Without plaque and stones. Periodontist – about the treatment of gum disease

A specialist of the diversified company LODE answered questions from readers during a live line in the press center – dentist-therapist Veronika Uglyanitsa.

– Signs of inflammation in the gums are observed in 98% of people. Timely examination of the periodontium allows you to identify many diseases at an early stage. Some diseases are characterized by a slow course, but without timely treatment in the place where the gum is inflamed, the structures that hold the tooth begin to collapse, which leads to its loss. It is important to understand that personal hygiene, that is, daily brushing of teeth, is one of the main assistants in the fight against gum disease. Already during puberty, against the background of hormonal changes in the body, dental problems may appear. Most often, these are aggressive forms of periodontal disease that proceed rapidly. In adulthood, most patients are diagnosed with periodontal disease, which proceed in different ways.

The doctor discovered inflammation of the gums. After a minute examination, he prescribed treatment, and before that he sent for a mandatory cleaning of his teeth from plaque. Is this cleaning necessary? It is embarrassing that after the procedure, the teeth at the base “lose weight” and gaps form between them.

N. Malyutina, Soligorsk

– A minute examination is enough to diagnose gingivitis, but not enough for a detailed examination of periodontal tissues. Cleaning your teeth from plaque is a must before any dental treatment. The procedure is also indicated for those who have a slight inflammation of the gums – gingivitis: it is desirable to carry out it twice a year. The teeth at the base really “lose weight” if the cleaning is carried out with high quality. But this is not due to the loss of their own tissues, but because dental deposits are removed. The resulting cracks are especially noticeable on the lower teeth, since it is here that the tartar lies in a layer, closing the interdental space.

How deep can plaque spread and what does it threaten?

T. B., Minsk

– Plaque moves under the gum, since there is a small space between the tooth and the gum – the gingival sulcus (normally its width is from 0.5 to 2 mm). When this space is filled with plaque, which is difficult to clean out, a favorable environment is created for the development of pathogenic microorganisms that unite in colonies. And it is difficult to fight such a colony. It is important to remember that there are both “good” microbes and “bad” microbes in the oral cavity. In order for periodontal – that is, “bad” – bacteria to begin their activity, a carpet of “good” microbes must be “lined”, and it is formed within 12 hours. Therefore, dentists recommend brushing your teeth every 12 hours so as not to create a favorable environment for pathogenic microorganisms. The destructive process occurs under the gum, it develops painlessly and almost asymptomatically and is not visually determined, but its consequences are serious. Therefore, you should know that the main and most noticeable symptom of periodontal disease is bleeding gums. If your gums are bleeding, you should see your doctor.

Periodontitis and Periodontal Disease: What’s the Difference? How many sessions of laser therapy do you need to treat periodontal disease? Tell me, if the teeth began to stagger, is it possible to somehow strengthen them?

V. S., Zhlobin

– Periodontitis and periodontal disease – diseases of periodontal tissues with a characteristic loss of bone tissue. One reason is pathogens. Periodontitis is a pronounced inflammation with bleeding, a lot of plaque and stones. Periodontal disease is also a disease of periodontal tissues. The changes here are less pronounced, there is no inflammation of the gums, but at the same time, tissue nutrition is disturbed, which ultimately also leads to tooth loss. Laser therapy is effective for both periodontitis and periodontal disease. The number of sessions is determined individually in each case. You can strengthen your teeth: it all depends on the degree of their looseness. So, the tooth staggers because the bone has decreased and there is no fixing apparatus holding it in the hole. After all, first the ligament of the tooth is destroyed, and then the bone itself. If there is enough bone tissue left, the tooth can be strengthened. Strengthening is carried out using surgical procedures, fixing splints, orthopedic removable or non-removable structures.

I have a hormonal disorder associated with the ovaries: interdental gum recession has begun. I did laser procedures, but the gums still “leave”, the teeth stagger. What to do? Will gingival plasty help restore its former appearance?

V. Legacheva, Minsk

– General disease affects the condition of your teeth and gums. It is important to choose the right treatment regimen for hormonal disorders that contribute to the progression of periodontal disease. With recession, the gum “leaves”, along with it, the bone tissue decreases. The task is to stabilize the condition, but recovery without surgery is almost impossible. It all depends on how and how much the gum has “gone”. A laser procedure without prior qualitative removal of pathogenic microorganisms in the pockets of the teeth will not help. For this, closed or open curettage is performed – mechanical removal of tartar, infected root cement and granulation from the periodontal pocket. With closed curettage, the gum does not open surgically, with open curettage, on the contrary. The open version is used in difficult cases, for example, with deep pockets, when it is difficult to carry out conservative treatment.

Periodically I carry out conservative periodontal treatment (generalized periodontal disease, there is gum recession). The orthodontist recommended braces as there is an overbite. Will gum recession progress? Is braces worth it? What is the incidence of gingival recession after braces in patients with periodontal disease?

N. L., Minsk

– Incorrect bite in general worsens the course of periodontal disease and periodontitis. The teeth do not close correctly: the chewing load is accordingly unevenly distributed. Incorrect position of the teeth creates conditions for increased accumulation of plaque. Gingival recession – displacement of the gingival margin and exposure of the necks of the teeth – is possible due to malocclusion. Properly selected orthodontic treatment will not damage either bone tissue or gums. Adequate treatment of periodontal disease, correctly installed braces will not cause gum recession.

Is there any seasonality in dental diseases? Why do gum problems worsen in spring?

P. Tkachev, Minsk

– Most often, exacerbations occur in the autumn-spring period. After a long winter, the body is already tired of fighting viruses, it lacks vitamins, so people catch colds more often, their immune defenses decrease. This also affects the health of the gums.

Is teeth whitening bad for gums?

N. Leontiev, Bobruisk

– Teeth whitening does not harm the gums, as they are carefully protected before the procedure so that the whitening gel does not cause a burn. So, the gum is covered with a special liquid rubber dam. This agent forms a film on the gum, hardening under the action of a photopolymerization lamp.

Source: https://aif.by/