The periodontal pathology is one of the main causes of tooth loss so it is essential to detect it timely and start with the corresponding therapy. The first sign of a periodontal disease is the gum bleeding and the inflammation around some teeth or around all of them. The spreading of such a disease from gums to periodontal ligaments and alveolar bone causes the weakening of the supporting tooth structure which, eventually, brings to tooth loss.
Some of the factors which may influence the development of the periodontal disease are: genetic predisposition, weakened immune system, systematic diseases, saliva composition, prosthetic replacements, oral hygiene and, especially and most importantly, smoking. Smoking has a strong influence on a series of mechanisms responsible for the gum destruction: weakening of some of the saliva components important for the human immune system, destruction of the periodontal tissue, slowing down the healing process of the damaged tissue.
Initial therapy of the periodontal pathology
The goal of the each therapy to treat the periodontal disease is the removal of the bacteria as the main cause of the inflammatory process. The dental plaque, which can be found on the borders of the teeth and root of the tooth, is the principal habitat which causes the inflammation of the supporting tooth structure – periodontal tissue
The treatment of a particular periodontal disease depends on its manifestation and its stage; in theory, it is possible to make a distinction between two therapies: for gingivitis and periodontitis
The treatment of gingivitis is, basically, the removal of the dental plaque from around the teeth and gums. It is achieved through the combination of professional cleaning in a dental studio performed by a doctor of dental medicine with special devices for dental plaque removal and a regular, everyday, oral hygiene performed by patient themselves at home, following the basic instructions given to them by the dentist. Different machine and manual instruments are used in the process of the professional dental plaque removal which break the firm plaque structure and enable the effective removal of the plaque. The most often used instruments are sound and ultrasound instruments which with their vibrations break off small pieces after which the teeth are being polished in order to remove the finer dental plaque particles and all sorts of dirt and pigments. After the plaque removal process is done, all teeth surfaces are cleaned and polished with a brush and a special abrasive paste. This procedure smooths out the teeth surfaces which slows down the re-appearance of the dental plaque
The periodontitis is always accompanied with gingivitis, so the first phase of the treatment is the same as when treating gingivitis. In this case its aim is to reduce the inflammatory process. Afterwards, it is necessary to remove the dental plaque from the deeper tooth structures – “pockets” – at the very surface of the root of the tooth. A gentle scrubbing and polishing of the teeth is done using the open and close method. These two methods are done conducted the local anaesthesia, similar instruments are used and the procedure is usually performed in a couple of steps, quadrant by quadrant. The fact that the periodontitis has been once cured does not give a guarantee that the disease will not reappear on the same or on a different place. A long-term health of the periodontal tissue depends greatly on maintaining the home and professional dental hygiene.
The initial therapy – cleaning the dental plaque and polishing the teeth surfaces above and below gum tissue – prevents the progression of the disease, the quantity of the bacteria around the gum tissue and slows down its development.
If the initial therapy does not give the wanted result we then proceed to a surgical therapy, in cooperation with the expert team of the dental studio. There are more methods which depend on the stage and the depth of the changes. Besides classical methods, in which the dead, periodontal pocket is surgically removed, even more complicated methods are used, with a use of special materials, natural and syntactical bone, which help improve the healing and regeneration of the soft and hard tissue. The receding gum does not usually imply that a person suffers from a periodontal disease. If the gum tissue is healthy and does not bleed, but is a little or a lot receded – we are dealing with gingival recession. Gingival recession is not a disease, but a problem with the gum shape. An important role in the development of the gingival recession has too rough, oral hygiene – that is, brushing, or nearly scrubbing, one’s teeth too often and too roughly. One of the characteristics of the gingival recession is that the gum tissue, although it is receded, is completely healthy. In case there are these kinds of problems, gum tissue can be moved with a small surgical procedure towards the crown of the teeth which will hide the recession.