Periodontology

How does periodontitis occur?

Dental plaque starts to accumulate on teeth shortly after brushing. Plaque is a soft, colorless, sticky deposit that forms on our teeth, primarily composed of food particles, bacteria, and their metabolic byproducts.
Regular brushing and flossing can effectively remove plaque, but with inadequate oral hygiene, it mineralizes within 48 hours and transforms into a hardened form known as calculus or tartar, which cannot be removed with standard brushing or flossing.
Professional removal by a dentist is necessary to effectively eliminate tartar buildup.
Periodontal disease starts as gingivitis, where inflammation is localized to the gum tissue surrounding the affected tooth.
While dental plaque is the leading cause of gingivitis, it can also rarely result from certain systemic diseases or developmental abnormalities.
The clinical signs of gingivitis include gum line swelling and redness. Its onset is often observed within a few days of bacterial plaque buildup on the surface of teeth. With gingivitis, gums become more sensitive, and may bleed during brushing or flossing. It may also cause bad breath.
Gingivitis can be successfully treated with proper oral hygiene practices and routine professional teeth cleaning, with no permanent changes to the periodontal tissues.
Untreated gingivitis can progress to periodontitis over time. Inflammation can also spread to deeper periodontal tissues, including the dental ligament, jaw bone, and cementum on the tooth root surface, leading to their collapse and subsequent tooth loss. As a result, periodontal pockets form, providing an environment for bacteria to accumulate.
When left untreated, periodontal disease slowly progresses, and the periodontal pockets deepen over time. As the disease progresses, the surrounding periodontal tissues continue to deteriorate, causing teeth to become increasingly mobile and loose, and eventually leading to the need for tooth extraction or loss.
Periodontitis is characterized by a range of clinical symptoms, including gum recession, pain while chewing, bad breath, and swollen, red gums that may bleed spontaneously or when brushing and eating.
Unlike gingivitis, periodontitis involves irreversible loss of periodontal tissues that, despite successful treatment, cannot be fully regenerated.
In addition to bacteria that trigger inflammation and tissue breakdown around the affected tooth, other factors such as smoking, diabetes, psychological stress, and genetics also significantly contribute to the development of periodontal disease.

The importance of early detection and treatment

Periodontal disease can progress without causing significant symptoms and may only be detected in its advanced stages. Regular dental check-ups are thus crucial in detecting early signs of the disease and starting timely treatment.

Treating periodontal disease

Through proper professional evaluation and treatment, it is possible to stop periodontal disease progression in over 85% of cases, thereby retaining most of the teeth.

Periodontal disease treatment involves the removal of bacterial plaque and the establishment of a solid oral hygiene routine. It involves six steps:

1. Good oral hygiene is key

Your dentist will provide you with information on the causes of periodontal disease and instructions on keeping your teeth and gums clean. They will show you the most suitable tools for your individual needs and teach you the proper techniques for using them.

2. Professional tartar removal

Professional teeth cleaning involves procedures that effectively reduce the amount of tartar buildup. These include ultrasonic plaque removal, air abrasion and tooth polishing.
If your dentist detects the presence of periodontal pockets, they may perform scaling and root planing procedures, followed by antiseptic disinfection of the oral cavity.
They will also remove any plaque retention factors, such as overhangs and fixed prosthesis. They may also recommend photodynamic therapy.

3. Antibiotic therapy

If persistent inflammation does not respond to the improved oral hygiene, your dentist may prescribe antibiotic therapy.

4. Disease state reassessment

Two months after professional teeth cleaning, your dentist will conduct a re-evaluation of the periodontal tissues to assess the progress made. If deeper periodontal pockets that bleed on probing are still present, they may recommend surgical treatment. In case no periodontal pockets are detected, your dentist will switch to supportive (maintenance) periodontal therapy.

5. Surgical treatment

Surgical treatment is only suitable for individuals with a high level of oral hygiene, as it may not produce the desired results otherwise.
During surgical treatment, dental plaque located below the gum line is removed and bone damage is repaired by reducing or eliminating periodontal pockets.
In cases where the bone damage is not extensive, a regenerative procedure may be performed in an attempt to restore the lost bone.
Surgical treatment of periodontal disease is performed under local anesthesia. It involves first peeling back the gum tissue that covers the tooth root, followed cleaning of the root surface using specialized instruments. Finally, the gum tissue is sutured back into place. The stitches are typically removed one to two weeks after the procedure.

6. Lifelong supportive therapy

The long-term success of periodontal treatment depends on two factors: good oral hygiene of the patient and regular professional hygiene care, which involves the removal of bacterial deposits. These procedures aim to prevent re-infection and further degradation of periodontal tissues.
Your dentist will schedule maintenance therapy appointments for you every three to twelve months, depending on the severity of your periodontal disease and any risk factors for its progression.
Maintenance therapy is typically recommended for the rest of the patient’s lifetime.

Periodontology – price list

At Dentavital Oral Health Centre, we prioritize ensuring that every patient’s experience with dental procedures is as pleasant and professional as possible, which is why we give our undivided attention to everyone who visits our practice. During your first visit, we perform a comprehensive clinical examination and hold a detailed discussion with you, following which we develop a personalized treatment plan that takes into account the cost and suitability of the chosen therapy.