Periodontitis is a disease that affects the tissues that support the teeth onto the jaw, namely the gums, the bone and the periodontal ligament.
Periodontal disease is caused by bacteria and the persistent inflammation it causes. The bacteria responsible for periodontitis are part of the normal bacteria present in the mouth. However, regular and persistent accumulation of plaque and tartar on the surfaces of the teeth can trigger a drastic increase in the quantity of periodontal bacteria.
The uncontrolled multiplication of bacteria around the periodontium, combined with unsatisfactory hygiene habits and a lack of medical and dental care, can cause an initial inflammation of the gums. However, with the progression of the disease, chronic inflammation will progress along the periodontal tissues, leading to the destruction of the space between the gums and the teeth. This will in turn leads to the formation of periodontal pockets, ideal spots for the colonization and multiplication of periodontal bacteria.
This process can be more or less aggressive depending on the type of periodontitis and also how far the disease has progressed once diagnosed. It is possible to determine the severity and progression rate of the disease. This depends on the quantity and type of bacteria, capacity of the patient’s immune system, as well as other risk factors involved, the main ones being genetic, smoking habits, uncontrolled diabetes and regular use of certain antihypertensive drugs.
One of the first warning signs is bleeding gums. Initially, gums will bleed when brushing the teeth. Gums begin to change color and shape, becoming red, swollen and sometimes, in the more acute stages painful.
The object of periodontal treatment is the elimination of plaque from the periodontal pockets to stop the progression of the disease.
Educating and motivating the patient on oral hygiene habits is crucial for the success of treatment. The dentist will provide the tools and establish the conditions for the patient to control the accumulation of plaque.
By professional scaling and polishing, plaque and tartar which has adhered to the surface of the teeth can be mechanically removed.
In some cases, when periodontitis is already very advanced, there are very deep periodontal pockets where deposits of plaque accumulate. With brushing or even medical help such as scaling of the teeth and roots, it is not possible to guarantee the correct hygiene of these pockets.
In these cases, the gums are lifted and the roots exposed, allowing an efficient decontamination of the whole area. This is done under local anesthesia.
Corrective periodontal surgery, in addition to being the only way of cleaning these deep pockets, can also remodel and reposition the gums, creating the necessary conditions for the patient to control plaque efficiently. In some cases, it is even possible to make use of bone and ligament regeneration techniques, lost due to the disease.
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