Periodontology – what is it?
Periodontal disease is, right after caries, the second most common cause of tooth loss. Development of this disease is primarily affected by poor hygiene, but also genetic predisposition, immune system disorders, general diseases and so-called modifiable factors: nicotine dependency, obesity or chronic stress. The periodontologist’s task is to accurately diagnose the causes of the disease and to plan comprehensive treatment.
Periodontics – types of treatments
Periodontological treatment can be divided into non-surgical treatment and periodontal surgery. The first group of treatments includes mainly the so-called subgingival scaling and curettage: cleaning the tooth surface (both crown and root) from bacterial plaque, which is the direct cause of gingivitis or periodontitis. Scaling is performed using manual or ultrasonic tools, adapted to individual tooth surfaces. The treatment is supplemented with antiseptics, and in exceptional cases antibiotics administered to control the infection.
Periodontological surgery can be divided into resection, regeneration and plastic surgery. The first group includes procedures for removing overgrown gums or epulis, as well as open curettage, during which the doctor can cleanse the infected root surface, seeing it. Regenerative treatment is an extremely dynamically developing branch of periodontology. It uses bone substitutes for reconstruction of the bones disappeared as a result of periodontitis. In regenerative surgery we use special techniques to restore the connection of the gingiva with the tooth. Periodontological plastic surgery aims to improve the aesthetics of a smile by shaping the gums. For example, the aim of treatments can be: to cover the recession (exposed necks), reconstruction of the gum between teeth, covering of exposed roots of molars, correction of frenulum and reconstruction of the gum width (to prevent a recession). Most periodontologists may perform the majority of surgical procedures in cooperation with a dental surgeon.
The periodontologist is also a specialist in the field of mucous membrane diseases. It recognizes and treats such changes as oral mycosis, recurrent aphthous stomatitis, as well as more serious ones, such as lichen planus or leukoplakia. Typically, the treatment is pharmacological and involves the use of medications in the oral cavity, but sometimes a periodontologist can use a laser method or photodynamic therapy. Both methods involve light exposure of changes to reduce them. Small changes can be removed surgically as well as using cryotherapy.
Periodontology – the course of the procedure
Professional periodontal treatment is carried out according to a defined scheme, consisting of several phases. The first stage is hygienisation – removal of plaque and tartar – usually done in the office of dental prophylaxis in our clinic. Then we perform also supragingival scaling and polishing of the tooth surface (see: dental prophylaxis). At this stage, caries treatment is also performed (see: conservative dentistry) and removal of unfit teeth (see: oral surgery). At subsequent visits, the periodontologist performs subgingival scaling and curettage procedures, always under local anesthesia, so that the patient feels comfortable.
After completing this phase, the patient comes for control after 4 – 6 weeks. Then the effects of treatment are assessed. If the patient and the dentist are not satisfied, surgical treatment is performed. Under a local anesthesia the periodontologist performs the appropriate procedures, usually completed by sewing the wounds. The patient receives post-treatment recommendations, which must be strictly followed. At the next visit, after about a week, sutures are removed, and the patient gets schedule of follow-up visits to monitor the healing of the treatment site. The subsequent phases of the comprehensive periodontal treatment include orthodontic or prosthetic treatment, under the supervision of appropriate specialists.
Treatment of the mucosa lesions with the use of laser or photodynamic therapy consists of irradiating them for several minutes with a special light. It is a completely painless method and stimulates the body to remove diseased cells, thanks to which the change reduces its size. Surgical removal is always performed under local anesthesia. For every suspicious change, the doctor takes a slice and sends it for histopathological examination to check it for cancer.
Periodontology – indications and contraindications