Periodontal or gum diseases are conditions that result purely from inflammatory causes. The inflammation is caused by depositions (plaques) and the subsequent dental calculus on the teeth surface. Both plaque and dental calculus can serve as a home for millions of bacteria. While plaque can be removed at home by brushing, dental calculus removal can only be performed in a dental office using professional techniques.
What symptoms indicate gingivitis?
The gums can be vividly red, swollen, painful. Bad breath or gum bleeding occurring spontaneously or when brushing your teeth and eating can also be caused by gingivitis.
What can be done in case of gingivitis?
We have good news! At this stage, periodontal disease can completely be reverted without any consequences. This condition can be cured by regular calculus removal (recommended every 6 or 12 months) and teeth polishing. In case gingivitis is present for a long term, it can extend to the bones and periodontium supporting your teeth.
What symptoms indicate periodontitis?
The symptoms or periodontitis may include the recession of the gum, the teeth become mobile and move away.
This condition causes the necrosis of tissues (bone loss) in all cases. Gum pockets are formed next to the teeth. Due to bone resorption, the dental roots are exposed and dental calculus can deposit on these surfaces as well. Bone resorption is sooner or later followed by gum recession.
What can be done in case of periodontitis?
Unfortunately, periodontitis cannot be cured according to recent knowledge, but its worsening and progression can be stopped. Thus the best method to cure periodontitis is prevention. The goal of the treatment is to achieve a stable, inflammation-free state.
As periodontitis is caused by dental calculus that is full of bacteria, the treatment begins with a thorough calculus removal in all cases. During the treatment sessions, dental calculus is removed even from the gum pockets, the number of bacteria is greatly reduced, the uneven surface of dental roots is smoothened, and the softened, infected dental tissue is removed (closed curettage). All of this is completely pain-free, performed under local anaesthesia.
The closed technique can be used effectively down to 6 mm of depth in case of teeth with a single root, and to 5 mm of depth in case of teeth with multiple roots. In such cases, a surgical intervention is required. The gum has to be detached from the teeth so that dental calculus, bacteria and inflamed tissue can be removed under visual control. After the intervention, the gum has to be fixed back to its place with sutures. This technique is called open curettage.
Regenerative interventions
In some cases, it is necessary to induce the formation of new bone tissue. In these cases, the open curettage is followed by placing a regenerative material (enamel matrix derivative, Straumann® Emdogain®) into the bone pockets. Regenerative materials can be combined with different bone substitutes and membranes, or these can be applied alone. These materials are completely tissue-friendly; they usually do not trigger an allergic reaction.
What is gum recession?
In patients who have a thin gum, periodontal diseases may result in receding gums besides or instead of pocket formation. Thin gums are less resilient against mechanical impacts (injuries, intense brushing), and this may also result in gum recession.
Apart from the obvious aesthetic disadvantages, dental sensitivity (against cold or hot temperatures or acidic foods and drinks) can also be caused by gum recession.
What can be done in case of gum recession?
Fortunately, we have some options to treat receded gums by now. These are all surgical interventions.
- Pulling the gum towards the dental crown: The gum is detached from the teeth and pulled towards the dental crown, then secured in place with sutures. The surgery is performed under local anaesthesia.
- Gum tissue graft surgery with tunnelling: This procedure is used when the thickness of the gums is insufficient. In such cases, a piece of connective tissue is grafted from the palate to the receded area. Here, the dentist forms small pockets for the grafted tissue. Both the palate and the gum receives sutures. This procedure is also performed under local anaesthesia.
In case you feel uncomfortable about tissue grafting, gum substitutes of synthetic origin can also be used.
Gingivoplasty procedures:
In some cases, you might be dissatisfied with the shape or contour of your gums, perhaps too large part of your gums is visible when smiling, or gum hypertrophy develops next to your teeth. Correcting these flaws with gingivoplasty is also available in our office.