How to fight gum disease?
Periodontal disease can be CURED! With periodontal disease treatment we are able to stop the loss of bone, but it is also necessary to MAINTAIN FOR LIFE, both at home (with the recommended hygiene methods) and in the office (to access areas where the patient does not arrive and prevent recurrences).
GINGIVITIS is an infectious disease manifested by bleeding gums. It is reversible, does not entail bone loss. It can be mild, moderate or severe depending on the degree of inflammation.
PERIODONTITIS or “pyorrhea” is a chronic disease also of infectious origin, which causes the loss of the bone that supports the teeth and, consequently, in the long or medium term, the loss of the dental pieces if treatment is not performed in time.
What is a periodontal / gum disease?
Periodontal disease is characterized by red, inflamed, bleeding, or receding gums, as well as bad breath, painful chewing, and motile teeth.
The main etiological factor is bacterial plaque. The accumulation of plaque, usually due to improper brushing, causes gingivitis or inflammation of the gums. If this is maintained over time, or the patient has a genetic predisposition to develop periodontitis, the loss of the bone that supports the teeth begins. Furthermore, there are several general and local conditions that facilitate its emerging or aggravate its course:
- Diabetes, pregnancy, tobacco, poor dental hygiene, stress, malnutrition, some medications (antihypertensive, immunosuppressive, hydantoin)
- Poorly fitted dentures and fillings, dental crowding, deep grooves, or anatomical defects.
Gum problems DO NOT HURT in the vast majority of cases.
Sometimes these symptoms are camouflaged by tobacco, which produces vasoconstriction and camouflages the signs of inflammation. So if you smoke, we recommend you to do a periodontal study to rule out any gum problems before it’s too late.
Periodontal therapy begins with a consultation and examination to determine the stage of the disease and develop a treatment plan. Depending on the stage of the disease, several treatments can be applied:
Periodontal Maintenance or Prophylaxis.
It is recommended at least once a year for healthy patients, according to the diagnosis of our hygienists, in some cases it is recommended between two and three times a year. The plaque and tartar are removed, which with our usual cleaning at home we cannot remove.
As a differentiation with other dental clinics in Clinica Dental Crooke Marbella we have the Airflow system of the Swiss company EMS. Compared to other methods of dental prophylaxis, treatment with Air-Flow Perio is especially characterized by its safety, effectiveness and sustainability.
The EMS Air-Flow Perio method is also indicated for the subgingival removal of biofilm as part of a periodontal preservation treatment, as well as for implant cleaning. For the removal of subgingival plaque in interdental spaces with a probing depth of up to 5 mm, the use of the glycine powder with the air polisher has proven to be a more effective procedure than treatment with manual instruments. It is also suitable for cleaning oral and lingual surfaces.
The subgingival application of the Air-Flow Perio air polisher not only saves time compared to treatment with manual instruments, but also in patient’s safety and comfort. In addition, a randomized trial in periodontal pockets of moderate depth shows that the application of Air-Flow Perio is more effective than conventional ultrasonic cleaning and scaling.
Glycine-based powders work without altering titanium surfaces. In direct comparison with sodium bicarbonate and bioactive glass, glycine-based EMS powders are undoubtedly the most innocuous, and their abrasion rates are the lowest.
In short, we can have a better and more effective treatment, and much less uncomfortable and painful, both for natural teeth and for implants.
Scaling and Root Planing Session
In more advanced cases in periodontal disease, to be evaluated by the periodontist, a deeper treatment is necessary.
Normally, several sessions of scaling and root planing must be done to decontaminate the root of the tooth. Previously, x-rays and a detailed study of each tooth must be carried out with an electronic probe (Florida Probe) that informs us of the degree of inflammation, recession, mobility and other important data to assess the response to treatment and based on that, we can establish guidelines for determined actions and an individualized forecast. Likewise, it is essential to instruct the patient in brushing techniques and interdental hygiene.
Once the scalings are finished, a microbiological analysis is done to determine if there are any more aggressive bacteria that has caused the inflammation and bone loss. This will help us to know whether to use antibiotics or not, and what specific antibiotic is necessary.
Once this 1st phase is finished, a periodontal evaluation will have to be carried out again and thus be able to assess the response to treatment and the need or not to perform surgery.
We can also carry out a genetic analysis to assess the predisposition to suffer from the disease. This will help us foresee possible complications and make certain decisions for the future.
It is the only phase that not all patients need. If residual bags remain after scaling, they must be removed for not being colonized by bacteria again. Likewise, regeneration of the lost tissues will be carried out when it is possible through the use of membranes or matrix derived from the enamel, and recessions will be covered by gum grafts in the teeth that need it.
They are very detailed microsurgery techniques, but with spectacular results in many cases. For the success of the treatment, it is essential that the patient does not smoke, since tobacco compromises the vascularity of the graft.
- Tissue graft
The grafts can be performed on teeth, on implants or in areas where parts are missing to recover the volume lost after one extraction.
They can be done for different purposes:
- Coating of exposed dental roots ( due to aggressive brushing, dental misplacement, piercings …).
- Increased inserted gingiva (in areas with traction of frenulum or short vestibule fundus).
- Increased thickness in areas where a tooth is missing to improve hygiene and aesthetics.
- Gum volume increase in dental implants.
In some cases we can regenerate the lost bone. Basically, in cases where there are vertical intraosseous defects. Depending on the morphology of the defect, we can resort to proteins derived from the enamel matrix, or to regeneration with collagen membranes.
To regenerate, it is essential that the patient does not smoke, and if the teeth are mobile, they must be splinted first.
When is gum surgery necessary?
Gum surgery becomes necessary when the gum tissue around the teeth is too unhealthy to be repaired with nonsurgical treatments.
How can you prevent gum disease?
Routine professional dental cleanings and regular at-home oral hygiene practices that include brushing and rinsing at least twice a day and flossing regularly will help prevent both gingivitis and periodontal disease.
What is a gum graft?
During a gum graft, tissue is taken from the roof of the mouth and attached to the affected gum line, allowing more tissue to grow and cover the exposed root surface.
What is a gum or periodontal abscess?
A gum or periodontal abscess occurs when a pocket of pus collects within the gum. It happens when tissue disintegrates as a result of a bacterial infection in the gums or tooth roots and supporting bone.