Do you know that Periodontal Treatment can help you to fight off infections in the structures around your teeth?
Periodontal diseases are infections that can affect your teeth, however, not in the actual teeth themselves.
These structures include gums, alveolar bone, and periodontal ligament.
Moreover, periodontitis can progress from gingivitis, which is the first stage of periodontal disease and only affects your gums, to the other structures.
These often occur due to a combination of bacteria and dental plaque.
Microorganisms can stick to the surface of your tooth and in the pockets around your tooth and multiply.
As your immune system reacts and releases toxins, it can cause inflammation.
In case you do not get treatment for periodontitis, they can gradually lead to tooth loss.
Furthermore, it can increase the risk of stroke, heart attack, and other health conditions.
With the help of good dental hygiene, you can prevent periodontitis.
Causes of Periodontitis
Plaque is a pale yellow bioform that collects on your teeth as part of a natural process.
It forms by bacteria that try to attach themselves to the surface of the tooth.
Brushing often gets rid of the plaque, but after a day or so, it will build up again.
If you do not remove it, however, it hardens into tartar and forms Calculus.
Moreover, tartar is harder to remove than plaque and it can not be done at home. It requires professional treatment.
Plaque can gradually and progressively damage your teeth and the surrounding tissue.
At first, gingivitis can develop and this inflammation of the gum occurs around the base of the teeth.
If gingivitis persists, pockets develop between your teeth and gums and they fill up with bacteria.
Along with the responses of your immune system to infection, bacterial toxins begin to destroy the bone and connective tissue that holds the teeth in place.
Gradually, the teeth start becoming loose and they may fall out.
Symptoms of Periodontitis
Some of the signs and symptoms of Periodontitis are:
Inflammation or swelling of gums and recurrent swelling in the gums.
Bright red and in some cases, purple gums, pain when you touch your gums, and receding gums that make your teeth look larger.
Moreover, extra spaces appear between your teeth, pus between the teeth and gums, bleeding while brushing teeth or flossing, a metallic taste in the mouth, halitosis or bad breath, and loose teeth are symptoms.
You may say that your bite feels different because the teeth do not fit as they did before.
Periodontitis vs. Gingivitis
One of the important things to note is that gingivitis occurs before periodontitis.
Gingivitis often refers to gum inflammation while periodontitis refers to gum disease and the destruction of tissue, bone, or both.
Let’s discuss them in detail.
Gingivitis
Bacterial plaque accumulates on the surface f the tooth, causing your gums to become inflamed and red.
Moreover, your teeth may bleed during brushing and can also irritate and bothersome.
However, in these cases, your teeth are not loose and there is no irreversible damage to the bone or surrounding tissue.
When you do not get treatment for gingivitis, it can progress to periodontitis.
Periodontitis
On the other hand, gum and bone pull away from the teeth, forming large pockets.
Additionally, the debris can collect in the spaces between the gums and the teeth and thus infect the area.
Your immune system attacks bacteria as the plaque speeds below the gum line into the pockets.
Bone and connective tissues that hold your tooth can start to break down, because of toxins bacteria produces.
As a result, your teeth can become loose and fall out. The changes due to this condition are irreversible.
Diagnosing Periodontal Diseases
Your dentist can simply diagnose periodontitis by looking at the signs and symptoms and carrying out a physical examination.
Moreover, they will insert a periodontal probe next to the tooth, under the gum.
If the tooth is healthy, the probe should not slide below the gum line.
While in the case of periodontitis, the probe will reach deeper under the gum line.
Your dentist can measure how far it reaches.
Additionally, a dental X-ray can also help to assess the condition of your jaw and bone.
Let’s discuss the phases of periodontal treatment.
Phases of the Periodontal Treatment
For the treatment of periodontal diseases, there will be three phases your dentist will take you through.
These are as follows:
- The Eliological Phase
- Surgical Phase
- Maintainance Phase.
Let’s discuss them in detail.
Phase I: The Eliological Phase
The treatment in this phase will focus on controlling the infection and restoring the healthy microbial that should be there in your mouth.
Moreover, your dentist will also take a look at what is actually causing the periodontal disease so they can address the root of the problem.
During this phase, they will also educate you on how you can take care of your teeth at home.
This will include taking care of your overall health.
You will also need to stop smoking and maintain excellent oral hygiene.
Certain procedures like Scaling and Root Planing can also occur during this stage.
During this, they will clean your teeth deeply and remove plaque and calculus. They may also prescribe medications.
Phase II: The Surgical Phase
In case the constructive treatments are not effective you may need to move the surgical phase.
It will most likely happen if the pockets of infection or plaque and tartar are too deep to clean.
Moreover, in this phase, your dentist will assess your condition somewhere between 4 and 8 weeks after the initial treatment.
Surgery can help to level the shallow bone defects or use regenerative surgical techniques for deep bone defects.
The goal of these surgeries is to remove the pockets of space between the teeth and bone that can be broken down or destroyed with periodontal disease.
In turn, this will help to eliminate the room for bacteria, plaque, and tatar to fester.
With the help of general anesthesia, your dentist will perform the surgery and you will not feel any pain.
The Maintainance Phase: Phase III
During this phase, your dentist will focus on preventing the periodontal disease from returning, and without it, there is a high chance of recurrence rate.
Additionally, your dentist will carefully detail the oral hygiene practices you need to follow like brushing and flossing your teeth.
Clean your teeth carefully to make sure you do not miss any of the hard-to-reach spots and use a mouthwash to kill off any leftover bacteria.
Make sure to visit your dentist for a three-month follow-up instead of waiting months to make sure everything is in good working order.
In some cases, you may enter a restorative phase. Implants or prosthetics will help in case your dentist extracts teeth or if a large amount of tissue or bone is removed.
Orthodontic treatment can help to align your teeth properly, laying them easier to care for.
Nonsurgical Periodontal Treatments
Your dentist will first start with nonsurgical treatments.
Deep cleanings that involve scaling and root planing can help. It is not as invasive as surgery and is effective in treating minor cases of periodontal disease.
During this process, they will scrape off the tartar from above and below the gum line, along with any rough spots on your tooth.
This will help to remove bacteria that contribute to gum diseases while also getting rid of the areas where bacteria may gather.
The cost of deep cleaning often depends on the location and your dentist.
However, your insurance may not cover it. You may also experience some bleeding but you will be able to resume normal eating and drinking later that day.
Moreover, your doctor will also prescribe some medications including either systemic antibiotics that you will take orally or local antibiotics in gel to apply topically.
They are often not enough on their own to treat periodontal disease, but they can help to make the recess of scaling and root planing more effective.
Some of the other medications are:
- prescription antimicrobial mouth rinse
- antiseptic chip, which is a tiny piece of gelatin that contains medications
- enzyme suppressant which contains a low dose of doxycycline to keep destructive enzymes from flourishing
Let’s discuss the surgical pocket reduction for periodontal treatment.
Periodontal Treatment: Surgical Pocket Reduction
This procedure can help to clean out tartar in deep pockets and eliminate or reduce those pockets.
Moreover, this will make the area easier to clean and prevent infections from developing in the future.
This is Flap Surgery.
During this procedure, your dentist will clean the pocket carefully, thus removing the tartar deposits after lifting up the gums to clean underneath them.
They will then suture the gums to fit more tightly around your tooth.
After the surgery, you may experience swelling for about 24 to 48 hours.
Furthermore, they will also prescribe antibiotics.
Make sure to maintain a diet of liquid or soft foods for at least two weeks.
Periodontal Treatment: Bone and Tissue Grafts
In case periodontal disease causes a loss of bone or gum tissue, your dentist may recommend bone or tissue grafts in addition to surgical pocket reduction.
This will help to regenerate bone or tissue lost and is a part of periodontal treatments.
During the process of bone grafting, your dentist will place natural or synthetic bone in the area of the loss, which can help to promote bone growth.
Moreover, your dentist may also use guided tissue regeneration.
During this procedure, they will insert a mesh-like material between the bone and gum tissue to prevent the gum from growing where the bone should be and allow it to regrow properly.
Additionally, they will also use a soft tissue graft during this procedure. This graft may be either synthetic material or tissue that comes from another area of your mouth.
They will place it to cover the exposed tooth roots.
During aftercare, do not use straws.
Make sure to eat soft or liquid foods for at least 6 to 8 weeks, depending on the recommendations of your dentist.
Outlook for Periodontal Treatments
Periodontal diseases can increase your risk for conditions like stroke, heart attack, diabetes, and respiratory diseases. If you do not get treatment, it can also result in extractions. Therefore, it is important to get treatment, If you start early, it can even save you from more invasive treatment in the long run.
Periodontal therapies and treatments can help and are very much effective as long as you follow the instructions of your dentist during the maintenance stage. This will decrease the risk of recurrence. Moreover, make sure to be careful with your oral hygiene and do not use any tobacco products.
Dr. Amal Al Qedrah Medical Center
Royal European Specialist Polyclinic