SPECIALTIES

Periodontics

Periodontal disease is a progressive inflammatory disease of the gums and tissue (bone) that supports the tooth. Periodontal disease is the No. 1 cause of tooth loss after age 30, and it is believed that 80% of the population under 30 years can suffer from this disease with varying degrees of severity and it is usually painless.

Causes of Periodontal Disease

The main cause of periodontal disease is plaque, a sticky, colorless film that is constantly formed on teeth. However, factors such as those mentioned below can also affect the health of your gums.

Smoke

Cigarette smoking is linked with many serious diseases like cancer, lung disease, cardiovascular problems, as well as many other health problems. In addition, smokers are at increased risk for periodontal disease. In fact, recent studies have shown that cigarette smoking may be one of the most important risk factors in the development and progression of periodontal disease.

Genetics

Recent surveys show that 1 / 6 of the population may be genetically susceptible to gum disease. Despite good hygiene and oral care, these people may be six times more likely to present periodontal disease. Identifying these people through rigid professional control before they present symptoms of the disease, and subject them to a previous treatment can help them to keep their teeth for a lifetime.

Pregnancy and Puberty

Brushing your teeth, flossing, a healthy diet and regular exercise are important for maintaining good health. However, at certain stages of the life of a woman, that care must be redoubled. Stages such as puberty and menopause or menstrual periods and pregnancy, are periods of intense hormonal changes that can affect various tissues throughout the body, including the gums. They can become sensitive and even react aggressively to the fluctuation in hormones, which increase susceptibility to periodontal disease. In addition, recent studies suggest that pregnant women who have periodontal disease also have seven times more chance of having a premature labor and low birth weight babies.

Stress

Stress is linked with many serious diseases such as hypertension, cancer, and many other health problems. However it is important to know that stress is also one of the most important risk factors to the development and progression of periodontal disease. Research shows that stress makes it harder for the body to fight infections, including periodontal diseases..

Drug

Some medications such as oral contraceptives, antidepressants, anticonvulsants, and certain drugs for cardiovascular problems, can affect your oral health. So you should also tell your dentist about medicines that you use, in the interview about the drugs

Bruxism or parafunction

Waking up with the masticatory muscles sore or someone observing you grind your teeth at night is a sign of bruxism or parafunction. Clenching or grinding the teeth, even if unconscious, submits the tissues around the teeth to excessive force and may hasten the destruction of periodontal tissues in case of illness.

Diabetes

Diabetes is a disease that alters the sugar levels in the blood. Diabetes develops by a deficiency in insulin production (a hormone that is the key component in the process of consumption of sugar by the body in the blood) or a body’s inability to use this insulin properly. According to the American Diabetes Association, approximately 16 million Americans have diabetes, yet more than half haven’t been diagnosed for this disease. If you are diabetic, you have a higher risk of developing infections, including periodontal diseases. These infections can impair the ability to produce and / or utilize insulin, which can complicate diabetes control, but also can make the infection more severe than in no diabetic individuals.

Malnutrition and other Systemic Diseases

As you know, a diet low in important nutrients can compromise the immune system and make it harder for the body to fight infections. Since periodontal disease is an infectious disease, malnutrition and diseases that interfere with your immune system can affect your oral health and may worsen the condition of your gums.

Periodontal Treatments

Treatment depends on the type of periodontal disease present and the severity of it.

There are many forms and stages of periodontal disease, the most common are:

Gengivitis

The first stage of periodontal disease is a marginal inflammation of the gums caused by plaque. The gum will have a reddish color, will be inflamed and constantly will bleed when you brush and floss. This stage of the disease is reversible if treated before they evolved.

Before treatment / After treatment

Before treatment / After treatment

Mild periodontitis

Inflammation will spread to the supporting bone. Small bone loss and periodontal pockets may occur. It is also easily treated, but needs intervention under local anesthesia.

Moderate periodontitis

At this stage there is an increase regression of the gums, periodontal pockets of moderate to profound, bone loss from moderate to severe, purulent secretion, and tooth mobility. At this stage treatment is more interceptive, requiring few sessions under local anesthesia.

Severe periodontitis

This is the most advanced and serious stage of periodontitis. Deep pockets, increased tooth mobility, tooth extrusion and fistulae are present at this stage. Inflammation can develop bone loss, and if this inflammation continues it will have tooth loss. At this stage the treatment is aimed at keeping the elements that are still viable, extractions and implant are usually necessary. It is essential at this point the collaboration and changing habits of the patient.

Exemple of bone loss

Exemple of bone loss

Stages of periodontal disease

Stages of periodontal disease

For a correct diagnosis of periodontal disease professionals evaluate some items:

– Color, bleeding and gingival tissue condition
– Measurement of pockets
– Reviews of bone X-ray
– Dental mobility
– The amount of plaque present
– These items will determine the stage of the disease and proper treatment.
– Our staff will evaluate the periodontal status of our patients at each periodic visit, and through monitoring visits it becomes possible to assess whether progress is occurring or not.

PREVENTION

The best way to prevent periodontal disease and dental caries is the maintenance of good oral hygiene. Brush your teeth every day will remove a thin bacterial layer called dental plaque that settles on tooth surfaces. Use dental floss daily to remove plaque between teeth, these areas the toothbrush cannot reach.

Brushing and flossing are essential to prevent periodontal disease.

Brushing and flossing are essential to prevent periodontal disease.

Non-surgical treatments

Non-surgical treatments are the treatment of choice for patients who are in the early stages of the disease:
Oral Hygiene
prophylaxis
supra and sub gingival scraping

Oral Hygiene

If periodontal disease is in early stage (gingivitis), the professional will guide your oral hygiene and may prescribe oral rinse with mouthwash.

Prophylaxis

Prophylaxis consists of cleaning, fluoride application and polishing with a prophylaxis paste and rubber. This step is done in conjunction with scaling, so prevention is effective.

Supra Gingival Scalling

Consists of the meticulous removal of toxins, microorganisms and dental plaque. This procedure is done to remove biofilm, plaque and toxins, in order to obtain a response from the body recovering from bacterial invasion.

Subgingival

Consists of the meticulous removal of toxins, microorganisms not visible to the naked eye present in the gum attached to the tooth. Tartar present in this way promotes the formation of so-called periodontal pockets. These bags should be treated periodically with scraping sessions, varying the number of sessions according to the severity of each case.

Surgical treatments

– Curettage or sub-gingival scraping
– Gingivectomy
– Gingivoplasty
– Gingivoplasty in restoration procedure
– Gingivoplasty or plastic surgery of the gum
– Increase of crown

Curettage or sub-gingival scraping

Gingival curettage removes a thin layer of tissue present in periodontal pockets in order to completely eliminate bacteria and damaged tissue. It can be done with ultrasound or root planing with specific curettes. But it is necessary to address deeper in the gums, usually under local anesthesia or sedation with nitrous oxide.

Gengivectomy

Gingivectomy is a surgical procedure that remodels the gingival tissue with cosmetic, physiological and functional purposes. Some indications of gingivectomy are: endodontic treatment, severe periodontitis, excess of gum tissue and others.

Gengivoplasty or plastic surgery of the gum

It is usually done with local anesthesia or sedation with nitrous oxide, and is recommended for remodeling the irregular and aesthetically unsatisfactory gingival tissue. It is a simple surgical procedure that adjusts the position of the gum around the tooth in question. A functional gingivoplasty will help you regain your beautiful smile, eat and speak with comfort and confidence. The gingivoplasty is indicated in the preparation of the tooth restorations and cosmetic procedures on the gums.

Gengivoplasty in restoration procedure

When suffering from dental caries below the gum line, usually there is insufficient bone structure for restoration or prosthetic crown. So it is necessary to do a gingivoplasty of the gum. The end of the tooth is exposed so you can restore it correctly without damaging the periodontal health.

Gengivoplasty in cosmetic

Usually done to correct the known gummy smile that hides the tooth below the gum excess. The gummy smile is the excess of gum over the tooth, which causes it to be shorter. During the procedure the gums are removed, exposing the tooth that was covered, returning the smile and confidence. This can be done on a tooth or a teeth sequence to return the natural smile.

Before and after Gengivoplasty

Before and after Gengivoplasty

Increase crown

is a surgical procedure that remodels the bone tissue around the tooth for cosmetic, physiological and functional purposes. Some indications of increased crown: Exposure of the end of teeth for restorations and root canal treatment, increasing the space for making prosthetic implant, removal of periodontal pockets and others.

Frequently Asked Questions

Is the set of tissues around the tooth that is responsible for fixing it: gingiva, alveolar bone and fibers that connect the root to the bone.
Periodontal disease is the commitment of periodontal tissues by the inflammatory process. This leads to bone resorption around the roots of the teeth. In gingivitis, no changes occurs in the bone, because the inflammation is confined to the gums.
The most characteristic sign is bleeding, but we must also be alert to: changes in the position of the teeth, gingival retraction mobility, withholding of food, swelling etc…
No if the dental floss is moving correctly. The bleeding indicates the presence of bacteria in this region and thus you should continue to use the dental floss in an attempt to remove them
It is not possible to treat this disease with drugs only, whether local or systemic. The plaque attached to the tooth must be removed mechanically.
The cause is multifactorial, but the plaque attached to the tooth is essential for disease progression. However some changes in the gums may be associated with hormonal causes, use of some medications, decrease of immunological resistance etc….
The basic risks are the tooth loss and all the ramifications of this problem, difficulty chewing and social problems etc… Other scientific studies have proved the link between periodontal diseases and increase incidence of myocardial infarctions and strokes, ie, patients with periodontal disease are more likely to have these problems.
It is made by removing the plaque stuck through scaling the tooth roots. When scraping tools do not reach every area of root compromise, surgery is recommended for easy access.
No, it always gets sequels, with the exception of gingivitis. Periodontal disease sequel cause cosmetic changes such as shifting the position of the teeth and gum recession with a consequent increase in the length of the tooth. There are surgical and prosthetic procedures that can minimize these defects.
The requests for maintenance should ensure the stability of health status achieved by treatment and thus avoid both the progression of the disease as their recurrence.
Yes, its prevention can be made ??only by removing plaque, home dental cleaning with flossing and brushing, do ??more regular cleaning by a dentist. In more advanced cases, it is recommended a frequency of 3 / 3 months and 4 / 6 months for most people.
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