Periodontology – Gum Diseases
Periodontology – Gum Diseases
WHAT ARE GIMENT DISEASES (PERIODONTAL DISEASES)? WHY IT OCCUR?
What is periodontal disease?
Periodontal diseases are inflammatory diseases that affect the gums and other tissues that support the teeth. Periodontal diseases are responsible for 70% of tooth loss in adults. These diseases can be treated easily and successfully when diagnosed at an early stage. Prevention or treatment of gum disease; It also brings other benefits such as the protection of natural teeth, more comfortable chewing and better digestion. Periodontal diseases begin with gingivitis, which 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 other tissues that support the teeth. A “periodontal pocket” is formed between the tooth and the gingiva. The presence of periodontal pocket 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 are the symptoms of gum disease?
There are many signs of gum disease;
- Bleeding gums while brushing teeth
- Red, swollen and tender gums
- Gums that can be easily separated from the teeth and moved away
- Inflammatory discharge between the teeth and gums
- Teeth that wobble or move away from each other (creation of gaps between teeth or increase in existing gaps)
- Changes in the relationship between the upper and lower teeth during biting
- Constant bad breath.
However, periodontal disease can reach advanced stages without any symptoms. For this reason, it is extremely important to go to 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. Removing dental plaque by daily brushing and using 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 their 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.
GINGUAL DISEASES AND TREATMENT METHODS
Periodontal diseases are diseases that can be largely prevented and controlled. Treatment; It depends on good oral hygiene, correct and early diagnosis and correct treatment approaches. Therefore, both the patient and the physician should actively participate in the treatment.
1st stage of treatment
The most important step in periodontal treatment is to eliminate the infection and to learn how to protect the oral health of the patient by applying effective and regular gingival, tooth and interdental cleaning. Elimination of infection; It is possible to clean the microbial dental plaque, calculus and root surface where the calculus is attached, by the physician, and to protect this condition of the patient. This process is called "initial treatment", it is an indispensable step in the treatment of all types of periodontal diseases and is performed in 3-4 sessions depending on the situation of the case. During the initial treatment, removal of local factors that facilitate bacterial adhesion, such as the replacement of bad and overflowing fillings, filling of decayed teeth, alignment with the gingival margin and correction of incorrectly shaped prostheses, root canal treatments and extraction of hopeless teeth, if any, should be performed. In addition, in the presence of a systemic disease, medical consultations are also made at this stage. At this stage, it is also necessary to plan for possible prostheses.
2nd stage of treatment
If the periodontologist detects a condition that cannot be fully treated with the initial periodontal treatment phase, he or she will recommend periodontal surgical procedures. Data such as pocket depths, gingival enlargement and recession, presence and shape of bone resorption, amount of gingiva after initial periodontal treatment affect the decision to be taken. Not all periodontal diseases and defects can be treated with the same surgical procedures. The determining factors in the choice of treatment are the characteristics of the patient and tissue, and the course and extent of the existing periodontal disease.
The main purpose of surgical periodontal treatment is; to eliminate pocket depths, to try to make the bone-gum-tooth relationship similar to the original, thus to create an environment where the patient and the physician can clean easily. For this reason, it is also called “corrective therapy”.
3rd stage of treatment
According to the situation of the case, patients are included in the control program at regular intervals in order to protect the periodontal health obtained after non-surgical and surgical treatments and to prevent the recurrence of the disease. After a successful periodontal treatment, tissue destruction begins again in a short time and disease symptoms appear in patients who are not taken to maintenance therapy and do not provide their own oral care. (pocket depth increases, bone loss and tooth loss occur) The patient should be followed up by a periodontist at intervals of 3-6 months, depending on the case.