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Gingivitis - Periodontitis

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Gingivitis - Periodontitis

Gingivitis

Gingivitis is the simplest form of periodontal disease, caused by gingival bacteria (microbial plaque). When we do not take proper care of our teeth for long periods of time and do not make regular dental visits for teeth scaling, the microbial plaque grows and produces substances harmful to the gums.

The main symptoms include red, swollen gums and bleeding when brushing. At this stage there is still no destruction of the bone that holds the teeth in place (alveolar bone) and the inflammation is limited exclusively to the gums. Treatment with a thorough scaling in one or more visits and good oral hygiene can restore gums to their previous, healthy state.

Periodontitis

Periodontitis, the leading cause of tooth loss in people over thirty, develops slowly and often painlessly, so many people are unaware of their problem and do not seek treatment.

In case of periodontitis, as in gingivitis, the gums are inflamed (red and swollen) but at the same time the bone that supports the tooth is destroyed. The loss of bone leads to receding gums and/or the formation of periodontal pockets around a tooth. As the supporting bone is destroyed by the microbes that cause periodontitis, the pockets become deeper and the number of microbes and calculus they contain increases, creating a vicious cycle of periodontal destruction. In the advanced stage of periodontitis, most of the bone supporting the tooth has been lost, and tooth mobility often occurs, resulting in the need for extraction. Pain in chewing, increased bleeding, halitosis and possibly presence of pus in the gums are often present in this final stage.

Smoking worsens the condition, reducing the blood supply to the gums and their defensive ability. Consequently, smokers have reduced gum bleeding and the presence of periodontitis is more difficult to notice. Another negative effect of smoking is the reduction of the activity of the body's defense cells, which leads to heavier bone destruction. Smokers show a reduced response to the treatment of periodontitis, but also to the long-term stabilization of their condition.

Periodontitis germs can also affect other organs outside the oral cavity, such as the heart and lungs. The two-way relationship between diabetes mellitus and periodontitis has also been demonstrated.

Treatment of periodontitis involves conservative and/or surgical scaling, and its effectiveness depends on the patient's cooperation in oral hygiene and regular follow- ups.

The conservative treatment is a deep scaling and root planing that is carried out in great detail on each tooth individually, during which the complete removal of the calculus located under the gums and the microbes that inhabit it is attempted. This cleaning is carried out with special ultrasound devices as well as hand scalers and as it is performed in depth, it is accompanied by local anesthesia. It is usually completed in two to four appointments, depending on the severity of the disease. It is not a painful as there may rarely be a minor irritation of the gums for a day, which is treated with simple painkillers. A side effect of the treatment can be increased sensitivity of the teeth to cold and hot stimuli for a short period of time, due to the removal of tartar from the surface of the teeth.

In some cases of advanced problems, surgical periodontal treatment may also be needed. This can occur if an area of the mouth does not show the desired improvement, or continues to bleed and often cause abscesses. Surgical periodontal treatment usually concerns only a few teeth and aims to improve the access of tools for the removal of bacteria and tartar, while in some cases it can be accompanied by an attempt to regenerate the bone that has been lost. It should be noted that bone regeneration is not a simple process and is successfully applied in very specific cases of bone destruction after very careful selection of patients who have a good chance of success. Smoking is a contraindication to the application of surgical periodontal techniques and it is recommended to stop smoking permanently or temporarily during the healing period after a surgical intervention.