Periodontal Diseases&Treatment

Gingivitis (gum inflammation) usually precedes periodontitis (gum disease). However, it is important to know that not all gingivitis progresses to periodontitis.

In the early stages of gingivitis, bacterial plaque builds up, causing the gums to become inflamed and to easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.

It’s the periodontist’s duty to treat any type of gum disease.

What to do prior to treatment: What to do prior to treatment: Dental examination, periodontal screening, setting up a periodontal record, taking periapical x-rays/tooth. During the next consultation the patient gets a detailed information on the planned treatments, type of anaesthesia and if needed the materials used, furthermore on the incidental complications and what is to be done after treatment. It is advised to eat before every dental treatment, because it is recommended not to eat until the numbness lasts, which is usually for 3-4 hours after the injection.

Ultrasonic Calculus Removal (scaling):

• aim: To remove the calculus and sediment from the area below and above the gum. To stop unpleasant breath odour.
• steps: First is the calculus removal with ultrasonic scaler (below and above the gum), then with manual instruments from the area below the gum. (After that the surface of the teeth will be polished with special pastes, brushes and rubber cups.
• advantage: It doesn’t harm the enamel, usually it is done without local anesthesia, in case of pain with local anesthesia.
• what to do after treatment: Cervical hypersensitivity (to cold, warmth, sweet or sour tastes) can happen but that can be stopped with the use of Sensitive tooth paste or fluor gel. Food colourants should be avoided (coffee, tea, wine, cola, smoking), they stain the teeth. Proper dental hygiene (brushing, flossing) is essential.

Curettage:

• aim: To remove the inflamed tissue under the gum in local anesthesia.
• steps: After local anesthesia, the removal of the infected tissue and the plaque on the surface of the root comes next.
• advantage: The surface of the root becomes smooth, the wall of the pocket healthy.
• what to do after treatment: As long as it’s numb eating is not recommended. The area must be kept clean.

Open Flap Curettage:

• aim: In local anesthesia, after a small gingival cut is made the inflamed tissue and the calculus in the lower areas are removed.
• steps: This is a more serious surgical intervention. In local anesthesia the upper part of the gum is removed from the tooth, then we can reach the tooth and the pockets better. After cleaning the pockets, the infected and damaged tissue is removed as well. This is necessary in case the pockets are deeper than 5mm. In that case we can use regenerative materials. After the intervention the wound is closed with stitches, which are removed within a week.
• advantage: The surface of the root becomes smooth, the wall of the pocket healthy.
• what to do after treatment: As long as it’s numb eating is not recommended. The most efficient oral hygiene is necessary with the help of a toothbrush, interdental cleaner and mouthwashes containing Chlorhexidine. Regular dental check-ups.

advantages of the treatment: Keeping the teeth, periodontal disease can be stopped and the forming of gingival recession can be prevented.