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PERIODONTOLOGY – TREATMENT AND PREVENTION
Prevention of dental disorders and dental gum diseases is an important part of dentistry that is primarily aimed at protecting the health of your natural teeth but it is also indispensible to a quality and successful conservative prosthetic treatment. Prevention and treatment includes numerous therapies – from oral hygiene education and tartar removal to surgical procedures. Don’t forget that we can do a lot for our dental health, before ultimately losing our teeth!
Dental disorders and dental gum diseases
Periodontal diseases (periodontopathy), otherwise known as diseases of the dental gum, jaw bone and related ligaments is, just after cavity, the second most widespread modern world disease! Most frequent cause of periodontopathy is dental plaque (biofilm) that contains a few hundred different bacteria species. If consistent oral hygiene isn’t maintained, the plaque mineralizes and turns into dental tartar.
Bacterial activity in dental plaque or tartar causes dental gum (gingva) inflammation that is called gingivitis. It is characterized by thick, swollen and bleeding dental gums. You probably experienced seeing blood on the toothbrush after brushing your teeth. This is a first sign of dental gum problems. Bleeding doesn’t have to be extensive and it frequently doesn’t even occur (e.g. with smokers) which causes us to think that we don’t have periodontal issues.
If the gingivitis isn’t treated, the bacteria will advance to the deeper parts of dental support and cause periodontitis, i.e. the bone and ligament inflammation. The course of this inflammation is usually slow, with no subjective symptoms for the patient, like pain and swelling, but if it’s not treated it can lead to partial or complete loss of supporting dental structures. The end results are loose teeth and ultimately the loss of teeth.
How frequent is the periodontal disease?
75% of all adults, independent of race and socioeconomic status, suffer from periodontits. This ailment is the most frequent reason for teeth loss in adults. It can also be related to general diseases like diabetes, cardiovascular and lung diseases as well as to genetic predisposition.
How can I tell if I have periodontitis?
Majority of people are not aware of their periodontitis or of the existence of periodontology specialists. Periodontitis is often left unnoticed due to its chronic course with very little symptoms. If you have a family member with a periodontal diagnosis you should make an appointment, since the genetic component plays a significant role in appearance of this disease.
What are the symptoms of periodontitis?
In the earlier stages of periodontitis or gingivitis, following symptoms are present (but not always): gum bleeding, small swelling, redness and slight pain. Later stages of the disease include dental gum receding, secretion and pocket discharge, change in the position of teeth, increased interdental spacing, mobility of the teeth and ultimately, tooth loss.
How is periodontitis diagnosed?
In order to make a diagnosis for periodontal diseases, we require x-ray diagnostics. To get a general overview, we do a painless measurement of periodontal pockets that takes 2-3 minutes. If any dental gum or periodontal issues are noticeable, we recommend complete periodontal appointment, which will provide a diagnosis that is used to determine the type of necessary treatment. The treatment might end up being just professional tooth cleaning or a specific periodontal therapy.
Periodontal (periodontitis) therapy
Initial therapy consists of plaque and dental tartar removal. It also includes a very important step; patient education on appropriate and consistent oral hygiene. If the situation implies larger bone damage which results in significantly loosened tooth, we will consider varied surgical and periodontal methods to replace the lost bone and attempt to preserve the tooth.
Do I need to make control appointments after the periodontal therapy?
After the periodontal therapy you enter the last and lifelong phase – the maintenance phase. Unfortunately, it is that exact phase that is often neglected. Maintenance phase implies a consistent system of control for periodontal patients and it is adjusted to each individual case. Control appointments should be done 2-4 times a year, and their frequency depends on the ailment activity and patient’s oral hygiene.
Does pregnancy affect periodontal diseases?
The predisposition to gingivitis is higher in pregnancy. Up to 60%-75% of pregnant women experience gingivitis, which is what gave rise to the term ‘pregnancy gingivitis’. This case is caused by an altered hormonal state i.e. higher concentration of estrogen and progesterone. Higher concentration of these hormones increases the inflammatory reaction of the gingva to bacteria in the dental plaque. It is for this reason that pregnant women need to give special attention to their oral cavity health.
Does smoking affect periodontitis?
Bleeding is the first sign of gum inflammation and with smokers this symptom is often not present so they usually visit the dentist in later stages of the disease (smokers are 7 times more likely to get periodontitis).
How many times a day do I need to clean my teeth?
Two times a day is frequent enough, but you should make sure to clean your teeth effectively, systematically and without skipping any teeth surface. It should be done as a gentle massage, with almost no pressure, by minimal circular motion exactly on the border between the teeth and gums. This area is most sensitive when it comes to bacteria and that is exactly where majority of food leftovers and bacteria end up.
What should I use to maintain oral hygiene?
Toothbrush choice is a very important one. The toothbrush needs to be simple to use, effective, atraumatic and with no added ‘special effects’ that are potentially damaging and most definitely not useful. The most important parts of the toothbrush are its fibers. It would be ideal to have a brush with very soft (ultra soft), condense fibers. Slightly rounded fiber tops avoid any gum damage and at the same time, give the best result in shortest time period. Your toothbrush should be replaced every 3 months.
It is also important not to forget about teeth spacing that, in fact, houses most bacteria and can’t be reached by a normal toothbrush since toothbrush fibers can’t go through that spacing. That’s why it is recommended to use an interdental toothbrush once a day. This type of brush needs to have both thick and soft fibers, and it’s important to choose the right size. If we have an appropriately sized interdental toothbrush, we can use it by gently pulling it through the interdental spacing only once and taking it out.
Prioritizing Prevention
The most important factor in avoiding periodontal diseases is prevention. Preventive measures consist of maintaining appropriate dental hygiene and making regular dental appointments that, in addition to consistent removal of dental tartar and polishing dental surfaces, also protects the health of your natural teeth.
Therefore, try to make some time for a dentist appointment at the Smile Studio and make sure to do it before you end up needing a more complex (and expensive) treatment.
What is iTOP?
Individual training for oral prophylaxis – iTOP, is an individually adjusted education program that teaches the patient acceptable, efficient and atraumatic types of dental and periodontal care and the techniques to apply it.
After a detailed consultation and determining the state of teeth and gingva, we move on to measuring interdental spacing by using a suitable instrument. After that we teach standard, interdental and solo (individual) teeth cleaning techniques as well as the correct manner of using dental floss.
Smile Studio has the international iTOP certificate for maintaining health of teeth and the entire oral cavity. Our periodontology specialist, Miljena Mia Girotto, MSc, is a participant in the international iTOP education program, where she reached the status of the Top-level instructor, meaning that she successfully educates dentists all around the world.
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