Periodontology

Periodontitis is an advanced chronic inflammation of gingiva. It is one of the most common diseases in general. The presence of bacteria in dental plaque leads to an inflammation that spreads to tooth supporting structures which are located around the root and it can also affect the surrounding bones. If not treated it can lead to visible gingival recession, teeth getting loose or completely lost. Inflammation like this affects the whole organism and aids certain diseases, such as heart and diabetic diseases. These are the reasons why target treatment and special diagnostics are very important.

Periodontitis therapy:

• Removal of soft and hard deposits from the teeth
• Treatment of periodontal pockets under local anesthesia
• Therapy for acute periodontal abscess (drainage)
• Surgical treatment of periodontitis (Widman surgery)
• Gingivectomy

Plaque is what causes gingival inflammation. Certain bacteria in the plaque release toxic matter to which the organism reacts with an inflammation. This, together with the already existing agressive bacteria leads to gingival tissue being decomposed. Eventually, gingival pockets are formed. One of the main symptoms of these pockets is bleeding while brushing your teeth. Gingiva can be red and swollen. It is also possible that you will notice no symptoms, so the disease is free to advance unnoticed. Plaque is still being formed even in these pockets. If the cause is not treated it will lead to a “non-stop” inflammation. The pockets will get deeper until they start damaging tooth supporting structures which will lead to bone resorption. The special tissues that surround and support the teeth are called parodontium and they also enable tooth movement so that while under load (chewing) the tooth is not damaged. The loss of supporting structures is an irreversible process, so even if periodontitis is successfully treated the new tissues that is formed can never completely be as strong as the original one. For that reason, timely treatment is very important.

Risks of heart diseases, rheumatism and preterm labor are significantly increased in cases of chronic periodontitis.

Factors that influence the course of the disease:

• Smoking
• General diseases like smoking
• Hereditary factors
• Overweight
• Bad nutrition
• Changes in hormone levels as in pregnancy or menopause
• Increased stress

The course of periodontitis can individually be very different. It often occurs in middle to older life ages and it is characterised by a slow, chronic course with occasional bad periods. In some cases, however, the course can be very agressive and sometis this disease can occur in younger people. In those cases the reason are mostly hereditary factors and especially agressive bacteria.

Symptoms and consequences of periodontitis:

• accumulation of dental plaque
• gingival inflammation (gingiva is enlarged, red, swollen)
• feeling of a foreign body between teeth
• gingival bleeding
• gingival recession
• bone resorption
• gingival pockets
• bad breath
• tooth migration
• tooth getting loose
• loss of teeth

Only the first stages of periodontitis are reversible (swelling, gingival inflammation, gingival bleeding) if treated adequately (dental plaque removal, improvement of oral hygiene.. ).

If it comes to bone resorption, degradation of the gingiva and the tooth supporting structures the damage is permanent and treatment will not reverse it to before the beginning of the disease. The best you can do in that case is to prevent further disease advancement with adequate treatment and regular oral hygiene. These are some of the methods used in treatment: removal of dental plaque, scale removal, dental pocket treatment, placement of medicine in pockets, pocket rinsing and periodontal surgery.