Periodontology

 

All of these are warning symptoms of a periodontal disease, popularly called "periodontitis”. Although it may seem to you that these signs have manifested relatively fast – especially in the periods of stress or during pregnancy – this is a disease which develops slowly and quietly, beginning from the early twenties. You should keep reading this text if you recognize any of these symptoms:

  • Swollen, sensitive, red gums which bleed when you brush or floss your teeth

  • Retraction of the gums which makes the teeth look bigger than before

  • The space between the teeth becomes larger or the teeth shift forward

  • Looseness of teeth

  • Bad breath which you cannot get rid of

  • A change in the way your teeth fit together when you bite

Although this disease is known since time immemorial the perception that people suffering from it will eventually lose their teeth hasn't changed yet. But this is not true. It is known for years now that a good hygiene of oral cavity and regular check ups with your dental medicine doctor are a guarantee that you will have your teeth your entire life. So why would it not be possible in your case?



The basic problem for people suffering from any kind of periodontal disease is the genetic predisposition which is present in about 30% of the population, and which can led to the development of the disease despite the greatest efforts. Does that mean that there is no help and that some teeth will be lost sooner or later? Not if you contact your dental medicine doctor and start the treatment for periodontitis. Do not forget that it is too late to contact the doctor when you have already lost all of your natural teeth!

Another very important reason why you should take care of the health of your gum tissue and tissue around the surface of the tooth is that the size of these tissues equals the size of your palms. You can imagine the infection which causes periodontal disease if you imagine your palms bleeding every time you wash them – you would certainly be worried and would seek help! It is proved that this infection in richly vascularized tissues (such as the tissues in your mouth) can complicate and speed up the development of the cardiovascular diseases and diabetes because the bacteria and inflammatory molecules enter the bloodstream directly, it is extremely dangerous for pregnant women because it can cause premature birth and babies have low birth weight.
One more important thing to know is that smokers have weaker blood flow through their gums and because of that they are not aware of the intensity of periodontal disease. If you have ever tried to quit smoking and noticed that the bleeding of gum tissue increased that can be one of the symptoms of periodontitis and the smoking had "hidden” it.

And now the treatment – what can be done and is it really as unpleasant and painful as you have heard from others? Let's solve the pain problem right away: the treatment isn't painful and you can go back to your daily activities the same day. The light feeling of discomfort can be easily controlled with analgesics – the pills that you usually take when you have a headache. We will briefly describe the treatment:

  1. detailed control of the teeth and the surrounding tissues and the analysis of a panoramic x-ray image

  2. diagnosis, treatment plan and prognosis

  3. instructions on how to maintain optimal oral hygiene – toothbrushes, interdental products, solutions

  4. removing all of the sediments above the level of dental gums, caries treatment and extraction of those teeth that cannot be saved

  5. scaling and polishing of the roots – the sediments underneath the gums are cleaned using local anaesthesia with the addition of ozone therapy and rinsing with disinfectant. This way the quantity of bacteria in the "pockets" is reduced significantly, to a number which allows the healing

  6. support therapy – regular check ups and removing accessible sediments in regular intervals

  7. if there is a need for them procedures from the domain of periodontal surgery are performed – smaller procedures in local anaesthesia with which the cleaning of the "pockets" is made possible by lifting the gums (cosmetic surgery) or procedures where the lost bone and soft tissues are replaced (regenerative surgery)

  8. splinting (fixating) the loose teeth, making prosthetic substitutes, placing the implants

  9. and again regular controls, professional teeth cleaning, controls... It is important to understand that this is a long process. There are no simple, quick, magical instant solutions nor one-time procedures (no matter what the cost is), only your and your doctor's persistence and hard work can yield results.

And what about the medications? Maybe you have heard that someone you know was prescribed antibiotics for periodontitis or maybe you got them yourself. Although this is an infection ANTIBIOTICS ARE NOT THE CURE FOR PERIODONTITIS! They can't reach the pocket – the space between the teeth and the gums where the largest part of the bacteria are found in high concentrations, therefore the antibiotics can reach only a relatively small number of bacteria in the gums. Also the antibiotic resistance shouldn't be forgotten because it increases with each use of antibiotics. In certain cases (aggressive periodontitis, necrotizing periodontal diseases) we will prescribe antibiotics, but only because it is proved that in those specific cases they are necessary and effective, they are never used as the only treatment, they are used only in the combination with the above described procedures.

Lastly the problems with the gums are even more accentuated than usual in pregnancy – the hormones affect everything including the tissues which surround the teeth. What should be done? Check ups, professional teeth cleaning, removal of the sediments, use of solutions which control the forming of the plaque, removal of granulation tissue, even the complete periodontal surgery is possible during pregnancy, all of the above is necessary and protects not only yours but also the health of your unborn child as well, and that is the most important thing for every mother.