Periodontology- Gum Treatments


What is Periodontal Disease?

These diseases can be treated easily and successfully when diagnosed at an early stage. Prevention or treatment of gum disease; Preservation of natural teeth also brings other benefits such as better chewing and better digestion. Periodontal diseases begin with gingivitis. So, gingivitis is the early stage of periodontal disease. During this period, the gums are bleeding, red and enlarged in volume. It may not cause much discomfort in the early period. If left untreated, the disease may progress to periodontitis and cause irreversible damage to the gingiva and alveolar bone supporting the teeth.

Periodontitis is a more advanced stage of periodontal diseases. Damage occurs in the alveolar bone along with the tissues that support the teeth. The presence of a “periodontal pocket” between the tooth and gum facilitates the localization of the infection and the progression of the disease. As the disease progresses, the teeth begin to shake and may even go into extraction.

What is the Importance of Periodontology?

The presence of inflammation or periodantal disease in the tissues that support the teeth can cause the loss of teeth without caries with the progressive disease. Periodontal treatment is the main treatment in dentistry. It aims to enable patients to maintain their own oral hygiene. Complaints such as my gums are bleeding, my teeth are moving as I get older, my gums are receding, my teeth are starting to shake should be examined by a specialist periodontologist.

The color of my gums has changed. Problems such as the receding gums between my teeth are among the subjects examined by the periodontology department.

In addition, it has been shown in studies that undergoing a periodontologist (gum diseases specialist) examination before making any prosthesis (porcelain crowns, removable prosthesis implant applications) prolongs the life of the prosthesis. This means that the tissues that support the teeth are not healthy, which means that the foundation of a building is not strong. A building whose foundation is not strong will not be very strong, and prostheses to be made on teeth that do not pass the periodontologist examination will not be very long-lasting.

What are the Symptoms of Gum Disease?

There are many signs of gum disease; Gums that bleed during tooth brushing, red swollen and sensitive gums, which can be easily separated from the teeth, receding gums, inflammatory discharge between the teeth and gums, oscillating or gradually moving away from each other (the formation of gaps between the teeth or the increase in existing gaps), the change in the relationship between the upper and lower teeth during biting partial dentures change in harmony, deterioration. Constant bad breath.

However, periodontal disease can reach advanced stages without any symptoms. For this reason, it is extremely important to visit the dentist at regular intervals.

What is the Cause of Gum Disease?

The most important cause of gum disease is the sticky and colorless film layer called “bacterial dental plaque” that accumulates on the teeth. Removal of dental plaque by daily brushing and use of dental floss is the basic requirement for a healthy mouth. If plaque is not effectively removed from the teeth, it turns into an irregular and permeable structure known as calculus or tartar. Harmful products released by the bacteria in the plaque cause irritation in the gingiva. Due to these products, the fibers that tightly bind the gingiva to the tooth are destroyed, the gingiva moves away from the tooth and a periodontal pocket is formed. Thus, it is easier for bacteria and products to progress to deeper tissues. As the disease progresses, the pocket gets deeper, the bacteria go deeper; It progresses to the bone and destruction begins in the alveolar bone that supports the tooth. If the disease is left untreated, eventually the teeth will become loose and may even need extractions.

How to Prevent Gum Disease?

The most important task in the prevention of periodontal disease falls on the person himself. In order to maintain the teeth in a healthy condition, it is necessary to remove bacterial dental plaque with daily oral care procedures (tooth brushing and using dental floss). It is equally important to visit the dentist regularly. Daily oral care procedures can minimize calculus formation, but may not prevent it completely. A dentist’s evaluation of the areas that cannot be reached with a toothbrush, dental floss or other cleaning tools is necessary for the removal of existing dental plaque and/or calculus.

What is the Treatment of Gum Diseases?

Treatment in the early period of dental disease includes removing the attachments (plaque and tartar) on the teeth and providing a smooth root surface. This process ensures the removal of bacteria and irritants that cause inflammation in the gingiva. Usually, this treatment is sufficient for the gingiva to adapt to the tooth again or to shrink the gingiva and eliminate the pocket. In the majority of cases in the early period of gingival disease, tartar cleaning is necessary.

Daily effective oral care is sufficient for a successful treatment, following removal of the plaque and providing a smooth root surface. More advanced cases may require surgical treatment. The aim of this treatment is to clean the tartar in the deep periodontal pockets surrounding the teeth, to ensure the elimination of the pocket by shrinking and to provide a smooth root surface and to create a more easily cleanable gingival form.

After periodontal treatment, patients should be regularly examined by a dentist, plaque control and new tartar deposits should be removed from the environment. But it should not be forgotten that; No process can be more beneficial for the maintenance of what has been achieved with periodontal treatment than the effective application of daily oral care procedures.

What Does Periodontological Treatment Include?
1. Initial Periodontal Treatment:

Taking all systemic and intraoral records of the patient,
Removal of plaque containing bacteria on the teeth,
Informing the patient about oral hygiene,
Informing the patient about periodontal disease,
Correcting the fillings of the tax in the mouth, ensuring the optimum condition for the patient to ensure his own oral hygiene,
Removal of calculus,
Removal of bacterial deposits on tooth roots,
Root surface flattening,
It includes checking the relationship (occlusion) between the teeth in the lower and upper jaws.
Oral Hygiene Control
It is a periodontologist to check whether the patient can provide his own oral cleaning 1 or 2 weeks after the scaling and polishing procedures are performed.

The areas where the patient cannot provide oral hygiene are explained to the patient again and their mistakes are shown.

2. Re-evaluation:

After initial periodontal therapy, the patient is reassessed. As a result of this evaluation, it is decided whether the patient needs advanced periodontal treatment.

3. Advanced Periodontal Treatment:

Advanced periodontal treatment includes surgical approach and gingival curettage.

In Surgical Approaches:

REGENERARTIVE SURGICAL PERIODONTAL treatment aims to regain lost periodontal tissues (ku support).

4. Maintenance Treatment:

It aims to maintain the health of the tissues after active periodontal treatment. In this treatment, patients come to their doctor for control in 3 or 6 months and ensure the continuation of the treatment.

Postoperative Recommendations After Periodontal Surgery:
Do not eat or drink anything for 2 hours after the surgery.
You should stay away from hot food and drinks in the first 24 hours after the surgery. Chewing should be done with the area not included in the operation. Soft and warm foods are suitable. Acidic fruit juices, alcoholic beverages and spicy foods should be avoided. Otherwise, they will cause pain.
You should not smoke in the days following the surgery. Smoking should not be avoided after surgery, as it will irritate the gums and jeopardize healing and increase the temperature in the mouth.
During the 2 weeks following the surgery, the prosthesis, if any, should be used as little as possible.
If there is no pat in the operated area or when it falls, the lip and cheek should not be lifted to look at the columns.
The paste placed on the surgical area is to make you comfortable and to protect the wound area from irritation. It prevents pain, facilitates wound healing and allows you to continue the activities you are accustomed to comfortably. The pat may feel uncomfortable within a few hours of its initial insertion. Do not play the paste with your tongue or finger. Do not panic if the placed paste breaks into small pieces. Call your doctor if large pieces break off or if they bother you a lot.
There may be slight swelling. You can prepare an ice pack on the operation area on the first day and apply it externally. Gently rinse your mouth with a glass of lukewarm water in which you often add a teaspoon of salt.
There may be some leakage from the surgical site in the first 4-5 hours after the operation. This will give your saliva a red color. In this case, do not panic and if the leakage continues, you can roll a clean gauze pad and apply it to the bleeding area for 20 minutes. Longer lasting bleeding should be controlled by your doctor.
In the first 24 hours after the operation, chills and a feeling of weakness may occur. This is normal and there is no need for concern. You can continue with your daily activities, but sports that require excessive effort should not be done.
Follow the prescription written by your doctor for post-operative recovery. Describe antibiotics if your doctor has recommended them.use as directed. If you have pain after surgery, you can take painkillers. In this case, aspirin or similar salicylic acid derivative drugs should not be taken.
You can apply normal brushing procedures to the non-operated areas. Brush the chewing surfaces of the teeth in the surgery area. If the paste is not applied, you can also brush the teeth in that area. However, do not go under the gums while flossing. If your doctor recommends it, you can use the recommended mouthwash after brushing.
Rinse your mouth after meals. You can wipe the paste with damp cotton or a cotton swab.
At the end of the period (1 week or 10 days) recommended by your doctor, call your doctor to have your stitches removed and checked.