Periodontics, treatment for gum disease

Periodontal disease affects the gums and the tissues structure that supports the teeth. It’s known as “pyorrhoea”. The bacteria present in plaque cause periodontal disease.

What is periodontal disease?

The bacteria present in plaque are the cause of the diseases that occur in this area. This plaque, if not removed, hardens and turns into a hard, porous substance called calculus (also known as tartar). The toxins produced by the bacteria in plaque irritate the gums. These toxins make the gums become detached from the teeth and form periodontal bags, which fill up with more toxins and bacteria.

As the disease progresses there is loss of bone, gums and the periodontal ligament that supports each tooth. All this leads to the appearance of the so-called “black spaces” and makes the tooth look increasingly longer. From that moment onwards the tooth loses what could be called its “grip” and starts to move around. Later, over time, the tooth falls out or has to be removed, as biting is impossible and eating becomes very difficult.

How do you know if you have gum disease? What are the signs and symptoms?

Sometimes, periodontal disease can progress with no symptoms or pain. You might find:

  • Soft, inflamed or reddish gums
  • Shrinking gums or teeth that look longer than normal
  • Bleeding from brushing or flossing
  • Gums that become detached from the teeth
  • Loose or separated teeth
  • Pus between the gum and the tooth
  • Continuous bad breath
  • Changes to the way the teeth fit together when you bite

Stages of the disease

There are different states of periodontal disease:

It makes the gums become red, inflamed and bleed easily. There’s normally little or no discomfort at this stage.

Appearance of gingivitis. At this stage it’s still reversible if treated professionally and with good oral care at home. If the gingivitis isn’t treated, it may progress to becoming a mild periodontitis.

In this stage, the periodontal disease starts to destroy the bone and soft tissue that support the teeth

If the disease continues uncontrolled it will progress to becoming moderate or advanced periodontitis. This is the most advanced form of the disease in which there is extensive bone and tissue loss and often involves the complete loss of teeth.

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Are there factors that increase the risk of developing periodontal disease?

  • Poor mouth hygiene.
  • Smoking is another significant risk factor related to developing gum disease. Plus, smoking can reduce the effect of some treatments.
  • There’s a hereditary component that makes some people more likely than others to develop severe gum disease.
  • Twisted teeth that are more difficult to keep clean.
  • Pregnancy and hormonal changes in women.
  • People with diabetes are at greater risk of developing infection, including gum disease.

What treatment is advisable for periodontal disease?

The basic treatment consists of deep cleaning to remove tartar that builds up above and below the gum line. This is done by curettage or scraping and smoothing the teeth to remove tartar where germs accumulate.

It’s also common to use mouthwashes with an antimicrobial agent like chlorhexidine to rinse out the mouth.

In some cases, the depth of the periodontal bags and the advanced state of the disease means that periodontal surgery has to be performed.

In cases where surgery is required, it may be advisable to perform a bone or tissue graft to replace the bone or tissue that has been lost as a result of the periodontal disease.

From then onwards, the most important thing is to carry out maintenance and monitoring in subsequent visits to the dentist. These monitoring treatments are done every 3-6 months depending on each patient.


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