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Gum Treatment and Aesthetics
Gum treatments and gum aesthetics play an important role in protecting oral health and achieving an aesthetic smile. Gum health is a critical element that affects overall oral health. Gum diseases, gum recession and aesthetic problems can negatively affect daily life. At this point, gum treatments aim to control gingivitis, correct recession and create a healthy gum line. Gum aesthetics includes surgical and aesthetic procedures performed to correct the gum tissue and provide an aesthetic appearance. These treatments offer an important solution for individuals who want to increase patient satisfaction and achieve a healthy, attractive smile.
What are gum diseases? How do gum diseases occur?
Gum diseases are diseases caused by bacterial plaque and tartar accumulated on tooth surfaces and gums, irritating the gums. These diseases are generally affected by the amount and duration of accumulation.
- Gingivitis: Accumulation of bacterial plaque and tartar on the tooth surface and not cleaning it for a long time causes inflammation in the gums. This inflammation first manifests itself as bleeding while brushing, eating, or spontaneously. If this condition is left untreated, more advanced gum diseases may occur.
- Periodontitis (Deep Gum Tissue Inflammation): As untreated gingivitis continues, bacterial plaque and tartar accumulate on the tooth surfaces and begin to damage the deeper tissues, connective tissues and bone tissue. Damaged connective tissues and bones begin to recede and a gingival pocket begins to form. Pockets formed in the gums lead to increased accumulation and progression of the disease. Periodontitis that is not treated in time causes the teeth to begin to shake and leads to tooth loss over time.
- Periodontal Abscess (Gum Abscess): While tartar accumulated on the gums and tooth surfaces causes gingivitis and periodontitis, these diseases usually progress silently. Tartar accumulates more in some tooth areas than others and can cause swelling, pain and abscess in that area.
- Gum Recession: Accumulations in the gums, hard tooth brushing, trauma, and genetic factors can cause gum recession. In the treatment of gum recession, it is important to first eliminate the cause of the recession.
Why do gums constantly bleed? Is this a sign of disease?
- Gum bleeding is usually caused by tartar and bacterial plaque accumulated in the gum pockets on the tooth surface. This bleeding serves as the gums' alarm system and is the first sign of gum disease. When you experience bleeding gums, you should take care to increase your oral hygiene, but if the bleeding does not stop, you should consult a dentist as soon as possible.
- Harsh tooth brushing and frequent consumption of hard and shelly foods are other factors that cause bleeding in the gums. When this situation continues, gum recession may occur. For gums to be healthy, these habits must be given up.
- Tooth decay, especially interface decay between the teeth, causes food accumulation and poor cleaning, causing gum bleeding. These bleedings occur especially while eating and brushing your teeth. When left untreated for a long time, it causes severe pain called septal pain and is confused with toothache. Treatment of tooth decay, healthy dental interfaces, and the use of dental floss and interface brushes ensure that the gums are healthy.
- Hormonal changes that occur during menstruation and pregnancy in women can cause bleeding gums. These bleeding gums can be seen in healthy gums.
- Bleeding disorders, immune system diseases, vitamin deficiency (Vitamin C), and some medications (blood thinners, etc.) can cause gum bleeding. In such cases, you should definitely consult your dentist.
What are the treatment options for gum diseases?
- Dental Stone Cleaning (scaling ): It is the process of cleaning tartar and bacterial plaque from tooth surfaces by dentists with professional devices. Stone cleaning is usually followed by an air flow process (cleaning of stains and plaque accumulated on the tooth surface) and polishing (polishing and polishing the tooth surface).
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Deep Dental Stone Cleaning (Subgingival Curettage): Periodontitis disease caused by long-term tartar accumulation cannot be treated with dental scaling alone. In this case, deep scaling (Subgingival Curettage) is performed to clean the tartar and bacterial plaques accumulated in the gum pockets and to restore the health of the tooth roots affected by these accumulations. In this procedure performed under local anesthesia, all root surfaces and gingival pockets of the affected teeth are cleaned one by one.
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Flap Operation / Surgical Procedures: In advanced gum problems, the gingival pockets become deeper and cannot be cleaned by scaling and curettage. In this case, a surgical operation is performed on the gums to clean the tooth roots. Following this cleaning, if necessary, graft (bone powder) can be applied to replace the lost bone and connective tissue.
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Antibiotic Treatment: In the treatment of gum diseases, in case of severity of the disease and gingival abscess, antibiotic treatment is also applied in addition to interventional treatments. However, it should not be forgotten that antibiotic treatment should always be under the control of a physician.
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Oral Hygiene Training: Although dentists treat gum diseases, the success of the treatment is in the hands of the patient. This success is achieved by ensuring correct and regular hygiene. For this reason, oral and dental health hygiene training is provided to our patients after the treatment.
Frequently Asked Questions
Tooth stone; It is the structure formed by the bacterial plaque accumulated on the tooth surface and the minerals in saliva coming together and hardening. Bacterial plaque is the name given to the mud-like structure formed by the combination of uncleaned food residues and bacteria in the mouth.
Dental tartar formation varies from person to person. The most important reason for this is that cleaning habits vary among individuals. Since tartar formation is also affected by the structure of saliva, changes in the mineral content of people's saliva cause differences in tartar formation.
The main cause of gum recession is bacterial plaque and tartar accumulated on the tooth surface and gums. These accumulations irritate the gums and lead to gum recession.
Another reason for receding gums is harmful habits or improper tooth brushing. Tobacco products such as cigarettes, cigars, and pipes create excessive heat especially in the mouth, irritating the gums and causing them to recede.
Improper and harsh tooth brushing causes the gums to recede as a result of trauma. Brushing healthy and hygienic teeth does not mean brushing hard and fast.
Incompatible restorations (veneer, filling, inlay, onlay, overlay) and incompatible implant-supported restorations cause a gingival recession in the teeth in that area.
Bruxism (Teeth Grinding Habit) causes gingival recession as it causes excessive pressure and trauma in the jawbone and surrounding teeth.
A rare but common cause of gum recession is piercing in tissues such as the tongue and lips. These piercings traumatize the gums and cause them to recede.
When these tissues called Frenilum, which are located in the mouth to limit the movements of the lip, cheek, and tongue tissues, are attached too closely to the gums, or when the movements of the lip, cheek, and tongue tissues are too much and strong, Frenilum tissues can cause gum recession.
The priority in the treatment of gum recession should begin with eliminating the cause of gum recession. It is not possible to restore the receding gum to its previous position without eliminating the reasons that caused the gum recession.
For this reason;
- If there is gingival recession due to tartar and bacterial plaque, dental scaling should be applied.
- Harmful habits such as cigarettes, cigars, and pipes should be abandoned, and if incorrect and harsh tooth brushing is the case, correct tooth brushing and oral hygiene training should be received from the dentist before treatment.
- Incompatible restorations must be replaced and the correct material selection must be made.
- Bruxism patients should be prevented from grinding their teeth with applications such as night guards and botox applications.
- If there are materials such as piercings or nose rings that cause gum recession, these should be removed.
- If it is determined that the gingival recession is caused by the frenulum tissues, Frenectomy (removal and shortening of the frenulum tissues) must be performed.
The way to regain the receding gum tissue is through surgical procedures. In this case, the amount of withdrawal and the types of tissue lost are important. Treatment options are available depending on the amount of recession and the type of tissue lost.
It is the process of surgically shifting the receding gum tissue coronally, that is, from the tooth root area to the chewing surface. This procedure is sometimes performed by shifting the gum tissue from adjacent areas of the receding gum.
It is the process of moving the gingival tissue taken from the patient's gum to the area where there is recession and closing the surface with a gingival recession with a surgical procedure. The amount of gum recession is important to perform this procedure.
If it is diagnosed that the connective tissue is also damaged in gum recession, the patient's connective tissue is used to regain the lost connective tissue. A connective tissue graft is taken from the patient's hard palate and placed in the area where the tissue is lost.
Bone tissue loss is also present at the most advanced level of gingival recession. There are three different ways to obtain bone tissue: autograft is bone tissue taken from humans, the allograft is bone tissue produced from human origin, and xenograft is bone tissue produced from animal origin. Bone powder (bone graft) preference is made according to the amount of bone tissue lost and the treatment plan.
One of the most important elements of aesthetic dentistry is gum aesthetics. The harmony between gums and teeth is important for perfect smile aesthetics. In gum aesthetics, the shape, color, proportions, and appearance of the gums are studied.
When we smile, the appearance of our teeth and gums in a certain balance creates our aesthetic perception. Situations, where this balance is disrupted towards the appearance of the gums, are called gummy smiles. Treatment options vary depending on the reasons that cause the gums to be more visible than the teeth.
Gum growths cause the teeth to cover and the gums to be visible when smiling. These excess gum tissues covering the teeth are removed by Gingivectomy, also known as gum surgery, and the teeth are made more visible.
It is important to determine at the first stage whether the gingival enlargement originates from the gums or the bone. If correct detection is not made, regrowth of the gums is observed.
If gingival enlargements are caused only by gingival tissue, removal of the enlarged gums is sufficient for treatment. However, if the growths originate from bone tissue, a surgical procedure is required to remove the excess bone tissue following the removal of the growing gum.
Another reason for a gummy smile is that the jawbone develops in a way that the gums are more visible than the teeth. In this case, orthodontic treatment comes into play. If bone development is directed correctly at an early age with orthodontic treatment, gum smile can be prevented.
The development of the human body ends at the age of 20 at the latest, and the development of the jaw bones also ends at the same age. Therefore, it is not possible to direct the bones with orthodontic treatment. With orthognathic surgery performed together with orthodontic treatment, the jaw bones are guided and the gingival smile can be treated.
The reason for a gummy smile may be that our muscles that work during smiling work excessively and the gums become visible. This problem can be treated by making the muscles work weaker by applying Botulinum Toxin (Botox) treatment.
The cause of a gummy smile may be the position of our lips when we smile. In this case, what needs to be done is lip aesthetics. This procedure may be a surgical procedure on the lip mucosa, or it may be an adjustment of the lip position with lip filler. Thanks to these procedures, the lips are positioned in a way that makes the gums less visible when smiling.
- Conditions such as inadequate oral hygiene, tartar accumulation, and dental plaque can lead to gum problems. Bacterial buildup can irritate the gums and cause them to enlarge.
- Puberty, pregnancy, and hormonal changes affect the gums and can lead to gum enlargement. Increased hormone activity during these periods may cause the gums to become sensitive and enlarge.
- Blood pressure, heart rhythm medications, and immunosuppressive drugs often used after organ transplantation may play a role in gingival enlargement.
- Poorly made and incompatible dentures can cause accumulation and dents, which can lead to gingival enlargement.
- Crooked teeth and teeth with structural anomalies can cause gingival enlargement.
- As with many diseases, genetic predisposition may also play a role in gingival enlargement through familial predisposition.
As with many diseases, genetic predisposition may also play a role in gingival enlargement through familial predisposition.
- Gum diseases such as gingivitis and periodontitis can cause the gums to swell, swell, and bleed. In this case, the gums may be darker red or purplish in color.
- The use of poorly made dentures amalgam fillings or some materials used in dentures may cause gum discoloration.
- Smoking can change the color of your gums. Smoking can irritate the gums and increase melanin production, leaving the gums darker.
- Hormonal changes, especially pregnancy, menopause and menstrual cycle, can cause gum discoloration.
- Some medications can cause discoloration of the gums, especially antipsychotics and medications for hypertension.
- Iron deficiency anemia can reduce the production of hemoglobin, which carries oxygen in the body, which can cause pale gums.
In the treatment of gum discoloration, it is necessary to first eliminate the cause that causes it. The first things to do are to restore the health of the gums, to replace poorly made restorations, and to quit harmful habits. After the cause of gum discoloration is eliminated, a surgical procedure is performed and the discolored area on the gums is surgically scraped under local anesthesia, allowing the tissue to renew itself.
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Our Specialists
Spc. Dt. Aytaç Gürsel
Oral and Maxillofacial Surgery Specialist
Dt. Ömer Demirçak
Dentist
Dt. Meriç Kaan Kuğu
Dentist