Gingivitis - Periodontitis
What are gingivitis and periodontitis?
Treatment of periodontitis
Professional teeth cleaning at the dentist’s office is the critical first step in treating periodontitis. It is equally important to adopt good personal oral hygiene habits at home and to have regular check-ups by the dentist.
Professional dental cleaning
In order for periodontitis to heal, all plaque (plaque and calculus) must be removed from the surfaces of the teeth through a professional dental cleaning.
In professional dental cleaning, the dentist performs a systematic cleaning of all tooth surfaces. In periodontitis it is especially important to clean and smooth the root surfaces below the gum line which are colonized with bacteria.
Also, anything that can make oral hygiene at home difficult should be removed. This includes tartar deposits above the gums and protruding edges of fillings or crowns.
A first professional dental cleaning can rarely be done in a single appointment. For patients with advanced periodontitis, several appointments must be scheduled.
Oral hygiene at home
To prevent new bacterial films from forming, patients with periodontitis must learn how to clean their teeth optimally.
It is not always easy to implement an optimal oral hygiene routine at home. A big challenge for example is to clean the interdental spaces. There are special oral hygiene aids for them, called interdental brushes. They are selected individually for each case in the mouth and the patient is trained in the correct use by the dentist.
During gum treatment, patients learn an oral hygiene technique tailored to their condition. Good compliance with optimal oral hygiene at home is decisive for treatment success.
Rechecks (Revaluation)
One to two months after the professional teeth cleaning, the result is checked and a decision is made as to how to continue the additional care by a professional.
In this reassessment, the dentist also checks whether the patients are able to perform proper oral hygiene at home.
If good oral hygiene is performed at home, a noticeable reduction in gingivitis and swelling (shrinking of the gums) can be expected. Even if the root surfaces are exposed, in an ideal case, fewer remaining periodontal pockets will be found with a pocket depth of no more than 3 millimeters. In these cases, the treatment of the gums can be considered finished and we make sure that the present condition remains with regular re-checks at the dental office.
Surgical treatment
In situations with very advanced periodontitis, the deeper periodontal pockets that remain can only be successfully reduced by surgical treatment.
If there are residual pockets more than 5mm deep after the first professional cleaning, the stone deposits that often remain can be removed with surgical treatment. Also, the aesthetics of the gums can be corrected and in some cases, an additional attempt can be made to regenerate lost periodontal tissues using so-called biomaterials (Directed Tissue Regeneration).
More complex treatments often take more than a year. These patients need to understand the course of treatment and what they can expect. Good patient compliance with oral hygiene at home, smoking cessation or a change in diet are essential.
Long-term care by the dentist (aftercare, recall)
After gum treatment, long-term success can only be ensured in patients with optimal oral hygiene at home on a daily basis, thus preventing the recurrence of gum inflammation due to new bacterial deposits.
For the best long-term success, it is also important to continue professional care by the dentist so that recurring problems are detected and treated early.
The intervals for these re-checks are usually every three, four or six months. The frequency depends on the quality of oral hygiene, the extent of gum inflammation and the presence of so-called residual periodontal pockets.
Possible side effects of periodontitis treatment.
Known side effects of gum treatment are the development of open spaces between the teeth and noticeable sensitivity of the exposed root surfaces.
During professional teeth cleaning, patients feel pain in different ways. In general, inflamed gums are more sensitive than healthy gums. It is important to know that all periodontal treatment can be done under local anesthesia.
Another unwanted effect of gum treatment is receding of the gum line (picking) after professional dental cleaning. This generally leads to the formation of open spaces between the teeth and greater sensitivity of the tooth root surfaces to cold or acidic foods. This increased sensitivity usually goes away after a few months.
