Periodontics comes from parodont, around the tooth, and deals with diseases of the gums and jawbone. This mainly concerns gum infections that can lead to the loss of jaw bone and ultimately the loss of teeth and molars. Within the practice we do not have our own periodontist, but we have very close collaborations with practices in the area.
Unfortunately, almost everyone has gingivitis. However, its severity varies greatly between people. Because gingivitis usually does not hurt, it is often discovered and treated too late. Due to gum disease, the jaw bone recedes and teeth eventually become loose. This means that gingivitis is just as much of a threat to your teeth as tooth decay (caries).
Around teeth and molars are gums, jawbone and fibers, the periodontium. The periodontium forms the supporting tissue of the teeth and molars. Healthy gums are attached to the teeth and molars. At the edge of the gums there is a narrow, shallow space between the gums and the teeth. This narrow space is called the pocket and is no more than 3 mm deep in healthy gums. Strong fibers connect the roots of the teeth and molars to the jawbone, making them firmly fixed in the bone. Healthy gums are pink in color, fit tightly around the teeth and do not bleed when brushing or eating. It also does not bleed when the dentist or dental hygienist examines it.
There are always bacteria in your mouth. These bacteria attach to the surface of your teeth and form a sticky layer called plaque. Even if you did not eat or drink, a new layer of plaque forms every day. Dental plaque has approximately the same color as the teeth and molars, so it is hardly noticeable. When the plaque has just formed, it is still soft and therefore easy to remove with your toothbrush.
If you do not completely remove plaque every day with good oral hygiene, the bacteria in the plaque will cause inflammation in the gums. The first stage of this inflammation is called gingivitis.
You can often recognize inflamed gums yourself: they are red, swollen, weak and a bit shiny and no longer fit tightly around the teeth. Also, if you see some blood while brushing or after using a toothpick, this is an important signal that your gums are inflamed. Inflamed gums are rarely painful.
If the inflammation in the gums is not clearly visible and there are no complaints, there is a risk that you will not notice your gum disease. Fortunately, the dentist or dental hygienist can do this with a simple examination: regular checks are therefore necessary!
Over time, the inflamed gums become weaker, the number of bacteria under the gum line increases and the space between your gums and the teeth – the pocket – becomes deeper. As the pocket depth increases, you can no longer remove the bacteria in the pocket with the toothbrush. This can ultimately cause damage to the periodontium.
If gingivitis is treated in time, the gums will recover completely and there will be no permanent damage to the periodontium. This requires good oral hygiene and treatment by the dental hygienist or prevention assistant. The treatment is usually short-term and consists of oral hygiene instructions, a thorough cleaning of the teeth to remove plaque and tartar and polishing the teeth.
Remaining plaque can calcify into tartar. Tartar itself is not harmful to the gums because it does not contain living bacteria and therefore cannot cause inflammation. But many bacteria easily adhere to the rough surface of tartar, which is also difficult to brush away.
You cannot remove tartar yourself with your toothbrush. Therefore, tartar must be removed regularly by the dentist, dental hygienist or prevention assistant.
If gingivitis is not treated in time, it will - in a limited group of people - progress to the second stage of gum disease called periodontitis.
In periodontal disease, the jawbone and fibers are also involved in gingivitis. As a result, the fibers are affected, the jawbone recedes and the pockets become deeper.
The plaque in the recessed pockets is inaccessible to the toothbrush and brushes or interdental brushes. As a result, the inflammation spreads further and further into the depths and even more jaw bone will be lost. Periodontitis rarely causes pain, so it can go unnoticed for a long time. However, the dentist and dental hygienist can easily detect periodontal disease by examining the periodontium.
Treating periodontal disease can prevent further jawbone loss. Good daily oral hygiene, treatment by the dental hygienist and, in serious cases, referral to the periodontist are necessary.
After an extensive oral examination, a treatment plan will be discussed with you. The treatment usually takes more time than the treatment of gingivitis and consists of oral hygiene instructions, thorough cleaning of the deepened pockets around the teeth and molars and sometimes surgical treatment. The treatment requires a lot of discipline in oral hygiene and good motivation from the patient.
Not everyone who has gingivitis also develops periodontal disease over time. It is not yet fully clear how this happens. It is known that not everyone has the same types of bacteria in their dental plaque. Some people have 'more aggressive' bacteria in their dental plaque than other people, which puts them at greater risk of jaw bone loss. A bacteriological examination can determine which harmful bacteria are present in your dental plaque. Your dentist or dental hygienist removes plaque from your deep pockets and has it examined in a microbiological laboratory. Depending on the result of the test, antibiotics may be given during treatment to significantly reduce or eliminate harmful bacterial species. As a result, the treatment will give a better result.
Health, resistance and lifestyle habits also play an important role in developing periodontal disease. For example, diabetes, smoking and stress increase the risk of developing periodontal disease. However, until now it has not been possible to predict with certainty in whom gingivitis will develop into periodontitis. That is why it is wise to prevent gingivitis.