Before starting with the article, I would like to introduce the word ?Periodontics? ? It means the branch of dentistry dealing with health & disease of tissues investing and supporting the teeth. Four basic tissues compose the complete periodontium

1. Gingera (The Gums).
2. Cementum (The layer covering the root of the tooth).
3. Periodontal ligament (soft tissue cushion between the tooth root and bone holding the tooth).
4. Alveolac bone (part of jaw bone which is housing the tooth root).

In health, these periodontal tissues make the attachment apparition of teeth, keep it firmly in its place and help in bearing the forces of chewing, biting, swallow and speeds. But when they are progressively destroyed by the presence of peenodontal disease, their oceans weakening of this attachment, making the teeth loose and unable to bear the loads of various activities and ultimately both falls out in course of time.

Diseases which attack these supporting structures are of two main types:

1. Those which attack the gingera(Gums) ? Gingivitis.
2. Those which involve chronic and progressive destructions of periodontal ligament, cementum and alveolac bone.

Periodontal diseases are infectious diseases caused by bacteria, present in mouth. The most important causative factor is Dental Plaque, which is soft deposit present on teeth, due to lack of proper cleaning of teeth. Many other factors contribute such as food lodgment, improper brushing habits, improper shape and size of teeth, faulty dental restorations and treatment procedures.Abnormal habits such as thumb sucking, lounge thrusting and mouth breathing, faulty nutrition and food habits and few debilitating diseases e.g. diabetics, hypertension, mental retardation, blood disorders, conditions such as pregnancy, menopause, puberty etc.

Periodontal disease can affect any individual of any age, sex, race and community at any time in life, but these are some risk factors or behaviors, which increase the susuplibility of an individual to get this disease and can modify the winze of disease to a more aggressive and rapidly deteriovaling form. These are smoking, diabetes, old age, pregnancy, family history of similar problem, hypertension.The worst fact about the periodontal disease is that the disease are very slow in onset, progression and hardly cause any symptoms or problems in the initial stages.

Patient is usually unaware of the presence of disease, though some may report bleeding gums, loose teeth, spreading of the teeth with appearance of spaces where none feeling in gums, relieved by digging with a tooth pick; There may also be pain of varied types and durations, including constant, dull, gunning pain, dull pain after eating, deep vadrating pain in jaws acute throbbing pain, sensitivity when cleaning gums, sensitivity of heat & cold, burning sensation in gums, and extreme sensitivity to unheated air. Usually what happens is that these symptoms appear at a very later stage of the disease and till that the poor patient, even being very keen about the health of his teeth, does not even get to know that this silent disease has already gone to its worse phase.

The problem which appears is that the disease which could have been reverted & health with just a bit of enhanced care & effort, is so much spread in the month, that patient is left with only fewer, more complicated, more extensive and expensive T/r options to save his teeth. Treatment for periodontal diseases do exist, and have miraculous results, but intervention vary according to the stage of disease at which the patient presents to the doctor.

1. Initial Stage:

Therapy is simple, non surgical and less extensive and the disease too is totally reversible mostly at this stage professional oral proplytaxis i.e. scaling and polishing will suffice; along with enhanced maintenance and hygiene care on the part of patient.

 2. Moderate Stage :

A little more extensive procedure generally known as gingeral curellage or deep scaling can be helpful and these are good chances of healing of tissues to their stage of health.

3. Advanced Stage : At this stage, T/r has to be surgical, along with basic phase of scaling, polishing & maintenance. Many periodontal surgical procedures depending on the type of disease are available.

1. Ginginectomy : A minor surgery done under local anesthesia for enlarged and malformed gums to enchance health and beauty of smile.

2. Flap Surgery: A minor surgical procedure where tooth root is cleaned of all the infectious material and diseased tissues after raising a small part of overlying gums under LA.

3. Periodontal Bone Grafting Procedures: Flap surgery combined with the placement of various natural and artificial bone, where the tooth has been severely weakened by bone loss by periodontal disease.

4. Guided Tissue Regenerations: Where in some artificial barrier marenals are used with purpose of stimulating bone growth in a guided manner.

5. Muco gingival surgeries (perso plastic procedure) : These surgical procedures are aimed at either enhancing the esthetics of mouth by enlarging tooth root coverage etc. or to enhance the successful outcome of rest of periodontal surgical procedure.

4. Terminal Stage :

It is the stage, where tooth is diseased beyond the limits and support has weakened to such an extent that it can no longer survive in the existing bone. Here comes the last resort of extraction of the tooth, which will be replaced by Dental Implant which is a synthetic substitute which is anchored to the jaw bone to replace the tooth and preserve the surrounding bone. In the end of this article, I hope that my effort of writing the same will definitely create some awareness about the periodontal disease, its prevention and treatment; and the importance of routine dental examination and professional prophylaxis. No doubt, the disease is wide spread, destructive and affecting almost the whole mankind, but if the solution is such an easy one that a little more awareness care & effort of twice daily brushing and a routine dental examination can save our teeth from such a deadly disease, then why not come a step further to incorporate for these two healthy practices in to our lives. Happy Brushing and check up visit to a dentist. Wish a very healthy long life to 32 pearls of your smile and long live the smile.