Periodontitis treatment at the dentist

Periodontitis, also known as periodontosis, is an inflammation of the periodontium. The term “periodontium” (from Greek παρα: near, next to, along; οδουσ: tooth) literally means “around the tooth”. The periodontium ensures that the teeth are firmly anchored in the jaw and consists of the jawbone, the gums, the skin of the tooth root and the dental cementum, which represents the outer layer of the tooth root. If one or more of these areas around the teeth become diseased, periodontitis can develop. Treating periodontitis at your dentist in Zug is essential to prevent negative health consequences.

In contrast to a simple inflammation of the gums (gingivitis), periodontitis also affects the deeper areas of the periodontium. If left untreated, periodontal disease can jeopardize long-term tooth preservation. As the disease progresses, untreated periodontitis in most cases leads to bone loss, loosening and ultimately even loss of the affected tooth. Periodontal diseases, which also include periodontitis, represent, alongside tooth decay, the greatest threat to dental health and are the most widespread diseases when it comes to long-term tooth preservation.

Teeth with periodontitis

Causes of the development of periodontitis

Diseases of the periodontium arise from bacterial infections and inflammation of the tissue and bone that surround and hold the tooth. Initially, often only the gums are inflamed. In this early stage of periodontal disease it is referred to as gingivitis.

If the gums are inflamed for a long time, the germs multiply in the mouth and secrete acids and toxins that attack teeth and gums. The inflamed gums swell and make cleaning the tooth surfaces even more difficult. In the advanced form of periodontal disease, the periodontitis, the connection between tooth and gums loosens and forms the gum pocket.
With the space created between the tooth and the gums, this pocket is an ideal breeding ground for the proliferation of germs and bacteria and thus the basis for the progression of periodontitis. As a result, the bone is attacked and ultimately the infection leads to bone loss, so that teeth can fall out because they are no longer supported by the jaw and tissue.

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Bacterial diseases in the oral cavity are, among others, promoted by the following factors:

  • increased sensitivity of the gums due to hormonal influences (for example during pregnancy or menopause)
  • individual susceptibility
  • various metabolic diseases such as diabetes or rheumatism
  • inadequate oral hygiene, resp. brushing teeth too rarely or not carefully
  • tobacco, as nicotine reduces blood flow to the gums
  • tartar, which forms another breeding ground for bacteria with its rough surface

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Recognize signs of periodontitis

Periodontal disease is usually painless at the beginning and is therefore often not noticed until late. The gradual progression of the disease is treacherous, as the patient often initially does not notice any symptoms with simple gum inflammation. However, if noticeable problems occur, there is a risk that periodontitis is already in an advanced stage.

If you observe the following signs, you should visit your dentist timely:

  • bleeding, tender, swollen or red gums
  • increased (pain) sensitivity of teeth
  • loose or “poorly fitting” teeth
  • Bad breath/bad taste in mouth
  • Gum recession

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The sooner the patient reacts to the disease at the first warning signs and has the periodontitis treated by the dentist, the better dental therapy can slow down the progression. With its classification as a chronic disease, periodontitis cannot be cured, but can only be prevented from progressing. Therefore, with timely and regular treatment of periodontitis by your dentist, at least the aggravation of the inflammation can be stopped, the condition in mouth improved and therefore the affected tooth, resp. teeth possibly be preserved.

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Diagnosis of periodontitis

In order to treat periodontitis, the dentist first determines the severity of the inflammatory infection on the periodontium. To do this, the depth of the respective gum pocket is measured using a periodontal probe. The measurement is taken from the edge of the gum to the bottom of the pocket. Depending on the depth of the gum pocket, this examination can be somewhat uncomfortable. A healthy tooth pocket depth is approximately 1-2 mm. With periodontitis, the pocket is over 3 mm deep. If the pocket is more than 6 mm deep, it is usually considered to be severe periodontitis and the pocket can extend to the root tips of the teeth. In particularly severe cases, patients can develop pockets that are over 10 mm deep. The pocket depths are therefore a measure of inflammatory activity.

Furthermore, the degree of loosening of the teeth is examined and the dentist can use x-ray images to determine how badly the jawbone has already been affected. The images can also be used to diagnose other possible causes of tooth loosening.

Treatment of periodontitis – from conservative to surgical

In most cases, periodontitis is caused by bacteria that settle in the dental plaque – especially in the spaces between the teeth and at the gum line. The main goal of treatment is therefore to reduce the amount of bacteria in general and specifically in the existing gum pockets, as well as to eliminate the inflammatory stimulus so that the patient’s discomfort is reduced and the tissue of the periodontium can be strengthened again.

Adequate periodontitis treatment can also help ensure that the periodontal disease does not further promote a number of possible serious general diseases such as diabetes or cardiovascular diseases. Last but not least, untreated periodontitis can also lead to impairments during pregnancy and has been proven to increase the risk of premature births. Particularly due to all of these general medical factors, periodontitis should never be left untreated

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  • In conservative treatment of periodontitis, the dentist will first clean the existing pockets and free teeth from deposits such as plaque and tartar, i.e. from bacterial foci. Gum pockets can be cleaned under local anaesthesia. This avoids pain during periodontitis treatment. The duration of periodontitis therapy depends on the extent and severity of the inflammation in the areas of the mouth to be treated. This also determines whether the patient should be given additional medication with local or systemic antibiotics. In general, the patient should no longer feel significant pain within a few days of treatment. Any remaining complaints can be treated with appropriate painkillers.
  • If the periodontal disease is already very advanced, the treatment mentioned is surgical. In this case, the gum is removed from the tooth, resp. teeth first as this is the only way the dentist has access to the entire affected periodontium in order to be able to carry out the treatment professionally. At the end of the procedure, the gums are sutured and the stitches are removed after around one week. This treatment is of course more invasive and therefore more significant postoperative symptoms are possible.

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Aftercare in the practice and at home

Because of its chronic nature, regular follow-up care is particularly important for periodontitis. Regular visits to the dentist serve to check the progress of teeth, gums and especially the gum pockets. This makes it possible to react early if the periodontal condition worsens again.

In addition, particular attention should be paid to careful oral hygiene in order to prevent the pathogenic bacteria from settling around the tooth and to avoid the risk of renewed inflammation of the surrounding tissue. In addition to regular teeth brushing, also special interdental brushes that are tailored to the patient’s needs and depth of the inflamed areas may be used. Patients can have their dentist explain the correct brushing technique and get advice on the right toothpaste and other aids such as rinsing solutions, dental floss or tongue cleaners.
We also recommend professional teeth cleaning at regular intervals (between 2 and 6 months, depending on the severity of the periodontitis), so plaque and tartar can be thoroughly removed in order to eliminate bacterial foci that are the basis of periodontal inflammation.

Only the combination of all these measures – at home and in your dental practice – can combat the causes of periodontitis as effectively as possible and actively support the preservation of your teeth and the entire periodontium. Please do not hesitate to contact us if you have any questions. Your dentists in Zug will be happy to answer these!

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