Periodontology

Periodontology is a branch of dentistry that deals with the diagnosis and treatment of periodontal diseases (periodontopathy) and the oral mucosa.

Healthy periodontium is essential for the proper maintenance of teeth in their sockets. It consists of: alveolar bone, periodontal ligaments, root cementum, and gums.

The symptoms of periodontal disease (commonly known as periodontitis) include:

• bleeding gums,
• swelling and pain in the gums (often associated with toothache),
• tooth sensitivity caused by exposed roots,
• bad breath,
• gaps between teeth as a result of tooth movement,
• looseness and eventually tooth loss.

Unremoved bacterial plaque hardens (mineralises) and leads to the formation of tartar. The bacteria contained in plaque and tartar cause gum inflammation and then, as they penetrate deeper and deeper into the periodontal tissues, destroy the ligaments that hold the tooth in the alveolar socket, the alveolar bone and other periodontal structures. This results in redness, swelling, pain and bleeding of the gums, and in advanced cases, elongation of the teeth (exposure of the tooth roots) as a result of bone loss and gum recession, the formation of periodontal pockets, loosening of the teeth and their loss.

Periodontal inflammation is also caused by:

• overhanging fillings, extensive caries,
• leaky prosthetic restorations,
• teeth grinding,

as well as systemic factors:

• stress,
• smoking (nicotine constricts blood vessels and masks inflammation),
• vitamin deficiency,
• poor diet,
• hormonal disorders,
• systemic diseases, e.g. diabetes, leukaemia.

These may be one of the causes or may affect the course of an existing periodontal disease.

Periodontitis treatment consists of three phases:

Phase I –HYGIENE

The most important thing is to detect the disease quickly and begin treatment in its early stages. In such cases, professional hygiene procedures are sufficient:

• scaling – removal of supragingival and subgingival tartar,
• sandblasting,
• tooth polishing,
• removal of irritants (overhanging fillings, leaky prosthetic restorations),
• oral hygiene instruction.

Phase II – CORRECTIVE

If, after hygiene treatments and the patient maintaining proper oral hygiene, there are still pathological changes in the periodontium, then more advanced treatments are necessary:

• deep scaling – cleaning the root surface of bacterial plaque and tartar,
• root planing – removal of infected root cementum and smoothing of the root surfaces.

It may also be necessary to perform periodontal microsurgery procedures, such as:

• lengthening of the clinical crown of the tooth,
• regenerative treatment of bone defects using bone-forming biomaterials,
• gingival plastic surgery,
• coverage of gingival recession,
• widening of the keratinised gingiva zone,
• upper lip and tongue frenulum incision,
• oral vestibule plastic surgery or deepening.

Phase III – MAINTENANCE

To prevent recurrence of the disease, the following are necessary:

• strict adherence to the dentist’s recommendations and
• regular check-ups scheduled individually according to your needs.

Remember – healthy gums are pale pink and do not bleed!