Periodontology — what is it and how can it help?

What does a periodontist do?

A periodontist is a specialist in the field of dentistry who deals with the diagnosis, treatment and prevention of periodontal disease, that is, the tissues that surround and support the teeth. These tissues include the gums, periodontal ligaments, and alveolar bone. The periodontist has a key role in the treatment of periodontal diseases such as gingivitis and periodontitis, which can lead to tooth loss if not treated properly.

In addition to treating diseases, the periodontist also deals with surgical procedures such as bone and soft tissue regeneration, gum transplants and implantation of dental implants. In addition, these professionals play an important role in prevention, educating patients on proper oral hygiene and helping them maintain healthy gums, which is crucial for overall dental health and the entire body.

It is worth emphasizing that regular visits to the periodontist are extremely important, especially for people with symptoms of periodontal disease, smokers, people with diabetes, as well as those who are exposed to stress, as all these factors can increase the risk of developing gum problems.

What are periodontal diseases?

Periodontal diseases are a group of conditions that affect the tissues that surround and support the teeth, that is, the gums, periodontal ligaments, and alveolar bones. They are usually caused by bacteria present in plaque that accumulates on the teeth and gum line. If not regularly removed through proper oral hygiene, plaque can lead to inflammation of the gums and other periodontal tissues.

The main periodontal diseases include:

• Inflammation of the gums (gingivitis): This is the mildest form of periodontal disease, manifested by redness, swelling and bleeding of the gums, especially when brushing or flossing teeth. Gingivitis is reversible with proper oral hygiene and regular visits to the dentist.
• Periodontosis (periodontitis): If gingivitis is not treated, it can go into a more advanced disease, which is periodontitis. In this phase, the inflammation spreads to the deeper structures of the periodontal, leading to the formation of periodontal pockets, which is the space between the teeth and gums where bacteria accumulate. As a result, damage to soft tissues and bones occurs, which can lead to loosening and loss of teeth.
• Advanced periodontitis: As the disease progresses, there is a significant loss of alveolar bone, which leads to serious functional and aesthetic problems. In extreme cases, it may be necessary to remove the teeth and then carry out reconstructive procedures, such as implantation of implants.

Periodontal disease can also have an impact on overall health. Studies show a link between periodontal disease and an increased risk of heart disease, diabetes, pregnancy problems and even respiratory diseases. That is why their early detection and treatment is so important.

Prevention, including regular brushing, flossing and visits to the dentist, plays a key role in preventing periodontal disease and maintaining oral health.

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What are the most common causes of periodontal disease?

Periodontal diseases such as gingivitis and periodontitis have many causes that can affect the development and severity of these conditions. Here are the most common of them:

• Insufficient brushing of teeth, failure to use dental floss and irregular visits to the dentist lead to the accumulation of plaque, which is the main cause of gingivitis. Untreated plaque turns into tartar, which is difficult to remove without professional cleaning, and its presence can lead to periodontitis.
• Smoking is one of the most important risk factors for the development of periodontal disease. Tobacco reduces the body's ability to fight infections and delays tissue healing, which promotes the development of inflammation in the mouth.
• Some people may be genetically predisposed to developing periodontal disease. In these cases, even with good oral hygiene, they may be more susceptible to these conditions.
• Chronic systemic diseases, such as diabetes, can increase the risk of periodontal disease. Diabetes, especially if it is not well controlled, leads to a decrease in immunity and an increase in susceptibility to infections, including periodontal infections.
• Hormonal fluctuations associated with pregnancy, menopause, puberty or menstruation can affect the condition of the gums. During such periods, the gums may be more sensitive, which increases the risk of inflammation.
• Some medications, such as antidepressants, blood pressure medications, or anticonvulsants, can cause dry mouth or affect the flow of saliva. Lack of adequate hydration of the oral cavity can favor the development of plaque and lead to periodontal disease.
• Stress weakens the immune system, which can increase susceptibility to infections, including those within the oral cavity. In addition, stressed people can neglect daily oral hygiene, which further increases the risk of periodontal disease.
• Nutritional deficiencies or a diet low in nutrients, especially vitamins C and D, can impair gum health and promote the development of inflammation.
• Bruxism, or grinding or clenching of teeth, especially at night, can lead to damage to periodontal tissues, which in the long term can contribute to the development of periodontal disease.

Understanding these risk factors is critical to preventing periodontal disease and maintaining oral health. Regular hygiene, a healthy diet, and control of risk factors such as smoking can significantly reduce the risk of developing these conditions.

Symptoms, or when to visit the dentist

Recognizing the symptoms of periodontal disease at an early stage is crucial for effective treatment and prevention of serious consequences such as tooth loss. Here are the most common symptoms that should prompt you to visit the dentist:

• Bleeding gums: If the gums bleed when brushing, flossing, or even on their own, this is often the first symptom of gingivitis. Bleeding should not be ignored, as it can lead to more serious periodontal problems.
• Swelling and redness of the gums: Healthy gums have a pink color and are well adhered to the teeth. If you notice that the gums are reddened, swollen, or painful, this may indicate inflammation.
• Gum Recession (Gum Recession): Receding gums that expose the roots of the teeth are a sign of progressive periodontal disease. This can lead to increased sensitivity of teeth to cold, heat or touch.
• Unpleasant smell from the mouth (halitosis): Chronic unpleasant odor from the mouth, despite regular brushing and the use of rinses, can be a symptom of periodontal disease. Bacteria that accumulate in the periodontal pockets can cause this problem.
• Tooth mobility: If you notice that your teeth are looser than usual, this may be a sign of advanced periodontal disease that damages the tissues that support the teeth.
• Changing the position of the teeth: Tooth shifting, change in bite, or the appearance of gaps between teeth may indicate progressive periodontal disease that causes loss of bone and periodontal ligaments.
• Pain when biting: Pain or discomfort when biting can be associated with periodontal disease, especially when they are advanced. This can also signal the presence of periodontal pockets or abscesses.
• Periodontal abscesses: If a gum abscess occurs, that is, a painful, pus-filled lesion within the periodontium, this is a symptom of an infection that requires immediate dental intervention.

Any of these symptoms should be taken seriously and prompt a visit to the dentist or periodontologist. Early detection and treatment of periodontal disease can prevent its progression and help maintain oral health in the long run. Regular check-ups with your dentist, even if you don't experience any symptoms, are crucial for preventing and early detection of gum problems.

What is periodontal treatment like?

Periodontal treatment includes a variety of procedures aimed both at stopping the progression of periodontal disease and at restoring the health of the tissues surrounding the teeth. The treatment process may vary depending on the stage of the disease and the individual needs of the patient. Here are the main stages and methods of periodontal treatment:

1. Diagnosis and evaluation of periodontal condition: The periodontist begins treatment with a detailed assessment of the health of the gums and periodontium. Conducts a clinical examination, which includes measuring the depth of the periodontal pockets, assessing the mobility of the teeth, the condition of the gums, and the presence of tartar. X-rays are taken to assess the condition of the alveolar bone and detect possible structural changes caused by the disease.
2. Conservative (non-surgical) treatment:
   • Scaling and root planning (SRP) is the main method of treating the early stages of periodontal disease. It consists of removing plaque and tartar from the surface of the teeth (scaling) and smoothing the roots of the teeth (root planing) to eliminate bacteria and toxins. This procedure is often performed in several sessions.
   • In some cases, antibiotics are used to fight bacterial infections. They can be administered orally or directly into the periodontal pockets in the form of a gel or liquid.
3. Surgical treatment:
   • Closed curettage is a procedure that involves thorough cleaning of periodontal pockets from deep sediment and infected tissues. This procedure is performed without opening the gums.
   • In cases of advanced periodontitis, when the pockets are deep, it may be necessary to perform open curettage. In this procedure, the gums are gently incised, which makes it possible to clean the roots of the teeth more thoroughly and remove infected tissues.
   • In some cases, procedures are also used to restore lost bone tissues and periodontal ligaments. These may include the use of materials that aid regeneration, such as barrier membranes, bone grafts or growth factors.
   • In cases where there is significant gum recession, gum transplants can be performed to cover exposed tooth roots and restore the aesthetics and function of the gums.
4. Supportive treatment:
   • After completing the main stages of treatment, the patient is given detailed instructions for proper oral hygiene. The formation of new plaque should be avoided and the recurrence of the disease should be prevented.
   • After the end of treatment, the patient should regularly visit the periodontologist or dentist for follow-up visits and preventive treatments, such as professional teeth cleaning.
5. Implant treatment: In cases where periodontal disease has led to tooth loss, implantation of dental implants is possible. The dentist prepares the patient for the procedure and then carries out the implantation of implants, which form the basis for new, artificial teeth.

Periodontal treatment is a complex process and requires close cooperation of the patient with the doctor. Regular monitoring of periodontal health and maintaining a high level of oral hygiene is crucial to prevent recurrence of the disease.

In summary, periodontology plays a critical role in maintaining oral health and preventing serious diseases that can lead to tooth loss and other health complications. Regular oral hygiene, early recognition of the symptoms of periodontal disease and systematic visits to the dentist are essential to maintain healthy gums and strong teeth throughout life. Awareness of the importance of periodontal health and proper prevention can not only improve the quality of life, but also affect the overall health of the body. Therefore, it is worth paying special attention to the condition of the gums and not to neglect regular check-ups with a specialist in order to enjoy a healthy and beautiful smile for many years.