Periodontics and periodontitis
Periodontics is the part of dentistry that studies and treats the alterations of the structures that surround and sustain the dental pieces, such as the gums, the dental ligaments and, the alveolar bone, which can cause the loss of teeth.
Generally the problem begins in the gums, tand it starts as a gingivitis, due to the deposit of the dental plaque.
It’s the inflammation of the gums.
Gingivitis is a form of periodontal disease.Periodontal disease is an inflammation and infection that destroys the supporting tissues of the teeth. This may include gums, periodontal ligaments, and alveoli (alveolar bone).
Gingivitis is due to the long-term effects of plaque deposits on the teeth. The plaque is a sticky material composed of bacteria, mucus and food that accumulates in the exposed parts of the teeth. It is also a major cause of tooth decay.
If the plaque is not removed, it becomes a hard deposit called calculus that is trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. The bacteria and the toxins that they produce cause the gums to become infected, inflamed and become sensitive.
These situations increase the risk of gingivitis:
- Certain infections and diseases (systemic).
- Bad dental hygiene.
- Pregnancy (hormonal changes increase the sensitivity of the gums).
- Diabetes not controlled.
- Misaligned teeth, rough edges of fillings and poorly placed or contaminated oral appliances (such as dental braces, prostheses, bridges and crowns).
- The use of certain medications such as phenytoin, bismuth and some contraceptive pills
Many people have some degree of gingivitis. This usually appears during puberty or during the early stages of adulthood, due to hormonal changes. It may persist or reappear frequently, depending on the health of your teeth and gums.
Symptoms of gingivitis include:
- Bleeding gums (blood on the toothbrush even with gentle brushing).
- Bright red or red gums.
- Gums that are sensitive to touch, but otherwise painless.
- Cold sores.
- Swollen gums.
- Gums with a shiny appearance.
TEST AND EXAMS
The dentist will examine the mouth and teeth and look for soft, inflamed, or red-purple gums.
The gums are usually painless or slightly tender when there is gingivitis.
The dentist will use a scanner to carefully examine the gums to determine if you have gingivitis or periodontitis. Periodontitis is a serious infection of the gums.
Most of the time, no additional tests are needed. However, x-rays of the teeth can be taken to see if the inflammation has spread to the supporting structures of the teeth.
The goal is to reduce inflammation.
The dentist or the oral hygienist will clean your teeth. They can use various instruments to loosen and remove deposits from the teeth.p>
PROFESSIONAL DENTAL CLEANING
Careful oral hygiene is necessary after professional dental cleaning. The dentist or oral hygienist will show you how to properly brush and floss.
In addition to brushing teeth and flossing, the dentist can recommend:
- Get a professional dental cleaning twice a year, or more often for more advanced cases of periodontal disease.
- The use of antibacterial mouth washes or other types.
- The repair of misaligned teeth.
- The replacement of dental and orthodontic appliances.
- Treat other diseases or related disorders.
Some people feel discomfort when the plaque is removed from their teeth. Bleeding and sensitivity of the gums should decrease after 1 or 2 weeks after professional cleaning and good oral hygiene at home.
Antibacterial or warm salt water rinses can reduce swelling of the gum. Over-the-counter anti-inflammatories may also work.
You must maintain good oral hygiene throughout your life or the periodontal disease will reappear.
These complications can occur:
- Reappearance of gingivitis.
- Infection or abscess of the gums or maxillary bones.
- Acute ulceronecrosing gingivitis.
WHEN SHOULD YOU CONTACT A MEDICAL PROFESSIONAL?
Consult your dentist if you develop redness and swelling of the gums, especially if a cleaning and a routine examination has not been performed in the last six month.
Good oral hygiene is the best way to prevent gingivitis.
You should brush your teeth at least twice a day. Floss at least once a day.
Your dentist may recommend brushing your teeth and flossing after each meal and at bedtime. Ask your dentist or oral hygienist to show you how to properly brush and floss.
Your dentist may suggest special devices to help remove plaque deposits. This includes toothpicks and special toothbrushes, irrigation with water or other devices. You should still brush and floss regularly.
Your dentist may also recommend anti plaque toothpastes or mouth rinses.
Many dentists advise professional dental cleaning at least every 6 months. You may not be able to remove all the plaque, even with careful brushing and flossing.
It’s an inflammation and infection of the ligaments and bones that support teeth.
Periodontitis occurs when inflammation or infection of the gums (gingivitis) occurs and is not treated.Infection and inflammation spread from the gums to the ligaments and bone that support the teeth. The loss of support causes the teeth to loosen and eventually fall off. Periodontitis is the leading cause of tooth decay in adults. This disorder is not common in young children, but it increases during the teenage years.
Plaque and tartar build up at the base of the teeth. The inflammation due to this accumulation causes “pouches” or gaps to form between the gum and the teeth. These bags fill with tartar and plaque. Inflammation of the soft tissue traps the plaque in the pouch. The continuous inflammation leads to damage of the tissues and bone around the tooth
The symptoms of periodontitis include:
- Bad breath
- Gums that are bright red or purplish red
- Gums that look bright
- Gums that bleed easily (presence of blood on the toothbrush, even if brushing is done gently)
- Gums that may be sensitive to touch, but otherwise do not hurt
- Loose teeth
- Swollen gums
Note: the initial symptoms resemble gingivitis (inflammation of the gums).
TESTS AND EXAMS
The dentist will examine your mouth and teeth. The gums will be soft, inflamed and red-purple coloured (healthy gums are pink and firm). Deposits of plaque and tartar can be seen at the base of the teeth and the pouches in the gums may be enlarged. In most cases, the gums do not hurt or feel slightly sensitive, unless a dental abscess is also present. The teeth may be loose, and the gums retracted, exposing the base of the teeth.
Dental x-rays reveal the loss of supporting bone and may also show the presence of plaque deposits under the gums.
The goal of treatment is to reduce inflammation, eliminate gum pockets and treat any underlying cause of periodontal disease.
The rough surfaces of teeth or dental appliances should be repaired.
You must perform a complete dental cleaning. This may involve the use of various instruments or devices to loosen and remove plaque and tartar from the teeth. The use of proper brushing and flossing is always needed, even after professional dental cleaning. The dentist or hygienist will show you how to properly brush and floss. People with periodontitis should have a professional dental cleaning every 3 months.
Surgery may be necessary to:
- Open and clean the deep bags in your gums.
- Provide support for loose teeth.
- Extract one or several teeth, so that the problem does not get worse and spreads to adjacent teeth.
For some people, cleaning the dental plaque from inflamed gums can be uncomfortable. Bleeding and sensitivity of the gums should disappear after 1 or 2 weeks of treatment.
It is necessary that you perform a careful brushing and cleaning with dental floss throughout your life or the problem may recur.
These complications can occur:
- Infection or abscesses of soft tissue.
- Infection of jaw bones.
- Reappearance of periodontitis.
- Dental abscess.
- Loss of a tooth.
- Teeth that twist (protrude) or move.
- Trench mouth.
WHEN SHOULD YOU CONTACT A MEDICAL PROFESSIONAL?
See your dentist if you have signs of periodontal disease.
Good oral hygiene is the best method of prevention. This includes flossing and brushing meticulously and professional dental cleaning regularly. The prevention and treatment of gingivitis reduce the risk of developing periodontitis.
Pyorrhea due to periodontal disease; Inflammation of the gums with bone involvement.