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Periodontology is the specialty of dentistry that studies hard (bone) and soft tissues system (gingiva) supporting structures of teeth

What is Periodontology?

Perí is the Greek word for 'around' and odoús is Greek for 'tooth'. Periodontology is the specialty of dentistry that studies hard (bone) and soft tissues system (gingiva) supporting structures of teeth, as well as diseases and conditions that affect them.

This set of tissues is called periodontium and its main function is to keep the teeth in their position inside the bone. It also acts as a buffer during mastication preventing damage to the teeth when they receive excessive forces. Periodontium is composed of alveolar bone, root cement, periodontal ligament and gingiva. Your teeth are inside the alveolar bone and are supported by the periodontal ligament which joins the cement that covers the root of the tooth. These living tissues can adapt to different changes in your mouth that allow to maintain the position of the teeth in a stable manner.

What is Periodontitis?

Periodontitis (per-e-o-don-TIE-tis) is a more severe form of the gum disease that happens as a result of a serious gum infection damaging the soft tissue. This disease is also called gingivitis and if left untreated it can destroy the bone that supports your teeth causing teeth to loosen or lead to tooth loss.

Gingivitis occurs because a film of plaque, or bacteria accumulates on the teeth causing redness and swelling of the gingiva. Periodontitis which is usually the result of poor oral hygiene, it’s very common but largely preventable. To reduce your chance of developing it you have to brush at least twice a day, floss daily and get regular dental checkups. The symptoms that indicate the presence of the disease are: bright red, dusky red or purplish gums, swollen gums, bad breath, shifting teeth, and a formation of pockets between teeth and gums.

More symptoms:

Remember that healthy gums are firm and pale pink and fit snugly around teeth. Here are other signs and symptoms of periodontitis:

The main first signs of periodontitis include:

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What are the causes of periodontitis?

The development of periodontitis starts with plaque which is a sticky film composed mainly of bacteria. Let’s look together at how plaque can eventually advance to periodontitis: 

When starches and sugars in food interact with bacteria normally found in your mouth then plaque starts to form on your teeth. It can be removed if you brush your teeth twice a day and floss once a day, but anyways plaque re-forms quickly.

If Plaque stays on your teeth it can harden under your gumline into tartar (calculus). Tartar which is filled with bacteria is more difficult to remove. Remember that the longer plaque and tartar remain on your teeth, the more damage they can do. Tartar can’t be removed by brushing and flossing. Therefore you are going to need a professional dental cleaning to remove it.

Plaque can cause gingivitis which is the mildest form of gum disease. Gingivitis is irritation and inflammation of the part of your gum tissue around the base of your teeth (gingiva) and  can only be reversed with professional treatment as well as good home oral care.

Ongoing gum inflammation can cause periodontitis. It will cause pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. Later, these pockets become deeper, filling with even more bacteria. If left untreated, these deep infections cause a loss of tissue and bone. Ultimately you may lose one or more teeth. It is also worth noting that ongoing chronic inflammation can put a strain on your immune system.

What are the risk factors of periodontitis?

There are a lot of factors that can increase your risk of periodontitis, including:

How is periodontitis diagnosed?

We can normally diagnose periodontitis by looking at the signs and symptoms. Carrying out a physical examination helps a lot. Our ClassDent dentist will probably insert a periodontal probe next to the tooth, under the gum line. The probe should not slide far below the gum line when the tooth is healthy. In cases of periodontitis, then the probe will reach deeper under the gum line. What's more, X-ray may help assess the condition of the jaw bone and teeth.

What are the stages of gum disease?

Gingivitis – Mild Gum Disease

Gingivitis – Mild Gum Disease

Is an early stage of gum disease. As a result it is so easy to ignore the first signs. It starts with an inflammation of the tissues surrounding and supporting the teeth. As mentioned before, poor dental hygiene, and consuming high carbohydrate foods can cause mild gum disease. Keep in mind that untreated gingivitis can progress to a higher level of inflammation, called periodontitis.

Early Periodontitis

Early Periodontitis

During this period the patient has a gingival pocket depth of 4 to 5 millimeters approximately. The gum will start to bleed during brushing and flossing and the gum tissue will start to draw back. In this condition the proper treatment can contain scaling and root planing. At this stage it is very important for us to encourage our patients to brush their teeth regularly with the proper technique and use floss.

Moderate Periodontitis

Moderate Periodontitis

Moderate levels of bone loss may occur in this condition. Gum recession will lead to tooth sensitivity and an uncomfortable feeling. You may also feel pain around the teeth and bleeding can occur. When the gums pull away from the teeth, the natural support system weakens. So the teeth can become loose. At this stage, the patient has gingival pocket depths of between 6 and 7 millimeters. During the treatment, it is essential to clean and sanitize the area inside of the gingival pockets.

Moderate Periodontitis

Severe Periodontitis

Lastly, in this case, the gums are severely infected. At stage four, the gingival pockets around the teeth are deeper than 7 millimeters. Now the patient feels intense pain while chewing and bad breath occurs. Tooth loss is also very common. We must note that advanced periodontitis has been tied to other serious health issues such as diabetes, heart diseases and certain types of cancer. After cleaning and sanitizing the area inside of the gingival pockets, our ClassDent doctor may recommend bone grafting or dental implants.

Treatment of periodontitis

The main aim of treatment is to clean out bacteria from the pockets around the teeth and prevent further destruction of bone and tissue.

In simple cases, you can solve the problem yourself. All you have to do is brush your teeth more frequently. Try to use an antiseptic mouthwash and dental floss. It is advisable to visit the dentist to perform scaling that can complete the appropriate daily tooth treatment. Even when the teeth and gums are healthy, brushing your teeth at least twice a day and flossing once a day will help you to prevent infection.

Proper dental care involves brushing teeth at least twice a day and flossing once a day. Remember that periodontitis is a chronic, or long-term, inflammatory disease. If good oral hygiene is not maintained, it will recur.

To restore periodontal health it is important to remove plaque and calculus.

ClassDent healthcare professionals will carry out scaling and debridement to clean below the gumline. This can be done using hand tools or an ultrasonic device that breaks up the plaque and calculus.

This may take one or two visits depending on how much plaque and calculus there is.

We recommend you to clean twice a year, and possibly more often, depending on how much plaque accumulates.

A number of medicated mouthwashes and other treatments are available, for example:

  • Prescription antimicrobial mouth rinse, such as chlorhexidine which is used to control bacteria when treating gum disease and after surgery.
  • Antiseptic chip which controls bacteria and reduces periodontal pocket size.
  • Antibiotic gel which helps control bacteria and shrink periodontal pockets.
  • Antibiotic microspheres used to control bacteria and reduce periodontal pocket size.
  • Enzyme suppressant which keeps destructive enzymes in check with a low-dose of doxycycline.
  • Oral antibiotics available in capsule or tablet form, used short-term for the treatment of acute or locally persistent periodontal infection.

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