From this article you will learn:
- causes of gum inflammation,
- how gums are strengthened at the dentist,
- treatment regimens.
The article was written by a dentist with more than 19 years of experience.
Complaints about weak, loose gums are typical for people with low-grade chronic inflammation of the gums (for example, chronic gingivitis or periodontitis). With a low severity of inflammation, such patients also experience bleeding gums and pain when brushing teeth, as well as swelling, redness or cyanosis of the gum margin.
In moderate to severe forms of inflammation, the above symptoms are gradually joined - periodic discharge of pus from under the gums, increasing mobility of the teeth, exposure of the necks and roots of the teeth. Patients notice that the gums seem to move away from the teeth (Fig. 4), which indicates the destruction of the dentogingival attachment and the formation of periodontal pockets.
What weak, inflamed gums look like: photo
Most often, loose, weak gums are characteristic of patients who have been trying to treat inflammation at home for a long time, using various rinses, gum gels or anti-inflammatory toothpastes. Their independent incorrect use always leads to only a temporary improvement, while the inflammation does not completely disappear, and the condition of the gums continues to slowly deteriorate. In this article we will tell you why this happens and what to do about it.
Introduction
The information world is very huge. Each of us is haunted by a million points of view
for any problem in any field of knowledge, you just need to ask a search query. The same thing happens in medical circles on the Internet - discussions of health problems are widely represented by both patients and doctors and often reach the point of absurdity:
For example, in questions:
- loosening of the tooth,
- exposure of the neck of the tooth,
- why are my gums and teeth exposed?
that is, in situations where the gums on a tooth have receded, patients are always confused: either they have periodontal disease
, then suddenly it changed to
periodontitis
, then periodontal disease returned again. And the search for an answer to the question becomes endless.
The problem of “how to treat periodontal disease” is picked up by doctors who only add fuel to the fire by recommending medications and even folk remedies for periodontal disease, without having sufficient competence to do so.
Let's consider these points of view professionally, and try to convey one simple truth, which for the vast majority of patients (and even some doctors) will be a revelation: the diagnosis of periodontal disease of the gums
» —
does not exist
.
An expert point of view is expressed by the famous periodontist, Doctor of Medical Sciences Laura Mikhailovna Tebloeva:
As a rule, for patients who come to me and say: “I have periodontal disease,” I always clarify - did you make this diagnosis yourself or did you see a doctor? Often patients answer that they have this information from their doctor. It turns out that the patient did not read somewhere and determine the diagnosis of “periodontal disease” for himself, but, unfortunately, such a diagnosis was made by a doctor.
Always treat gum problems
When a patient comes to the doctor, he complains about something. What symptoms does he see a doctor with before receiving a diagnosis of periodontal disease? What worries him?
Literally, patients tell the doctor this: my gums have sagged, my gums have become exposed, my lower gums have receded. And for some reason the symptom of gum subsidence automatically means that the patient has the so-called. periodontal disease.
More experienced patients, who have already heard a lot of professional terms, who delve into the professional colloquial language of doctors, say this: “The necks of the teeth have become exposed a little, the teeth have become a little higher.” But, according to statistics, most patients complain about sagging gums.
And so, when patients come to the doctor with complaints about the problem of exposed tooth necks, the doctor diagnoses them with periodontal disease. Of course, he begins to treat them. And to treat it specifically for periodontal disease.
But time passes, money also goes away, and the question of why the gums recede and the necks of the teeth become exposed, why the gums recede, has not been resolved. And the patient still has periodontal disease.
Strengthening gums at home: drugs, methods
As we said above, the best way to strengthen gums is proper and regular oral hygiene. However, there are a number of remedies that can further help you - improve the condition of your gums. Such products should not contain antiseptics and antibiotics, because the latter should be used only in short and infrequent courses (24stoma.ru).
High-quality oral hygiene –
In short... Teeth should be brushed after every meal, including lunch. To brush your teeth, you must first use dental floss, without which nothing will ever allow you to clean the interdental spaces from rotting food debris (toothpicks and mouth rinse are ineffective for this). At lunchtime, good hygiene involves a combination of dental floss + chewing gum. But if you no longer have gingivitis, but periodontitis, we advise you to have a second set of toothbrush and toothpaste at work.
You need to brush your teeth not 15 minutes after eating, but within the first 5 minutes. If you are visiting, at a restaurant, or outdoors, you should always have dental floss and a pack of chewing gum in your purse/pocket. It is very important to avoid snacks between main meals - no cookies, chocolate buns, etc. (apples that are not too soft are fine). If you eat candy, you need to brush your teeth. These are the simplest basic rules, the implementation of which is much simpler than the expensive and lifelong treatment of chronic periodontitis.
How to use dental floss and brush correctly -
Important: If you have crowns and bridges on your teeth, or if you have diagnosed periodontitis with deep periodontal pockets, be sure to use a home irrigator to rinse periodontal pockets and clean artificial crowns (in addition to basic hygiene methods). The cost of the irrigator will be 3-5 times cheaper than the cost of splinting mobile teeth, and also 10-20 times cheaper than the cost of open curettage of periodontal pockets.
Toothpastes for weak gums –
Such toothpastes can be divided into 2 groups. The first group of pastes contains potent antiseptics (usually chlorhexidine), and it is undesirable to use them for more than 2-3 weeks. It is optimal to use such pastes only as part of complex therapy during professional treatment of gingivitis/periodontitis at the dentist. Such pastes are good for relieving bleeding and swelling of the gums, and you can read more about them here .
But such pastes are not suitable for constant use, and their uncontrolled use can even cause harm (such pastes only suppress the symptoms of inflammation, making a person think that everything is fine). Therefore, to strengthen the gums, not antiseptics are used, but mild anti-inflammatory agents - extracts of medicinal plants, thymol, eugenol, clove oil, eucalyptol, bisabolol, allantoin, phenyl salicylate, as well as sodium fluoride.
a) Toothpaste “Parodontax-F” –
instructions for use- manufacturer - UK,
- active ingredients – extracts of echinacea, peppermint, sage, myrrh, chamomile, ratania, mineral salts, zinc citrate,
- fluoride content – 1400 ppm,
- price from 150 rubles (75 ml tube).
Comments: Parodontax toothpaste has a formulation that has remained unchanged since approximately 1890. This is a natural toothpaste that contains high concentrations of medicinal plant extracts and mineral salts, which have a pronounced anti-inflammatory and astringent effect, due to which gum bleeding is reduced. Unlike many others, these pastes can be used on an ongoing basis to treat and prevent gum inflammation (due to the fact that they do not contain antiseptics).
b) Toothpaste “Parodontocide” –
instructions for use- manufacturer – Russia,
- active ingredients – mint and sage extracts, thymol, eugenol, allantoin, phenyl salicylate, sodium fluoride,
- fluoride content – 1000 ppm,
- price from 120 rubles (50 ml tube).
There are other good anti-inflammatory toothpastes besides the ones listed above. You can independently evaluate the compositions of pastes, taking into account our recommendations for active ingredients made above. However, an important point is not only the names of the active ingredients, but their concentration in the paste. And in the above pastes there is a fairly high concentration of medicinal plant extracts, as well as other medicinal components.
What tactics are used to treat periodontal disease?
I want to start with the fact that patients who come with a diagnosis of periodontal disease, they need, every single one, treatment... not from the periodontist to whom they initially turned.
If we talk about the tactics of managing patients with the so-called. periodontal disease, which then come to me again, it’s a shame to voice this, but the treatment of periodontal disease was carried out right up to injections of Lincomycin into the exposed gum.
According to statistics, almost always the treatment of periodontal disease in adults with medications is burdened with a course of some antibiotics and physical therapy.
And most importantly, the task of all these manipulations is completely unclear: what do doctors want to achieve in this way, to destroy some kind of flora or to stop some destructive processes in the gums? It is very difficult for me to say what happens to the competence of a doctor who injects antibiotics for the so-called. periodontal disease, but this is absolute blasphemy. Is it possible to cure periodontal disease by destroying the flora? As a result, the gums will never recover.
Treatment of gum periodontal disease reaches the point of absurdity
I would like to note the widest range of drugs and folk remedies that patients use to attempt self-treatment of periodontal disease at home. Among the folk remedies, one can note the treatment of periodontal disease with hydrogen peroxide, and even treatment with soda:
What about the use of various toothpastes for periodontal disease? What goals do patients have? The purpose of toothpaste is preventative, not curative. And no toothpaste will eliminate inflammation, because there is no such inflammation in periodontal disease.
It is not difficult to guess that in these combinations of procedures the question of how to cure periodontal disease remains open.
Therapeutic treatment
Conservative treatment is prescribed in the mildest cases, when it is necessary to stop the inflammatory process and potential gum loss due to periodontal diseases (periodontitis or periodontal disease). Usually, the matter is not limited to one procedure: the doctor prescribes a complex treatment, which may include several techniques.
- Professional cleaning.
Removal of hard dental plaque is a basic procedure that precedes the main treatment. - Cleaning periodontal pockets.
To remove pathogenic microorganisms, the closed curettage technique is used. It can be carried out with standard instruments, as well as with the help of a laser and the Vector device (and its analogues). - Rehabilitation physiotherapy.
Used to improve cell health and better restore blood circulation in soft tissues (laser therapy, electrophoresis, current therapy, etc.). - Taking vitamins
, antibiotics, anti-inflammatory and preventive therapy.
There is no inflammation with periodontal disease
When does the so-called periodontal disease, there is no inflammatory process in the gums. The clinical picture of “periodontal disease” differs sharply from periodontitis; it is with periodontitis of the tooth that inflammation occurs.
And injections into the gums, endless restorations of the necks of the gums - this is running in circles. Over time, again all the restoration fillings are chipped, and again these patients come to have these fillings restored again. And this happens endlessly
:
And the diagnosis of “periodontal disease” does not go away. As Desna ran away, she continues to leave. The fillings increase, that is, the teeth increase in size, because the gums sag more and more, and nothing useful happens.
When such a patient gets an appointment with me, unwinding his entire tangle of ordeals during the consultation, it becomes clear that all previously performed gum treatment consists of 3
factors:
- Lost time,
- lost money
- shattered hopes.
The diagnosis was incorrect and the treatment was appropriate for the incorrect diagnosis. What went wrong?
Patients should always go for a consultation with such a diagnosis... to an orthodontist
.
Because periodontal disease is an occlusal injury
.
What I see in these patients with signs of periodontal disease is a completely different diagnosis. This is an occlusal injury that can only be corrected by an orthodontist.
Possible consequences
The most common complications of tooth trauma include gum inflammation. Due to severe mechanical damage, soft tissues become injured and inflamed, which slows down the recovery process. The following negative factors can aggravate the problem:
- decreased immunity,
- lack of vitamins D and group B,
- trauma to the oral mucosa,
- damage to the gums by hard brushes, dental floss or orthodontic appliances.
Inflammation of the gums can be local and generalized. In any case, you should consult a specialist.
What is occlusal injury
Occlusal trauma is when a tooth experiences excessive stress due to:
- the tooth is not in the dentition,
- the tooth is not in the correct position,
- the tooth has not grown physiologically,
- the tooth is tilted, at the wrong angle.
The occlusion of the teeth is impaired. That is, when chewing in a patient with impaired occlusion, a destructive force of chewing pressure is created, and the bone tissue in the area of these above teeth begins to decrease.
What is chewing from a physiological point of view?
It's teeth hitting teeth. The strongest blow, since the masticatory muscles are the strongest in the body.
In simple words, in a patient, from such a hyper-impact, hyper-contraction of the masticatory muscles, which develops during chewing, from this beating of teeth against each other, the bone begins to contract. Bone tissue shrinks. And after the bone, the gum also contracts, because the bone and gum are tightly connected. The gum descends, following the bone. And here we answered the main question - why gums recede.
Let's now begin to form an understanding of the answer to the next question: what to do if your gums have receded.
Causes of tooth bruises
According to statistics, closed dental injuries are most often encountered by children, adult men and professional athletes. You can get a serious injury:
- when falling or getting hit in the jaw,
- during an accident,
- in a fight
- in training.
The main causes of mechanical damage also include some bad habits:
- bite your nails,
- bite the threads,
- open bottles with teeth
- crack nuts and seeds,
- hold hard objects in your mouth.
This causes damage to the enamel, increasing the risk of serious tooth injury. Bruises are accompanied by aching pain, unpleasant sensations when closing the jaws and loosening of the injured dental unit.
Orthodontics comes to the fore
Today, a huge mistake is happening both in the search for the causes of periodontal disease and in making a diagnosis, as well as in the method of effective treatment. Instead of putting the tooth into occlusion, removing it from a traumatic bite, patients are offered all these manipulations that I have previously voiced, which are not at all aimed at getting rid of these complaints, but only at the fact that patients are wasting time, the processes are getting worse.
In the treatment of the so-called periodontal disease is a big problem in the loss of time for inadequate treatment, and the loss of time for the patient is a complication of the pathology of dental occlusion, and the transition of the stage of the disease to a more advanced form.
If a patient, for example, three years ago had a loss of bone tissue of two millimeters, then due to the “treatment of periodontal disease” he has already lost five millimeters, that is, we have lost time.
And if he came to the orthodontist with a loss of bone tissue of two millimeters, then it would be easier to stop the loss of gums, it would be easier to eliminate the development of gum pathology after orthodontic treatment, when the teeth become aligned with the dentition.
We can already talk about the fact that we close all exposed necks of gum recession, thereby treating the neck of the tooth. But when patients waste time on treatments that are inadequate for the disease, sometimes closing the recession is no longer possible. Because there are also strict indications and contraindications for the treatment of gum recession.
Why do gums recede?
Gum loss, or recession (in scientific terms), is very rarely an independent disease. Usually this is a consequence of other diseases and pathological processes in the body, which in one way or another affect the condition of the oral mucosa. The main reasons that provoke poor circulation, atrophy and gum loss are:
- inflammation of periodontal tissues with accumulation of pus and plaque in periodontal pockets;
- poor hygiene, accompanied by the formation of tartar. Gradually, this leads to drooping of the moving part of the gum;
- mechanical, thermal and chemical injuries;
- errors during orthopedic and orthodontic treatment, due to which the gums are injured;
- improper hygiene;
- malocclusion;
- pathologies of the structure of the mucous membrane (the gums are initially thin and weakened) and/or the cortical layer of the bone is too thin, which impairs blood circulation;
- general diseases of the body that affect blood circulation and the functioning of the immune system;
- old age, when gum atrophy may occur.
