Periodontics is a dental specialty dealing with prevention, diagnostics and diseases of the periodontium.

Periodontium refers to tissues which surround teeth, maintain them in the maxillary bones and determine their main functions. The periodontium consists of gingiva, periodontal ligament, cementum and alveolar process of the maxillae and mandible. Healthy periodontium, just like healthy teeth, is one of the principal conditions for general good health.

 

A major cause of the disease are bacteria living in the oral cavity in the form of dental plaque. Their development results mainly from poor oral hygiene. Negative impact of local factors, such as cavities, malocclusion, fillings that aren’t properly adjusted, wrong dental prostheses, parafunctions (grinding and tooth-clenching) may also impede effective tooth cleaning. General factors, such as genetic influence, some illnesses (diabetes, osteoporosis), low immunity, smoking and stress also contribute to diseases of the periodontium, to a lesser degree, though.

Modern nosology divides diseases of the periodontium into over 30 disease entities, which are classified into two groups: gingivitis and periodontitis.

 

Gingivitis is a common disease which affects people of all ages: children, teenagers and adults. It is mainly connected with poor oral hygiene and the presence of tartar, which is mineralized dental plaque. The main symptoms of gingivitis, which are often disregarded, are bleeding gums, also while brushing.

Gingivitis is completely reversible, although if not treated in time, it may progress to periodontitis. As a result of damaged periodontal tissues, and a damaged supporting bone in particular, periodontal pockets are formed, in which bacteria gather and develop the disease, characterised by periods of exacerbation and remission. Apart from gum bleeding and swelling, symptoms such as revealing more tooth structure than is normally evident, tooth sensitivity to temperature, gingival suppuration, tooth mobility and drifting, sometimes pathological tooth mobility appear. Tooth mobility indicates a more advanced stage of the disease. At this point, the treatment may not always be effective. Untreated periodontal disease leads to premature loss of teeth!

The treatment of periodontal diseases involves several stages and often requires taking special measures. The first stage, which is the basic one, involves removing bacteria from the oral cavity, but first of all from periodontal pockets.

This stage mainly includes: oral hygiene instructions, along with choosing individualized dental supplies (various types of toothbrushes, toothpaste, dental floss, mouthwashes, gum massage gel, oral irrigators, etc.); professional dental hygiene treatment including scaling and teeth polishing carried out by a qualified dental hygienist by means of hand tools and ultrasonic tools; periodontal pockets cleaning (called curettage or root planing), carried out by a perdiodontist (2-4 visits), sometimes together with antibiotic therapy- special antibacterial preparation and antibiotics injected into periodontal pockets after they have been cleaned. The main goal of the initial stage of treatment is to stop the disease process. In case of gum inflammation and the early stage of periodontal inflammation, the above-mentioned treatment can be sufficient.
 
In the treatment of advanced stages of the periodontal inflammation it is essential to enter the second phase of treatment, which involves correction and includes:

• Surgical treatment: guided tissue regeneration, the main objective of which is to rebuild bone destroyed by inflammation. It involves filling bone defects using special membranes and other bone-replacing material, as well as replacing bone with material from your own body. Similar techniques are often used in the process of preparing patients for implantological treatment. Biological materials for periodontal regeneration, such as Emdogain gel, are also used.
• Surgical treatment of soft tissues- e.g. correction of lip frenulum surgery or gum graft to replace receding gums and improve the aesthetics.
• Tooth stabilisation with different types of splints.
• Correction of occlusion.
• Specialist planning of conservative, orthodontic, and first of all, prosthetic treatment, including the nature of the diseases of the periodontium, which requires the best conditions for teeth cleaning and maximum reduction of occlusal overload.

After periodontal treatment we recommend regular check ups and oral hygiene visits in order to maintain oral health. This is the third stage of the treatment- the stabilisation stage.