Treatment of periodontitis
Treatment of periodontitis (PERIODONTOLOGY) is a branch of dentistry that deals with the prevention and treatment of periodontal diseases, as well as diseases of the oral mucosa. The periodontium is a set of tissues that surround and hold the tooth in place. In addition, it is designed to protect the teeth against the penetration of infection from the infected gingival pocket or root canal. Periodontitis is the common name for periodontitis. It is a chronic disease in which bacteria attack our gums, which can lead to serious changes to the teeth. It is a disease in which the periodontal tissues become infected, which in turn leads to inflammation. As a result of inflammation, the tissues that support the teeth are destroyed. The result is a weakening of the attachment of the tooth, and in the worst case – its loss.
What causes periodontitis?
- improper care of oral hygiene
- plaque, tartar
- poorly chosen diet (deficiency of the necessary vitamins and minerals)
- alcohol abuse
- malocclusion leading to periodontal changes
Other comorbidities have a great influence on the development of periodontitis, e.g .:
- metabolic disorders
- problems with the circulatory system
- decreased immunity of the body
Periodontitis – treatment step by step:
It should be remembered that the onset of periodontitis is usually asymptomatic.
However, it is important to pay attention to symptoms such as: tooth sensitivity to extreme temperatures, unpleasant smell from the mouth, change in taste – unpleasant aftertaste, slight pain and bleeding of the gums – especially when brushing, inflammation, reddening of the gums, lowering gums, excessive accumulation of plaque, increased tooth mobility. In order to treat periodontitis, it is recommended to instruct in proper care of oral cavity hygiene and to remove irritants. In the early stage of periodontitis, systematic removal of tartar (as recommended by a doctor or hygienist) is recommended, as well as the use of toothpastes and liquids intended for oral hygiene for sensitive teeth – individually selected by a doctor or a hygienist. Sometimes it is necessary to implement pharmacological treatment (antibiotic therapy). If the periodontitis is advanced and the bones are significantly damaged, immediate surgical intervention is needed. Treatments for the treatment of advanced periodontitis include: curettage, gingivectomy, and flap surgeries are more advanced. In addition to treatments on the roots and pockets of the gums, there are also surgical corrections of the gums and bones, and preparations that allow the regeneration of lost bone and periodontal tissues are used.
Curettage is a procedure that involves the very careful removal of tartar from the periodontal pockets, which accumulates in the pockets due to inaccurate oral hygiene. The build-up of calculus penetrates the gap between the gum and the tooth, increasing the gap, which in turn leads to inflammation. Curettage can be performed in two ways – closed or open, depending on how deep the pockets with tartar are. Closed curettage is performed when the pockets are not very deep (up to approx. 5 mm). Subgingival concrements are then removed without the need to surgically uncover the root. Open curettage requires surgical unveiling of the root. Both procedures, both open and closed curettage, are performed under local anesthesia.
Gingivectomy, also known as gingivoplasty, is a procedure performed when the gums are not symmetrical, overlapping the teeth too much, or having an inappropriate shape. It is the removal of excess gums or giving them the desired shape. This procedure is performed under local anesthesia. Flap operations are performed when the periodontitis is significantly advanced and it is necessary to remove the inflamed tissue. This procedure involves the surgical exposure of the gums in the area of the inflamed lesion – the purpose of this procedure is to expose the roots and the bones of the alveolar process. This will facilitate access to the inflammatory focus. If, during the procedure, it turns out that the bone loss is significant, there is a possibility of guided bone regeneration, i.e. supplementing it with appropriate bone substitutes. The flap procedures are performed under local anesthesia, and afterwards the operated area is covered with sutures.