque below the gumline must be removed by a dentist/hygienist. Some people are more at risk of developing tartar and may therefore need to go the dentist for more frequent treatment.
Periodontal Disease
Periodontitis, or periodontal disease, starts as gingivitis. The initial inflammation of the gum spreads down to the root area of the tooth, loosening the tooth’s attachment and spreading to the jawbone. In this way, the pocket-like space between the gum and tooth gradually deepens, but without you realizing. If your teeth feel loose, it may be a symptom of advanced periodontal disease. This means that the plaque and tartar have moved so far down the tooth root that they are impossible to remove yourself.
Plaque
Gingivitis (gum inflammation)
Gingivitis (gum inflammation). The gum is red and swollen and sagging around the teeth.
ENGELSK TANNKJØTTSSYKDOMMER
Treating Periodontal Disease
The aim of professional treatment for periodontal disease is primarily to stop further progression of the disease. In most cases, any lost attachment of the tooth cannot be restored. The dentist/hygienist will first instruct you in daily cleaning of your teeth. They will then clean beneath the gum surrounding all the affected teeth, usually after giving you anesthetic. This ”deep-cleaning” is a difficult and time-consuming procedure, and typically has to be performed over several separate sessions at the dentist. If loss of tooth attachment is extensive in one or more teeth, and the results of the first professional cleaning are not satisfactory, a surgical procedure may be necessary.
Tartar
Loss of jawbone
An X-ray image reveals the extent of jawbone loss around the tooth.
The aim is to: • gain access to the root for removal of both plaque and tartar • reduce the depth of the gum pocket • and if possible, reattach the tooth using special techniques (for information about the latest procedures, see below) Any surgical procedure will always be performed under local anesthetic.
After Surgery
Usually, the surgery is a moderate procedure causing only slight discomfort afterwards. You should use an antiseptic mouth rinse for some time afterwards because using a toothbrush disrupts the healing process and could damage the treated gum. You can resume your usual dental hygiene routine as soon as the gum has healed and your dentist tells you it is safe to do so. It is especially important to keep the area between the tooth and gum plaque-free. Surgery may result in ”long teeth” because some of the root is exposed, but modern treatment aims to prevent this by selection of the appropriate surgical technique. Some patients find that their teeth feel looser immediately after surgery, but this is only temporary. The teeth may also be more sensitive to cold and heat. This sensitization is usually relieved by using a daily fluoride rinse or special toothpaste.
After-Care/Maintenance
For lasting improvement and to prevent recurrence of your periodontal disease, you will need to: • keep the surface of your teeth just above the gumline clean • go for regular checkups from your dentist/hygienist
The Latest Treatments
The dream has always been to get the jawbone to grow back so that the teeth can reattach. Research has resulted in several techniques, which in some cases may promote regeneration of lost tooth attachments. These techniques may be used to supplement surgery. Antibiotics are not widely used to treat gum disease, but may be appropriate in special cases, either applied directly in the gum pocket or taken as a course of tablets.
The dentist/hygienist measures the depth of the gum pocket with a special instrument.
Here the gum pocket is 6 mm deep.
Tobacco and Dental Health
Both smoking and other forms of tobacco use cause staining of the teeth and fillings. The gums also become stained in users of oral tobacco. The link between tobacco use and a number of diseases of the oral cavity, from gum disease to cancer, is well established. Recent research shows that the incidence of severe periodontal disease is far higher in smokers than among non-smokers. It is also more difficult to treat periodontal disease and achieve stable recovery if you smoke. Talk to your dentist/dental hygienist about how to quit tobacco.
Ask your Dentist or Hygienist
This brochure provides basic information about the causes of gum disease and what you can do to prevent it, and the professional treatment options available. If you are unsure of anything, ask your dentist/hygienist.
Reimbursement
Part of the cost of providing systematic treatment and after-care for gum disease may be reimbursed to your dentist according to fixed rates (revised annually) under the Norwegian National Insurance Scheme. Ask your dentist/hygienist if you are entitled to subsidized treatment.
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