Parodontosis — how to prevent it and how to treat it

What is parodontosis?

Periodontitis, also known as periodontal disease, is a group of diseases that affect the tissues that support the teeth, such as the gums, root cement, alveolar bone, and periapical membrane. This disease can lead to serious health problems, such as tooth loss, if not properly diagnosed and treated.

Parodontosis begins with the accumulation of bacteria in the mouth that form plaque on the surface of the teeth. This plaque can be removed by brushing your teeth daily and using dental floss, however, if oral hygiene is improper, bacterial plaques can accumulate and form tartar.

As tartar builds up on the teeth and below the gum line, inflammation of the gums occurs, called gingivitis. Gingivitis is the first stage of parodontosis and is reversible if properly treated by removing bacterial plaque and improving oral hygiene.

If gingivitis is not treated properly, the inflammation can worsen, penetrating deeper periodontal structures, such as bone and periapical membrane. This process leads to tissue destruction, bone loss and the formation of gum pockets, which can eventually lead to tooth loss.

Treatment of parodontosis depends on the stage of the disease. In the case of mild forms, it is often enough to remove tartar, improve oral hygiene and check with the dentist. If the disease is advanced, surgical treatment may be necessary to remove the affected tissues and rebuild the lost bone. In some cases, the doctor may also recommend the use of antibiotics.

Symptoms of parodontosis

Parodontosis can have various symptoms, which usually develop gradually as the disease progresses. The initial symptoms may be easy to overlook, but they become more pronounced as the disease progresses. The following are some of the common symptoms of parodontosis:

1. Changing the color of the gums — the gums can change color from light pink to dark red or purple.
2. Bleeding gums — Gums can bleed when brushing teeth, flossing, or on their own.
3. Swelling and redness of the gums — the gums can become swollen, sensitive and red.
4. Gum Retraction — The gums can recede, which makes the teeth appear longer and exposing the roots of the teeth.
5. Formation of gingival pockets — deep spaces between the gums and teeth, called gingival pockets, can appear when the gums move away from the teeth.
6. Tooth Sensitivity — Teeth can become sensitive to hot and cold stimuli, as well as to sweets.
7. Change in bite — bone loss and incorrect tooth positions can lead to a change in bite.
8. Tooth movement or loosening — Teeth may begin to move or become loose due to loss of supporting bone and tissue.
9. Halitosis (bad breath) —due to the accumulation of bacteria and dead cells in the mouth, bad breath can be one of the symptoms of periodontitis.
10. Pain — in the advanced stages of the disease, pain can occur when eating, brushing teeth or spontaneously.

Treatment of parodontosis

Treatment of periodontitis depends on the stage of the disease and the individual needs of the patient. The main goal of treatment is to control infection, remove bacterial plaque and tartar, and reduce the depth of gum pockets.

Professional teeth cleaning

Cleaning your teeth regularly at the dentist can help remove bacterial plaque and tartar, preventing inflammation. In the case of mild parodontosis, this may be sufficient to control the disease.

Scaling and root planning

These are deeper dental cleaning treatments that aim to remove tartar and smooth the roots of the teeth to reduce the amount of space where bacterial plaque can accumulate.

Scaling, also known as “scaling” or “stone removal”, is one of the basic treatments used to treat periodontitis. Scaling is the process of mechanically removing tartar that accumulates on the surface of the teeth and below the gum line. Tartar is a mineralized bacterial plaque that can lead to inflammation such as gingivitis and periodontitis.

Scaling is usually done in the dental office by a dentist or dental hygienist. The procedure can be performed with hand tools such as scalers, or ultrasonic, which use vibrations to remove the stone. Scaling can also be combined with root planing (root smoothing), which aims to remove bacteria and smooth the surface of the roots of teeth to reduce the amount of space where bacterial plaque can accumulate.

In the case of mild periodontitis, regular scaling in combination with proper oral hygiene may be sufficient to control the disease. In advanced periodontitis, deeper treatments such as closed or open curettage or even periodontal surgery may be necessary to remove diseased tissue, rebuild lost bone, and improve periodontal structure.

Drug treatment

Pharmacological treatment of parodontosis can be used as an adjunct to the mechanical removal of bacterial plaque and tartar, and as a means of infection control. Drug treatment may include antibiotics, antiseptics and other drugs that support the treatment of periodontitis. The following are some of the commonly used pharmacological treatments:

• Antibiotics — In some cases of periodontitis, the dentist may recommend the use of antibiotics to help fight off the bacterial infection. Antibiotics can be administered orally, topically (in the form of gel, cream or cartridges) or even in the form of injections. Examples of antibiotics used to treat periodontitis are doxycycline, metronidazole or amoxicillin with clavulanic acid.
• Antiseptics — Antiseptics are agents that help reduce the amount of bacteria in the mouth. They can be used in the form of mouthwashes, gels or toothpastes. An example of an antiseptic is chlorhexidine, which is often used in the treatment of parodontosis as a mouthwash.
• Anti-inflammatory drugs — In some cases, doctors may recommend the use of anti-inflammatory drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, to reduce inflammation and pain associated with periodontitis.
• Modulating enzymes — in some cases, treatment with modulating enzymes, such as oral medications containing a subantimicrobial dose of doxycycline (SDD) may be used. This therapy is aimed at inhibiting enzymes (collagenases), which can lead to the destruction of periodontal tissues.

It is important to remember that the pharmacological treatment of periodontitis should be used as a supplement, and not a substitute for the mechanical removal of bacterial plaque and tartar and the maintenance of proper oral hygiene.

Periodontal Surgery

Surgical treatment of periodontitis is usually used in cases where non-invasive treatments such as scaling, root planing and drug treatment do not bring the expected results or when the disease is advanced. Surgical methods of treatment are aimed at removing diseased tissues, restoring lost bone, reducing the depth of gingival pockets and improving the structure of the periodontium. Here are some of the surgical methods for treating periodontitis:

• Flap surgery is a procedure in which the surgeon makes an incision in the gum, deflects it away from the teeth, removes tartar and curettes (cleans) the gingival pockets. Then the gum is sewn back into place. This method allows better access to the gum pockets and facilitates their cleaning.
• Tissue regeneration — in case of bone loss or damage to periodontal tissues, it may be necessary to perform a tissue regeneration procedure. This may include the use of separation membranes, bone grafts, or the use of materials that stimulate bone and tissue regeneration.
• Gum transplant — If there is significant gum retraction, a gum transplant can be used to restore tissues and protect the roots of the teeth. This usually involves taking tissue from another part of the mouth (e.g., from the palate) and transferring it to the area of the retracted gums.
• Open curettage (gingivectomy) — in some cases, it may be necessary to remove part of the affected gum. Gingivectomy involves the surgical removal of excessively enlarged or damaged areas of the gums.
• Crown extension surgery — In the event that the teeth are too short or exposed due to gum recession, crown extension surgery may be used. It involves the surgical removal of part of the gum and possibly the bone to lengthen the crown of the tooth.

Elimination of threats

Treatment for periodontitis may also include controlling risk factors such as cigarette smoking, diabetes, stress, or unhealthy diet. Improving these factors can help prevent further progression of the disease.

Prevention of periodontitis

Prevention of periodontitis is mainly about maintaining good oral hygiene and regular check-up visits to the dentist. Here are some tips that can help prevent parodontosis:

• Brush your teeth at least twice a day using a soft toothbrush and fluoride toothpaste. Follow the proper brushing technique, which is brushing at a 45-degree angle to the gum line, with gentle, circular motions.
• Flossing — floss daily to remove bacterial plaque and food debris from the space between your teeth where the toothbrush cannot reach.
• Mouthwash — Consider using an antibacterial mouthwash to reduce the amount of bacteria in your mouth. Mouthwash can be used after brushing and flossing.
• Regular dental checkups — Visit your dentist at least twice a year for professional teeth cleaning and to check the condition of your gums and teeth.
• Healthy diet — Maintain a balanced diet rich in protein, vitamins and minerals, and low in sugars and high-starch foods. Avoid snacking between meals, especially sweet snacks.
• Quitting smoking — smoking increases the risk of periodontitis. Quitting smoking can significantly reduce the risk of gum disease and contribute to overall oral health.
• Limit alcohol consumption — excessive alcohol consumption can lead to dry mouth, which increases the risk of gum disease. Limiting alcohol consumption can help maintain oral health.
• Controlling diabetes — people with diabetes are more likely to develop gum disease, such as periodontitis. Good blood sugar control can help reduce the risk of gum disease.

Following these tips will help maintain oral health and reduce the risk of developing periodontitis.