Periodontal Treatment

Dental Surgery
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Braces are necessary to avoid and prevent potential oral damage

There are several different gum diseases, periodontitis is one of them. Periodontitis is a chronic inflammatory disease of the supporting structures of the teeth, resulting in their breakdown: gums, bone and periodontal ligament. It is multifactorial with regards to its start and progression, determined by complex balance (or imbalance) between pathogenic bacteria,  environment, individual response and susceptibility, genetics and acquired risk factors (local or systemic). Periodontitis affects not only your oral health but also general health. Periodontitis increases the risk of cardiovascular diseases, poor pregnancy outcomes for women, worsens diabetes management. There is also emerging evidence about links to Alzheimer's disease and rheumatoid arthritis.

Can periodontitis be cured & how long will the treatment take?

Once you develop periodontitis, it will always stay with you – it is not possible to fully cure it, although it can be STABILISED  by active treatment, regular maintenance appointments and control of risk factors. Gum disease requires monitoring and maintenance, therefore after active phases of treatment, you will need to come for regular review and maintenance appointments in the following years for the rest of your life (or as long as you will have any teeth).

Treatment of periodontitis

Treatment of periodontitis is based on a 4-step approach.

1. Motivation of the patient and risk factor control. This may include teaching correct daily dental care routine, professional oral hygiene performed by dentist or hygienist, smoking cessation, dietary advice, improved control of diabetes and other general health conditions.

2. Cause-related therapy. Also known as non-surgical periodontal treatment. The procedures are usually performed under local anaesthetic. During the procedure, plaque and tartar which is below the gums are removed with special hand-held and ultrasonic instruments. Laser therapy or antibiotics may also be used.

3. Management of non-responding sites. If after the second step there still are areas that have not healed fully, further treatment is required in those areas. Depending on the individual situation, it might be non-surgical or surgical therapy.

4. Supportive periodontal care. Once stability is achieved, it is important to maintain it. Based on the individual situation, the appointments might be every 2 to 12 months and may include assessment of the gum health, personalised advice on dental care routine, cleaning of active pockets, discussion of further treatment needs.

Treatment limitations

You must be aware that the success of your periodontal therapy is largely dependent on you. You must follow the instructions for home care very closely to get a good result. You should also understand the possible consequences of not completing periodontal treatment once it is initiated, which are the same as having no treatment done. However, due to many factors such as smoking status, stage of disease, lack of adequate home care, nutritional or hormonal factors your problem may persist or even worsen with time and teeth can be lost despite undergoing the treatment. A well-treated and well-maintained patient will lose 1 tooth every 10 years; a well-treated, but not maintained – tooth every 5 years. An untreated patient may lose 1 tooth every 3 years.

Benefits of the treatment

With periodontal treatment, your gums will become healthier, which will help you keep your teeth longer. The improvements will depend on how good your cleaning becomes and how severe your disease was to start with. If your gums bleed, are red or swollen, this will get better, if your gums are sore, treatment should help and if your teeth feel loose, they may feel firmer after treatment. Your breath may become fresher.

Risks of the treatment

The gums occasionally feel sore after the active treatment but should feel better after a few days. Your teeth may become sensitive to hot, cold or sweet substances but usually, this will decrease within a few weeks. Sometimes you may need to use special toothpaste or have other treatment. You should also be aware that with inflammation-reducing, gums are going to shrink, so the gaps between the teeth may get bigger and teeth might appear longer. This might result in food getting trapped between teeth more often and the appearance of black triangles between the teeth.

Oral hygiene

Your teeth cleaning habits are extremely important for the successful treatment of periodontitis. It is recommended to brush the teeth at least two times a day with a soft brush and to also clean spaces between the teeth with appropriate interdental brushes or tooth floss. In addition to adequate teeth cleaning at home, regular professional oral hygiene appointments are necessary to maintain healthy teeth and gums. Patients with gum disease should have professional teeth cleaning with a hygienist or dentist every 3-4 months.

Alternatives of the treatment

No treatment. The result of not having treatment will depend on how severe your disease is. With no treatment, the gum disease will only get worse. Your teeth may become painful or you may lose your teeth sooner.