Periodontics is the odontology speciality responsible for the diagnostic prevention and treatment of diseases that affect the tissues round the tooth, i.e. the gums, the periodontal ligament, the radicular cementum and the alveolar bone.
The main periodontal diseases that affect the teeth are: periodontitis (destruction of the bone holding the tooth in place) and gingivitis (inflammation and bleeding of the gums without affecting the bone).
Periodontics is also the branch responsible for preventing and treating diseases that affect dental implants such as peri-implantitis (inflammation of the soft tissues around the implant and affecting the bone holding the implant in place).
The factors leading to these diseases are the build-up of tartar and bacterial plaque due to poor oral hygiene habits, poor tooth-brushing technique, smoking, etc. or sometimes to genetics or family history.
Their treatment consists of correct hygiene to control bacterial plaque and eliminate the factors that cause it (tartar and periodontal pockets). In more serious cases periodontal surgery will be required in order to remove the damage and enable good subsequent maintenance of the affected area.
Inflammation and infection of the tissues holding the teeth in place; because it doesn’t affect the bone, this is a reversible disease. It is very common and generally appears in the early stages of adult age, although children and adolescents too can sometimes experience swelling or bleeding of the gums.
It is caused by plaque deposits (accumulation of bacteria, proteins and food waste) for long periods of time on the external wall of the teeth. These plaque deposits harden and turn into what we call tartar. Both plaque and tartar cause gum irritation and inflammation. Infection is caused by the bacteria and toxins produced by plaque and tartar.
- Poor dental hygiene
- Badly controlled diabetes
- Bad tooth alignment
- Certain medicines, such as: Hydantoins, birth control pills, bismuth.
- Bleeding gums
- Shiny red gums
- Inflammation or swelling of the gums
- Mouth ulcers
- Gums sensitive to the touch
If you have any of these symptoms you must visit your dentist, who will careful check your mouth and carry out tests to establish whether or not you have this disease.
Your dentist will clean your teeth to completely remove all plaque and tartar. After treatment, it is essential that you continue to take very good care of your oral hygiene every day. The dentist will show you how to properly use a toothbrush and interdental brush.
Bleeding and sensitivity will disappear in 1 to 2 weeks if you continue to take proper care of your teeth and gums after professional cleaning. If you don’t, the disease will reappear.
Also known as pyorrhoea, is the main cause of tooth loss in adults. This disease appears when gingivitis is left untreated, so that the inflammation and infection spreads to the ligaments and to the bone that holds your teeth in place.
This causes the teeth to come loose and fall out.
In gum periodontitis the gums shrink away from the teeth, leaving spaces or pockets that become infected by the bacteria in the plaque. Sometimes the infection can lead to a dental abscess, which can also cause destruction of the bone.
- Bright red gums
- Bad breath
- Sensitive to the touch
- Gums that are inflamed or bleed easily
- Loose teeth
The diagnosis will be made by the dentist who will examine the patient’s mouth and make a series of tests to establish whether or not they have the disease. X-rays will reveal the presence of plaque under the gums.
The objective is to eliminate the gum pockets caused by plaque build-up and treat the underlying causes.
Your dentist will completely clean your mouth and explain importance of continuing to ensure good oral hygiene at home. Patients with periodontitis must have their mouths cleaned professionally every 6 months.
Sometimes surgery will be required to clean deep pockets and to provide support for loose teeth. Your dentist may have to extract one or more teeth to stop the problem from aggravating or spreading.
This is the presence of bacteria on the surface of dental implants caused by their exposure to the oral cavity.
When inflammation of the soft tissues around the implant is reversible it is called mucositis, and when the inflammation starts to affect the bone as well as the soft tissues it is called peri-implantitis.
- Poor positioning of dental crowns/or implants
- Poor oral hygiene
- Poor quality of the alveolar bone to which the implant is fitted
- Abusive alcohol and tobacco use
- Untreated caries near the implant
- Not visiting your dentist for regular check-ups once the implant has been fitted
Here the aim is to mechanically remove plaque (subgingival debridement) and reduce the bacteria causing the infection (by means of antibiotics or antiseptics). Sometimes the implant will have to be removed.
Preventing periodontal diseases
Good oral hygiene is the best way to prevent these diseases and their complications.
It is advisable to brush your teeth at least twice a day and to use an interdental brush at least once a day.
Your odontologist can show you how to brush your teeth and use an interdental brush after every meal and before going to bed. Ask them if you have any doubts.
Your odontologist can also describe or prescribe devices to help remove plaque, such as special toothbrushes or dental water jets.
Many odontologists recommend professional dental cleaning at least every 6 months. It is easy for a little plaque to go unnoticed, even with careful brushing and interdental brush use.