The evolution of Gigivitis

Many of us ignore the pain we feel in our jaw, striking it off as a toothache. we regard this as a trivial problem. But this ‘trivial’ problem could worsen as you continue to ignoring it. This is how people develop periodontitis. Speaking to the Health Capsule Dr. Vipula Wickramasinghe, General Secretary of the Sri Lanka Dental Association and Regional Dental Surgeon of the Colombo District, explained that the most common reason for the loss or extraction of teeth is due to periodontitis.  

 Explaining what periodontitis is he said, “You can simply say that it is an extension of gingivitis. However, gingivitis involves only the gingiva. Whereas periodontitis is a disease that involves the tooth, the gingiva, the alveolar bone, the tooth bearing bone, and the periodontal ligaments, which connect the bone and the tooth. The inflammation of these three tissues is called periodontitis”. 
He further said that according to the last oral survey, which are results from 2003 and the last available statistics, 27% of people over 60 years of age don’t have a single tooth in their mouth. He explained that it is a very bad outcome and the last oral health survey was done in 2013, but the results are yet to be released.  

Causes

Speaking of how periodontitis is caused Dr. Wickramasinghe said, “If you don’t treat gingivitis properly it leads to periodontitis. In gingivitis you have the inflammation of the gingiva. The plaque in the gingival pocket, with the calcium and the saliva it gets hardened, that makes calculus. When left untreated, bacteria in that calculus will inflame the bones and the periodontal ligaments. This is the same bacteria and the same scenario as gingivitis, but it is a more aggressive form of gingivitis.”   

Symptoms

He further explained that there are two types of symptoms. Those which are visible to the naked eye and those which are seen after examination. “The symptoms that can be seen through the naked eye are the redness and the swelling of the gingiva. When you touch it there may be a discharge of pus. You may also have a lot of caluculii around the tooth and there will be slight or high mobility of the tooth,” he continued.  

“After an examination you will see very deep pockets and there will be bleeding and discharge of pus. There will also be a very bad odour and a very high degree of mobility with regard to the tooth,” said Dr. Wickramasinghe.   

Risk factors

Speaking of the risk factors Dr. Wickramasinghe said, “People who do not brush their teeth properly fall into the high risk group. In Sri Lanka the main reason for periodontitis is the fact that dental hygiene has not been maintained since childhood. Furthermore, people who are diabetic are much more prone to periodontitis and people who are immune compromised, people who take immune substitute drugs for example cancer patients and HIV patients. There are also people with poor nutrition. There are certain drugs, medication for other diseases which can bring 
about periodontitis”. 

Prevention 

He further stated that prevention is better than cure. “People should be advised that if they have any sort of bleeding or any sort of plaque surrounding the tooth they have to consult a doctor. Untreated gingivitis can progress to periodontitis,”said the doctor. 

“We must prevent people from getting gingivitis. Both the doctor and the patient play a part in this. Proper brushing and maintaining good dental health, seeking advice from the doctor on taking medicines and mouthwashes and manual cleaning and other type of treatment are essential. If you have done that you won’t fall it. But there is a certain percentage of people in whom the gingivitis process takes place due to genetic reasons. One should mandatorily visit the dentist once in six months and this should be a regular part of one’s life. It is more important to focus on the prevention of gingivitis rather than on treatment,” he continued.  

Treatment

Dr. Wickramasinghe explained that the treatment for periodontitis is a little more complicated than the one given for gingivitis. “The proper oral hygiene instructions must be given to the people and then cleaning of the teeth, maintaining good oral hygiene, controlling diabetic level or other disease level are essential,” advised the doctor. 

“There are some advanced treatment for periodontitis such as a bone graft or a gingival graft. But in Sri Lanka, the most common treatment that is done for adults is exfoliation or extraction of teeth. Due to mobility a lot of people lose their teeth because of periodontitis. It is very important that you maintain your oral hygiene from your childhood, otherwise at the later stages in your life you will develop periodontitis. The most common cause for the extraction or the loss of teeth in adults of over 50 years is due to periodontitis,” 

he concluded.