Periodontics

It's the branch of dentistry that treats diseases of the connective tissue system and teeth support. This system is comprised of alveolar bone, connective periodontal fibers and cement.

Periodontal Disease

Once you get to know all about the tissues that involve the teeth, we can learn about the diseases that affect them:

BACTERIAL PLAQUE

Between the gum (free gum) and the tooth there's a reduced space - around 1 to 3 mm deep - where the bacterial plaque stays. This plaque adheres strongly to the surface of the teeth, and can be removed mechanically by brushing (interdental brushes) and flossing. The bacterial mass increases with the increased adherence of organisms, addition of new bacteria and synthesis of extracellular polymers.

As it builds up, the diffusion of the biofilm starts getting harder and harder. As a result of the quick use of oxygen by the surface bacteria deposited, and the poor diffusion through the biofilm source, oxygen gradient develops. Oxygen is a highly important ecologic determinant since the bacteria vary in its skills to grow and multiply in different levels of oxygen.

Food products dissolved by the saliva are an important source of nutrients for the bacteria plaque just below the gum line. Bacteria metabolism residues and bacteria themselves wind up affecting the gum, causing inflammation - gingivitis.

Once gingivitis settles and there's no action over the bacterial plate - plaque mechanical control - periodontitis is established.

PERIODONTITIS

Periodontitis is an inflammation that goes beyond the gum reaching the tissues that surround and support the teeth - bone tissue, connective periodontal tissue and radicular cement - forming then a periodontal pocket. In other words, a gap 3mm deep is created between teeth, causing bone loss.

Many bacteria found in periodontal pockets produce hydrolytic enzymes. These enzymes can break the complex macromolecules of the host into peptides and amino acids. There's a chance they are responsible for the destructive process of periodontal tissues. When the bone and mainly the periodontal link are destroyed, these tissues can no longer be regenerated.

This inflammatory process is followed by an immune process. Both act on the gums to protect people from microbial attacks so that they do not get into the tissues. Sometimes these defense reactions are detrimental to the host because its cells and the structure of adjacent tissues can be harmed. This way the inflammatory and immune reactions can go deep into the base of the pocket and involve the alveolar bone in this destructive process. This defense process can paradoxically explain many of the tissue injuries in case of gingivitis or periodontitis.

Some of the consequences of periodontitis are: loss of the tooth, dental mobility, dental sensibility, abscesses, gaps between teeth (diastema), esthetic modifications of the smile and occlusion problems.

Gum is noticeably damaged when:

Red and swollen;
Bleeds while brushing, even if you put some strain on it and floss it correctly;
There's habitual bad breath;
There's calculus or tartar;
There's pus;
There's a bitter taste in the mouth;
Teeth become loose (mobility);
There's migration of the position of the teeth (teeth are opening);
There's gum retraction.

Note

The cause to periodontitis is the bacterial plaque. The only way to fight it is by brushing and flossing it correctly, following your dentist's orientation.
There are some patients who are prone to periodontal diseases whereas others are not. There's no cure for periodontal diseases. It can only be controlled.
There's no such thing as a drug to cure periodontal disease. The control consists of brushing and flossing to remove the bacterial plaque mechanically.
Beautiful teeth do not necessarily mean healthy teeth.
Diagnosing periodontal disease can only happen through a thorough examination of the teeth.
Control of periodontal disease should be done every three months. Each case is a case and only the dentist can advise you on how often this control should be done.

Motivation

Patient's motivation is the hardest part of the treatment. A patient with periodontal disease has to learn how to take well care of his teeth. This can only happen if they finally understand the importance of removing the plaque mechanically.

What does a periodontal treatment consist of?

It's the removal of the bacterial plaque and the calculus (tartar). Get rid of the gum inflammation, pain, periodontal pocket, pus and the infection. Preserve the gum and the bone mass.

In short, promoting periodontal health so that it does not occur again, avoiding tooth loss.