Periodontal disease has became one of the common diseases. The infection that affects the periodontal tissues (alveolar bone, gingiva, periodontal ligament and cementum) teeth is basically known as periodontal disease. Simply saying, it can be called as a serious infection that affects the bone and supporting soft tissues of the teeth. It may even cause tooth decay and other severe issues. Usually, poor oral hygiene causes periodontal infections. Lack of proper cleaning leads to the growth of plaque and tartar. Mass of plaque and tartar cause damages to the periodontal tissues and finally reaches in periodontal diseases.

Let us go deep about periodontal diseases and it is prognosis. Plaque (biofilm) is made up of millions of bacteria. Growth of plaque should be prevented from the early stage. When the plaque is not removed properly, it causes infection. Over time, the infection spreads and becomes severe dental issues like periodontal diseases. Periodontal diseases are classified into different types according to it is severity:

• Gingivitis: The mildest form of periodontal diseases is called gingivitis. As a result of the infection, gums will become swollen, red and easily bleed. In adequate oral hygiene is the main cause of gingivitis. It can be cured with good oral care and professional treatment. Other factors that can cause gingivitis are-smoking, diabetes, inadequate nutrition, puberty, HIV infection, certain medication, substance abuse, puberty, stress, and other systemic diseases and conditions.
• Periodontitis: Gingivitis, when untreated will develop further and become periodontitis. Over time, the plaque spreads and develops below the gum line. As a result, the symptoms get worse. Without proper treatment, teeth can be lost or should have to be removed eventually. There are different forms of periodontitis such as:
  • Aggressive periodontitis: Patients with aggressive periodontitis will be healthy otherwise. The most common features of aggressive periodontitis include bone destruction and rapid attachment loss.
  • Chronic periodontitis: As a result, the supporting tissues of the teeth will inflame and cause bone loss. It is the most common form of periodontitis. The main characteristic of this type of periodontitis are pocket formation and gingival recession. It can occur at any stage and most prevalent among adults.

Periodontitis can also occur as a manifestation of systemic diseases. Diseases associated with this form of periodontitis are-diabetes, respiratory diseases and heart diseases.

Necrotizing periodontal disease: It is a kind of infection with the characteristic of gingival tissue necrosis. Necrosis may also affect the periodontal ligament and alveolar bone. These abrasions are visible among individuals with systemic conditions such as malnutrition, immunosuppression and malnutrition.

Gum depigmentation is a cosmetic procedure done for aesthetic reasons. Normally, the color of the gum tissue (gingiva) is pink. But, in many people it may not be so. Some of them will have certain black spots or patches and makes their smile awkward. It can be caused due to different reasons. Excess deposits of melanin or long term use of certain medication can be the reasons. Some may have small spots or blotches on the gums whereas some may a complete black gums. Black gums indicate that, all or most of the gums are affected. People with gummy smile have more problems with this. But, it can be removed completely with simple surgical procedures. During the surgery, the surgeon will remove the pigmented areas and get you the natural pink color back.

The technology has improved and use of laser in treatments has become very common. Depigmentation can be done using laser. Laser can wear away the melanocytes which produce melanin. Reducing the production of melanin can also reduce the discoloration or dark spots on the gums. Laser gum depigmentation can make the gums lighter and make the gum color more uniform. Laser treatment will not have the complications of bleeding, pain and other post operative discomforts. The wounds will take almost four days to heal completely. Depigmentation will not occur again during the follow up treatments after the laser treatment. Laser is considered to be a most reliable and satisfactory procedure.

As a result of the treatment, your smile will look more beautiful and healthy. It can accelerate the rate of confidence in an individual. In rare cases, people may have itchy gums for a short period after the surgery. The treatment may require only one visit. Apart from surgery, some doctors may use bleaching solutions or chemical agents. But, it may not give a long lasting and satisfactory result. Gum depigmentation is not medically dangerous. People fear of depigmentation due to cosmetic reasons.

Mild to moderate periodontal diseases does not require surgeries. It can be treated with non-surgical methods. Two simple methods of non-surgical treatments are scaling and root planing. Professional Dental cleaning is very common and is suggested for everyone. It should be done at least once or twice in a year. The dentist will remove the plaque and tartar during the check-up. The dentist will suggest you professional cleaning more than twice a year, if you have signs of gum diseases. The bacteria accumulate above and below the gum line of teeth and it cannot be completely removed with daily home care.

Sometimes, a simple cleaning may not be sufficient to remove the bacteria/plaque. Such cases require deep cleaning, called scaling and root planing. This is a non-surgical procedure, but done under local anesthesia. Scaling will help to scrape away the plaque and tartar from above and below the gum line. Planing is done to smooth the rough spots on the tooth root. It helps to remove the bacteria and cleanses the teeth surface.

Some may use drugs to treat periodontal diseases. It may be used along with surgeries or alone in order to eliminate the bacteria or to prevent the destruction of tooth attachment. Antibiotics are used to treat periodontal diseases. The doctor will prescribe you the right choice for you. Some of these are available in the form of mouth rinses or as a gelatin-filled chip. They can fight against the plaque and bacterial infection and protect the teeth from diseases.

Fluoride treatments are another option for non-surgical treatments. Chewing tablets, toothpastes and rinses are available in the market. Fluoride can protect the teeth and helps to make it stronger. The doctor may prescribe a short course of systemic antibiotics in a low dose of doxycycline in the form of tablets only in some cases.

Proper oral hygiene can also be considered as a non-surgical treatment option for periodontal disease. It may include-brushing the teeth twice a day, flossing and regular dental check-ups.

There are non-surgical and surgical treatments for periodontal diseases. Severe conditions of periodontal diseases cannot be cured with non-surgical treatments and it requires surgeries. The main aim of the surgery is to remove the plaque/tartar from the gums and to strengthen the affected bone and gums.

Gum graft can be used for two reasons-to improve the appearance of one's smile or to protect the teeth from gum recession. The process in which the tissue that surrounds the teeth pulls away from a tooth, exposing more of the tooth or the tooth root is known as gum recession. It is very common among people. At first it appears as a negligible issue and becomes severe over time. People may not notice that their gum is receding day by day. When it become more exposed and look ugly, they realize the issue. Exposed tooth can cause many other issues such as tooth sensitivity. If left untreated, gum recession may eventually result in tooth loss. Gum grafting is the treatment meant for people with such issues.

Gum graft procedure can be of different types. It may vary according to the needs of the patient. It may include:

• Pedicle grafts: In this procedure, the grafting is done taking gum around or near the tooth that require treatment. The pedicle or flap will cut away partially and the edge will remain attached. In order to cover the exposed tooth root, the gum will be pulled over or down and will be sewn to the place. People who have plenty of gum tissue near the tooth are only eligible for this procedure.
• Connective-tissue grafts: One of the most common method to treat root exposure is the connective-tissue graft procedure. The flap of the skin is cut at the palate and tissue from under the flap is removed and then stitched to the gum tissue surrounding the exposed root during this procedure. The tissue from under the flap is called subepithelial connective tissue.
• Free gingival grafts: Free gingival grafts are bit similar to that of connective-tissue graft. The procedure involves the use of tissue from the palate. For this procedure, a small amount of tissue will be removed directly from the palate and then attached to the affected gum area. This procedure is used usually in people who have thin gums.

After a thorough check-up, the dentist will be able to suggest you the best kind of treatment to you. The procedure may not require hospital stay overnight. The dentist will give you instructions to follow after the procedure. It may include medication, physical activities and diet. In order to control bacterial attack during the healing period, you may be asked to rinse the mouth with a special mouth rinse. In order to prevent infection, you may have to take medicines during the healing period. You might also be suggested to have soft food after the surgery. The pain and discomfort after the procedure may depend up on the kind of surgery you have under gone. The wound may heal quickly. The surgery may have the complications of a general surgery including inflammation and infection. It may take one or two weeks to heal completely.

If you experience any unusual symptoms such as continuous bleeding, severe pain, bruising and swelling you might have to consult your doctor.

• Bone graft surgery: During this procedure, the affected bone will be replaced using fragments of bone, synthetic bone or donated bone. Grafts has the power to restore the teeth stability and it act as the platform for bone re-growth.
• Bone surgery: It is done in order to prevent bone loss. During the procedure, the surgeon smoothen the shallow craters in the bone. This procedure makes the bone stronger and makes it difficult for bacteria to amass and grow.
• Soft tissue grafts: This procedure is done in order to boost the receded gums or fills. Tissues will be taken from the roof of the mouth will be stitched to the affected area.
• Flap surgery/pocket reduction surgery: During this procedure, the tartar will be removed by lifting the gums back. Pocket reduction surgery is done to reduce the pockets below the gum line to prevent the growth of bacteria over there.
• Guided tissue regeneration: This procedure is done when the bone that supports the teeth is destroyed. The bone and gum tissue will be stimulated with this procedure. This procedure is usually done along with flap surgery.

Most of the periodontal surgeries are minor and can be done in the clinic with local anesthetic. They are not meant to cure the disease completely. These surgeries may not hurt much. The patient may face very little discomfort. One of the negative aspect of the surgery is that, the patient may have teeth sensitivity.