PERIODONTOLOGY (GINGIVAL DISEASES)
Periodontology is a discipline related to the diseases that occur in soft or hard tissues surrounding the teeth and their treatment. The most economical and effective way to be protected against periodontal diseases and dental caries is the daily oral care at home.
It is an elastic-looking tissue that is in light pink color, has a firm consistency and ends after thinning at the point where it joins the teeth. The gingiva is a tissue that completely covers the cervical area of the tooth. There is a circumferential groove (gingival crevice) located at the point where the tooth and gingiva meet. In healthy gingiva, this groove is shallow. If gingival health is impaired, this groove becomes deeper. Gingival crevice depth is a very important criterion in diagnosing diseases. Healthy gingiva does not bleed with tooth brushing. When the patients notice gingival bleeding, they mostly think that brushing will damage the gingiva and do not brush their teeth and gums. As a result of this incorrect movement, the problem will increase even more if the gums are not brushed, and gingival bleeding will increase. However; when gum bleeding occurs, if the teeth and gums are very regularly brushed and floss is used, gingival bleeding can be observed to be significantly reduced or even lost.
The accumulation of nutrient residues on the tooth that we call bacterial plaque leads to the deterioration of gum health and the formation of inflammation. The majority of periodontal diseases are chronic inflammatory diseases. Diseases are very insidious until very advanced stages; they may not show signs of pain and may progress unnoticed until they cause tooth loss. Gingival bleeding is one of the most important symptoms seen in every stage of gum disease.
It is the first stage of periodontal diseases that occur only with the loss of gingival health. Inflammation is not yet passed to hard tissues. The gum appearance is red, swollen and very bright. Bleeding while brushing teeth, or sometimes even spontaneous bleeding, is the most important symptom.
How is the treatment of gingivitis?
In the very early period, intensive oral care of the patient, removal of bacterial plaque on the teeth, regular and proper brushing and flossing are sufficient for the treatment of the disease. The treatment of the established gingivitis is done by cleansing the teeth. Then, intensive and meticulous oral care of the patient is very important. The correct oral care should be explained to the patient by the dentist and the correctness of the application should be checked in the second session.
It starts with the spreading of inflammation in the gums to the hard tissues. The disease deepens with the gingival crevice, swelling of the gingiva and the loss of the bone tissue around the teeth. A pocket is formed around the tooth, creating a very suitable environment for the growth of bacteria. The periodontal pocket depth is the most important criterion for the diagnosis and treatment of the dentist. In addition, X-rays should absolutely be controlled.
Periodontitis progresses very slowly, except in some cases. It can exist insidiously for long years. Bad odor in the mouth, gingival bleeding and as the disease progresses, gingival recessions are seen. In parallel, cold-hot sensitivity may occur in the mouth. In time, the teeth start to move away from each other like a fan and the abscess formations can be seen. The teeth begin to shake, and at very advanced stages, the teeth may spontaneously displace.
In some forms of periodontitis, the genetic tendency is effective; the disease progresses very quickly and patients can be faced with edentation at a very young age. If there are adults with a similar history in their family, regular check-ups with dentists gain importance.
How is the periodontitis treated?
The aim of treatment is to correct structural disorder on soft and hard tissue. In the initial treatment, the tooth surface is cleaned. Then, the root surface planing (curettage) follows. These treatments made at the early stages are sufficient for a good result.
Surgical approaches are required in advanced stages. It is possible to correct the deformations around the teeth caused by the disease and to shallow the periodontal pocket only with surgical interventions. During the intervention, it may be possible to recover the hard tissue by a number of techniques depending on the shape of the deformation in the bone. Very advanced conditions can result in tooth extraction.
PROTECTION FROM GINGIVAL DISEASES
The most important prevention method is regular and appropriate oral care. Brushing teeth three times a day and the use of and dental floss supportively allows the removal of the bacterial plaque from the teeth. Thus, since the most effective negative factor is eliminated, periodontal diseases are prevented. Diagnosis of the disease at an early stage with 6 monthly checks is one of the most effective ways of preventing major problems.