With 8 year successful follow-ups and scientific records; patient turning 100 years old.

Rev. Fr. JOHN MATHEW ELANJILETH, an Indian origin 91 years and 43 days old male, as on 08-05-2012 (8 years back), reported to our clinic with the complaint of missing upper left back tooth. Fr. John had been working as a chaplain in USA for the past 50 years.

Rev. Fr. JOHN MATHEW ELANJILETH reported that his upper (maxillary) left second molar was extracted 10 years back from a private dental clinic in USA. He wanted to have dental implant done in the region, but the dentists in USA were not willing to do so since his age was above 80 years & other dental insurance issues. So he came to India to enquire about the same.

Prof. Dr. JIJO PAUL, Director at Mazhuvenchery speciality dental clinic, Aluva, examined the patient and confirmed that the patient was fit to undergo dental treatment with dental implant after taking the OPG X-ray and other diagnostic measures. Prof. Dr. JIJO PAUL at his age of 40 years, prepared patient for surgical procedure as per surgical protocol & dental implant was placed in the maxilla in relation to 27 on 8th June 2012.

After 6 months when proper osseointegration was ensured, an abutment was fixed on the implant on 15-01-2013, following which a zirconium crown was placed on 18-01-2013. Father John has been undergoing follow-up visits at regular intervals. The patient has undergone 8 years of successful follow-ups. Father is fully satisfied with his dental implant & his radiographic findings are also satisfactory at his age. Now he is 99 years.

Gingivitis means inflammation of the gums, or gingiva. It commonly occurs because a film of plaque, or bacteria, accumulates on the teeth. Gingivitis is a non-destructive type of periodontal disease, but untreated gingivitis can progress to periodontitis. This is more serious and can eventually lead to loss of teeth.

Signs of gingivitis include red and puffy gums, that bleed easily when the person brushes their teeth.
Gingivitis often resolves with good oral hygiene, such as longer and more frequent brushing, and flossing. In addition, an antiseptic mouthwash may help. In mild cases of gingivitis, patients may not even know they have it, because symptoms are mild. However, the condition should be taken seriously and addressed immediately.

Types

There are two main categories of gingival diseases:

Dental plaque-induced gingival disease: This can be caused by plaque, systemic factors, medications, or malnutrition.

Non-plaque induced gingival lesions: This can be caused by a specific bacterium, virus, or fungus. It might also be caused by genetic factors, systemic conditions (including allergic reactions and certain illnesses), wounds, or reactions to foreign bodies, such as dentures. Sometimes, there is no specific cause.

 

Causes

The most common cause of gingivitis is the accumulation of bacterial plaque between and around the teeth.

The plaque triggers an immune response, which, in turn, can eventually lead to the destruction of gingival, or gum, tissue. It may also, eventually, lead to further complications, including the loss of teeth.

Dental plaque is a biofilm that accumulates naturally on the teeth. It is usually formed by colonizing bacteria that are trying to stick to the smooth surface of a tooth.

These bacteria might help protect the mouth from the colonization of harmful microorganisms, but dental plaque can also cause tooth decay, and periodontal problems such as gingivitis and chronic periodontitis, a gum infection.

When plaque is not removed adequately, it can harden into calculus, or tartar, at the base of the teeth, near the gums. This has a yellow color. Calculus can only be removed professionally.

Plaque and tartar eventually irritate the gums, causing gum inflammation around the base of the teeth. This means that the gums might easily bleed.

 

Other causes and risk factors

Changes in hormones: This may occur during puberty, menopause, the menstrual cycle, and pregnancy. The gingiva might become more sensitive, raising the risk of inflammation.

Some diseases: Cancer, diabetes, and HIV are linked to a higher risk of gingivitis.

Drugs: Oral health may be affected by some medications, especially if saliva flow is reduced. Dilantin, an anticonvulsant, and some anti-angina medications can cause abnormal growth of gum tissue.

Smoking: Regular smokers more commonly develop gingivitis, compared with non-smokers.

Age: The risk of gingivitis increases with age.

Poor diet: A vitamin-C deficiency, for example, is linked to gum disease.

Family history: Those whose parent or parents have had gingivitis have a high risk of developing it too. This is thought to be due to the type of bacteria we acquire during our early life.

 

Signs and symptoms

In mild cases of gingivitis, there may be no discomfort or noticeable symptoms.

Signs and symptoms of gingivitis might include:

  • bright red or purple gums
  • tender gums that may be painful to the touch
  • bleeding from the gums when brushing or flossing
  • Halitosis, or bad breath
  • inflammation, or swollen gums
  • receding gums
  • soft gums

 

Diagnosis

A dentist or oral hygienist will check for symptoms, such as plaque and tartar in the oral cavity. Checking for signs of periodontitis may also be recommended. This may be done by X-ray or periodontal probing, using an instrument that measures pocket depths around a tooth.

 

Treatment

If diagnosis happens early, and if treatment is prompt and proper, gingivitis can be successfully reversed. Treatment involves care by a dental professional, and follow-up procedures carried out by the patient at home.