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Periodontology

A periodont is the aggregate of tissues surrounding a tooth: bone, tooth supporting ligatures and gums. Such structures are as important to oral health as teeth. Periodontology covers all procedures relating to these structures.

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There are two main and most frequent periodontal diseases: gingivitis and periodontitis. The main causes of them are bacterial plaque continuously accumulating and remaining on the teeth and tartar. Smoking, poor nutrition, stress, genetic heritage, medicines taken and diabetes mellitus have a great effect on the development of the diseases.

  • Gingivitis. This is a gums inflammation manifesting itself as redness, swelling and bleeding of the gums. At this stage the disease is curable, as the damage only covers the gums, while the bone and tooth supporting ligatures remain healthy. Often, the first symptom is bleeding of the gums noticed when brushing teeth. Gingivitis is usually cured quite easily: one must observe the oral hygiene recommendations, brush teeth thoroughly and undergo professional oral hygiene on a regular basis. Uncured gingivitis progresses to the more serious form (periodontitis) all its stages uncured, it finally ends with the loss of teeth. The timely start of appropriate treatment can stop the development of the disease.

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  • Periodontitis. This is an inflammation that covers the gums and other periodontal structures. The gums redden, bleed and swell up away from the teeth, forming a “pocket” between the teeth and the gums; the teeth look extended because the gums and the bone decline, spaces between the teeth increase, an unpleasant smell and taste appears and eventually the teeth become loose. Periodontitis is classified as mild, average or serious, depending on how much of the bone is lost. However, if the disease does not stop or pass on its own and goes through.

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How is this performed?

  • The first stage of treating periodontitis is professional oral hygiene. The plaque and tartar are removed with the use of special instruments to reduce inflammation. Depending on the difficulty of the condition, the patient may need several visits with the specialist. The doctors also explain the importance of personal oral hygiene; the patient is trained to care for their teeth properly and advised on what remedies should be used.

The first impression after the procedure may be that the situation got worse: the teeth may become sensitive and the tooth root surfaces may open slightly. However, such sensations are temporary. Sensitivity disappears within several weeks, the gums heal and the swelling disappears as well. Oral hygiene is essential to protect teeth damaged by periodontitis in order not to lose them. Shallow tooth pockets disappear, deeper ones noticeably decrease and the teeth become less loose under the appropriate care of teeth. The procedure may be repeated several times to improve the condition of the patient without surgical treatment, that is, without passing to the second stage of treatment.

  • The second stage applies in cases when hygiene alone fails to manage the disease. Under local anaesthesia, the so-called “patch surgery” is performed: the gums are surgically withdrawn from teeth to see and reach the tartar unable to be removed during the regular procedure. After a thorough cleaning and polishing of the tooth surfaces, the gums are reinforced along the seams.
  • The third stage is a supportive treatment. Whereas periodontitis is a disease that is usually possible to be stopped rather than cured for good, the observance of all recommendations and regular visits with an odontologist-periodontologist are of high importance. Otherwise, the disease relapses and becomes even harder to manage. Supportive treatment means 2-4 visits with an odontologist a year for a revaluation of the current condition of the teeth, performance of professional oral hygiene and decisions on further treatment. Thorough daily care of the oral cavity and regular visits with specialists will help you preserve your own teeth for many years.

Other procedures

  • Tongue or lip band plastics.

The tongue is attached to the bottom of the oral cavity and the lips to the gums through a mucous membrane fold called the band. In some cases, the tongue or lip band is too short and this aggravates tongue or lip movement and speech, may cause pain or even affect the position of the teeth. The band plastics procedure is simple, painless and really short; it is usually performed with a laser: a small incision is made in the band to loosen it.

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  • Tooth crown extension surgery

This procedure is required before prosthesis, when the height of the remaining tooth is insufficient to make a high quality crown. The height of the gums around the tooth undergoing the prosthesis is reduced, thus extending the crown.

  • Gingivectomy

This is a procedure, during which a part of the gums tissue is removed surgically. It is usually performed with a scalpel or specific instruments by cutting off the undesirable part of the edge of gums. Electric surgery (to cut tissues with high frequency electric current) or a laser are employed for the procedure more and more often because such methods usually mean faster healing and less discomfort after the procedure. Gingivectomy is performed under local anaesthesia and is thus painless. It usually lasts from a couple of minutes up to one hour, depending on the amount of tissue to be removed.

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Gingivectomy may be performed due to several reasons:

  •  In cases of more serious forms of periodontitis, the gums’ pockets accumulate plaque and bacteria that encourage the further development of the disease. Gingivectomy is then performed to make the treatment easier: the pockets decrease and become easier to clean and maintain.
  • Tooth crown extension is performed after a gingivectomy around the required tooth.
  • Some medicines and uncommon diseases cause a very noticeable thrive (overgrowth) of gums; it looks abnormal and disturbs chewing and speech. Gingivectomy removes the excess tissue and restores the normal look of the gums.
  • People with small teeth and a wide smile often have the so-called “gums smile”, when their smile reveals teeth and gums under the upper lip. Gingivectomy improves the aesthetics of their smile.

Gums are covered with a specific bandage for 1-2 weeks to protect the wound after the procedure. The normal look of the gums is restored within 3-4 weeks and they fully heal within two months. The duration of healing depends on the patient and the extent and method of the surgery performed, and is thus individual.

The periodontologists of the DentalPRO clinic will explain the possibilities, necessity, course and safety of any of the above procedures and answer all your questions during your consultation.