The disease affecting the tissues that surround and hold your teeth in place, i.e. the gum,bone and periodontal ligament joining the former to your teeth, is known as periodontal disease.
Gingivitis
The accumulation of bacteria and leftover food after every meal, known as dental plaque, is the main cause of periodontal disease.
Dental plaque deposits itself between meals. If you don’t brush your teeth often enough, i.e. fewer than three times a day, or if you don’t do it properly, plaque will accumulate between your gums and teeth and will end up calcifying, turning into tartar.
Your organism fights these bacteria, causing a defensive reaction with inflamation of your gums. This is what’s known as gingivitis.
Signs of gingivitis
Smooth, red, swollen gums which bleed easily when brushed or while eating, and even sometimes spontaneously. Healthy gums are pink and are perfectly connected to the underlying bone.
Treating gingivitis
- Analysis of the way you brush your teeth: we will study the way you brush your teeth and how often, recommending the adequate technique.
- We will recommend the use of interdental brushes of the appropriate thickness for your teeth, as well as a specific toothpaste and mouthwash to prevent gingivitis.
- Yearly cleaning at your dentist’s.
When brushing your teeth, you must always include your gums.
Periodontitis
When gingivitis is left untreated, dental plaque and tartar accumulate and strongly attack the periodontal tissues, causing your gum to come away from your tooth and producing periodontitis.
Risk factors
- Genetic: there is always a certain tendency for periodontal disease to be passed down from parents to their children.
- Environmental: mainly tobacco and alcohol.
- Local: malocclusion and malposition of the teeth, i.e. your teeth don’t close properly or are crossed, meaning that food is more easily trapped between them, making proper cleaning more difficult.
- General: uncontrolled diabetes, leading to a greater tendency to suffer infections, or in some cases, pregnancy.
Signs of periodontitis
- Reddening, bleeding and swelling of the gums, i.e. the same symptoms as gingivitis.
- Receding gums: the bone and gum holding the tooth in place recede, revealing part of the root and making your teeth look longer.
- Bad breath.
- Movement in one or more teeth or molars.
- Tilting teeth: your teeth start tilting inwards or outwards, crossing over one another or fanning out
Treating periodontitis
- Intensification of the cleaning procedures described in the section on treating gingivitis.
- Possible antibiotics treatment, combined with the use of a chlorhexidine mouthwash for several weeks.
- Curettage or scraping and planing of the roots for deep cleaning of the periodontal pockets. If this doesn’t work, we will apply surgical treatment to the pockets, cleaning them and realigning your gums and bone so that you will be able to brush your teeth and roots properly. This will stop plaque from accumulating.
Gingival or periodontal recession
This involves changes in the “neck” of a tooth. Periodontal recession means that your gums are receding, a problem which will gradually reveal the roots of your teeth.
Periodontal recession will create an aesthetically unpleasant effect, particularly if it affects your top teeth. By uncovering part of the roots, it will make your teeth look longer, with darker roots and, in more advanced cases, dark spaces between your teeth.
The exposed roots can cause hypersensitivity to hot and cold, producing pain when brushing your teeth or eating.
Treatment of gingival or periodontal recession
- Brushing with a gentle toothbrush, initially insisting on the area where the tooth meets the gum.
- Use of interdental toothbrushes to prevent plaque from accumulating at the roots.
- If necessary, the use of a specific toothpaste and mouthwash for sensitive teeth.
Here we will have to study the evolution of your condition and establish whether the origin of the recession is generalised periodontitis, and if it is, to what extent. It may also be caused by brushing your teeth too hard or by the vestibular frenum pulling on your gums.
If the recession is important or looks ugly, we can graft a piece of gum taken from your palate or from another part of the oral mucosa.
Periodontal abscess
This is an acute infection in a periodontal pocket.
Signs of a periodontal abscess
- Swelling around the tooth.
- Reddening.
- Intense pain when eating, or even for no reason.
- The appearance of pus when pressed or when we open the abscess slightly with a scalpel.
- Bad breath.
Treating a periodontal abscess
An abscess requires urgent treatment with antibiotics, anti-inflammatory medicine and a chlorhexidine mouthwash. If it isn’t suppurating but is very inflamed, opening the abscess with a scalpel will release the pus and greatly relieve the symptoms.
When you have recovered from the above symptoms, it is advisable to have the periodontal pocket cleaned from within. By means of curettage, i.e. scraping and planing the roots, we will remove plaque from the roots and take steps to prevent the abscess from reappearing.
You must keep a close eye on your tooth and its evolution, since the problem can sometimes lead to the need for its extraction. That’s why a yearly or 6-monthly check-up and cleaning are essential.
