What is Gum Disease Treatment (Periodontology)?

What is Gum Disease Treatment (Periodontology)?

Periodontology examines the health and disease conditions of the teeth and tissues around the teeth, diagnosis, treatment and post-treatment of diseases occurring in these tissues. It is a branch of dentistry that aims to protect the acquired health.

PERIODONTOLOGY

What is gum disease?

Periodontal Diseases are inflammatory diseases that affect the gums and bone tissues that support the teeth. Diseases involving the gums and jawbone are responsible for 70% of tooth loss in adults. When periodontal diseases are diagnosed at an early stage, they respond to treatment easily and successfully. The main gum diseases are:

Gingivitis:This period is the beginning of gum disease. Symptoms; The gums are bleeding, red and enlarged in volume. Gingivitis may not cause much discomfort. Gums that bleed while brushing teeth are usually sensitive. If left untreated, the disease progresses to periodontitis, which is an advanced stage, causing damage to the gums and the bone that supports the teeth.

Periodontitis:It is a more advanced stage of gum diseases. Damage occurs to the alveolar bone along with other tissues that support the teeth. A "periodontal pocket" forms between the tooth and the gum. In this pocket, bacteria begin to multiply rapidly. Because it is a small area that cannot be cleaned. Symptoms: As the disease progresses, teeth begin to shake and may even need to be extracted. Gums can easily separate and move away from the teeth. Inflammatory discharge between teeth and gums. Teeth may become loose. The patient may even notice that their teeth are moving away from each other over time. Because there is destruction at the cellular level in the alveolar bone, there is mobility. There is always bad breath.

However, periodontal diseases can sometimes reach advanced stages without causing any symptoms. For this reason, it is extremely important to go to the dentist at regular intervals and have panoramic x-rays taken.

Gum diseases also occur in children. Bleeding, swelling and redness of the gums may occur. This situation is often due to insufficient brushing. It is caused by not being able to clean crooked or crooked teeth. These findings are observed in untreated cavities and overflowing fillings.

Why does gum disease occur?

When teeth are not cleaned properly, food residues accumulated on and between them produce bacteria. These structures, called bacterial plaque, are responsible for tooth decay and gingivitis, and over time, they form dental stones under the influence of saliva. If plaque is not effectively removed from the teeth, it turns into a hard structure called tartar. Bacteria in plaque and tartar cause destruction of the gums. If the disease is left untreated, the teeth will eventually become loose and may even require extraction.

How to prevent gum disease?

• Effective, Ideal tooth brushing.
• Dental floss should be used before brushing the teeth in the evening. (Or an interdental brush)
• Dentist check-up every 6 months.

What is the treatment of gum diseases?

Even if you take ideal care of your teeth, sometimes you may have gum disease due to genetic reasons.

• The first step in treatment is It can be completely healed with a good scaling performed by the dentist and with the patient paying attention to oral hygiene.
• In more advanced cases, it involves removing the attachments (plaque and tartar) on the teeth called curettage and ensuring a smooth root surface. Curettage removes bacteria and irritants that cause inflammation in the gums. Usually, this treatment is sufficient for the gum to adapt to the tooth again or for the gum to shrink and the pocket containing bacteria to disappear. In the majority of cases in the early stages of gum disease, daily effective oral care following scaling, plaque removal and ensuring a smooth root surface is sufficient for successful treatment.
• Surgical treatment includes flap operations for more advanced cases. If the fused bone needs to be supported in the flap operation or if bone is to be created in that area, bone grafts can also be placed. Thus, new bone formation can be achieved. However, bone formation never reaches its previous level. Flap operation These are stitched operations.

Gum Aesthetics (Gingivoplasty)

In periodontology, a procedure is performed on the gums both in terms of gingival tissues and aesthetics. team interventions can be made. Healthy gums are light pink, slightly rough with an orange peel appearance, and do not bleed. Smile line adjustments are not an issue that can only be solved by making changes to the teeth. Gum aesthetics also plays a big role here.
Situations that require gum aesthetics;

• Excessive exposure of the gums when smiling (Gummy Smile)cases,
• In case the gum levels are in a different position than they should be,
• In case of gum recession,
• In case of gum discoloration,
• In cases related to gum diseases, (Gum enlargement due to medication use, etc.)
• In cases of gingival level disorders due to crowding,
• In some cases where the length of the teeth is very short, gingival aesthetics may be required for crown lengthening procedures. is needed.

Gum Aesthetic Operations

• Gum resections (Gingivectomy)in cases where too much gum is visible. strong>
• Gum shaping (Gingivoplasty)
• Gum graft applications in gingival recession
• Removal of gingival pigmentation (Brownish gum discoloration)

Gingivectomy and Gingivoplasty:In aesthetic dentistry, if your gums are visible especially when smiling, operations called gingivectomy are performed. Or if your gums do not appear symmetrical, if one tooth is above and the gum level of the other tooth is below, gingivectomy is performed and then if it is planned, laminates are made. In some cases, inflammatory, drug-related or hereditary gingival enlargements may occur. If there is no osteoporosis in these gingival enlargements and there is no operation requiring bone formation, the enlarged gums are destroyed with gingivectomy. Gingivoplasty is generally applied after gingivectomy to restore the normal physiognomy, that is, shape, by surgically correcting the gums. Gingivoplasty can also be performed alone.

Crown Lengthening Operation:It is a procedure performed to lengthen the visible parts of the teeth inside the mouth, called crowns, which remain above the gum level. In some cases, the fracture line or decay progresses below the gum level. In such cases, it is necessary to extend the gum level towards the root part for the sake of gum health or for the retention of crown and bridge treatments.

Soft tissue grafts to form the gum:

There are various reasons for gum recession. Let's list the main ones.

• Age: In individuals of older ages, there will be a withdrawal that we call physiological withdrawal, which is not considered a disease. This is a natural condition and no treatment is required.
• Misuse of toothbrush: It is caused by excessively hard and long-term brushing. The oral hygiene of these people is extremely good. There is no inflammatory disease in the gums. The gums are destroyed by brushing pressure.
• Due to anatomical structures: Some teeth are located outside the tooth row. The gums on the lips and cheeks of these teeth are candidates for recession. When you pull your lower lip down with your hand, you will see the thin muscle structures going towards the gums. With this muscle bond called Frenilum, recession may occur, especially on the cheek surfaces of the teeth.
• Gum diseases: Recession in the gums occurs due to the formation of bacterial plaque.
• Formation of excessive forces on the teeth: Gum recession is observed in teeth exposed to excessive forces and in people who clench their teeth and grind at night.

To cover the gingival recession, gums must be removed from a different part of the mouth (usually the palate or palate). Soft tissues taken from the gum area where there is no recession are used. It is usually done for aesthetic purposes or for preventive purposes to prevent gum disease from progressing. As a result of gum recession, some teeth may appear very long, and the root surfaces of these teeth are exposed. In such a case, the aesthetically exposed root surfaces are covered with soft tissue grafts.

Bone tissue grafts used in flap operations:

During flap operations, bone loss is advanced. in regions of size Bone formation is stimulated by the application of artificial or natural bone powder. Your physician will decide whether bone grafts will be needed.

After flap operations, the gums shrink slightly as a natural result of gum healing. This is why sometimes teeth appear to be elongated. The more advanced the disease is before treatment, the greater the amount of withdrawal. Recessions may occur in the form of exposed roots and may disturb the patient. There may also be hot and cold sensitivity. Sensitivity can be reduced by using high-fluoride toothpastes and desensitizing products. After flap operations, teeth may show more loosening than before, but this may disappear completely within 4-5 months or decrease even more than before.

No matter what type of treatment is applied by the dentist, the patient must always maintain good oral hygiene. must. After the flap operation, the patient must pay extreme attention to oral hygiene. Otherwise, all improvements achieved will quickly reverse. One of the most frequently asked questions by patients is whether gum diseases can be cured by using medication. There is no such gum medicine. After the operations, the patient is given antibiotics and some painkillers with a prescription prepared by your doctor.

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