Periodontology is a department of dentistry, which is interested in health of surrounding tissues of the teeth. The roots of the teeth are placed in the alveolar bone and covered by the gum. Between the root and the bone periodontal ligament takes place, which is consisted of fiberelastic ligaments. This tissue ensures that the chewing forces are delivered equally among the root.
Periodontal disease (PD) is partial or general the infection and inflammation of the hard and the soft tissues around the teeth.
The main reason of PD’s is insufficient oral hygene. It is inevitable of collection of plaque on the tooth surface, which are not brushed properly twice a day. Beside the bad oral hygene, also excessive tobacco consumption, genetic liability, some systemic and/or infectional diseases (like diabetes, AIDS, etc) may cause PD.
The early stage of PD is called gingivitis. Only the gum is affected by gingivitis. If the teeth are not brushed properly, plaque starts to collect on the teeth surfaces in 4 to 6 hours. Then the bacteria invade the plaque and gingivitis begins in 1 to 2 days. Bleeding is the major symptom of gingivitis. At this stage redness and swelling without pain is observed. Professional scaling and daily oral care on regular basis is enough to fix this condition.
If gingivitis is not handled properly on time, the next step of infection is periodontitis. It is a disease, in which the bacteria proceed to the deeper layer in gum and reach to the alveolar bone and start to destruct all the tissues on their way. There is a 1-2 mm deep periodontal groove where the healty gum meets the tooth neck. In periodontitis this groove transforms to periodontal pocket, where the bacteria can locate and easily multiply.
Symptoms of Periodontitis
- Rocking teeth
- Gingival recession
- Sensitivity to cold
- Occlusal changes
- Bleeding during brushing
- Flaring of teeth
- Redness and edema on the gum
- Exfoliation of teeth without caries
As always, early diagnosis and early intervention is very important for success of the treatment. If the periodontal disease is only at the beginning stage, it can be easily healed with professional scaling and daily oral care. In later stages, after the periodontal pocket formation and bone resorption began, scaling and root planing (SRP) is mandatory. SRP is performed by a periodontologist in 2 to 4 sessions. After this procedure the root surface transforms to a smooth and some kind of polished surface, which is not suitable to hold the bacteria. During the healing period a new connection between the gum and bone starts to form. It takes about 4 to 6 weeks to repair.
- In some advanced PD cases another additional surgical procedure may be necessary after SRP. In this procedure, the gum and mucosa is removed until the healty bone, all the infected tissue is cleaned and if necessary bone graft and membrane can be placed. Recovery period after flap operation is about 6-8 weeks.
- Beside the clinical treatment procedures, also systemic antibiotic use may be necessary in some cases.
- The patients daily care is as important as the clinical treatment. If the patient don’t follows doctor recommendations, the treatment will be fail inevitably.
- The patients with former PD story must see the doctor every 3 to 6 months. The success of the treatment, the effectiveness, the cooperation of the patient should be evaluated and the patient has to be informed about his/hers condition.
- The former prohtesis and/or fillings , which may be responsible to start the infection, should be replaced with new and compatible ones.
- If the teeth are crowded, which means also a lot of not cleanable surfaces, orthodontic treatment should be considered to obtain good aligning and straigth surfaces.