PERIODONTICS
Periodontics
The tissues that support the teeth are just as important as the teeth themselves. For this reason, periodontics addresses all pathologies that may affect the tissues surrounding and supporting the teeth (gums, periodontal ligament, and bone). Its goal is therefore to prevent, diagnose, and treat any potential issues that may arise. Your gums should look healthy and strong.
How can periodontal diseases be prevented?
Proper oral hygiene (twice a day) is one of the ways to prevent periodontal diseases. In this way, we can control the levels of dental plaque (or biofilm, a film of bacteria and food debris that deposits on the surface of the teeth and gums).
Through two methods:
- The mechanical method, which consists of conventional or electric brushing, the use of dental floss, and interdental brushes for wider spaces between teeth where the floss passes easily.
- The chemical method, which involves the use of specific toothpastes and mouthwashes or oral gels.
We could say that good hygiene is a key aspect for reducing disease levels, but it is not the only one. To make a proper early diagnosis of a potential periodontal problem, we must carry out regular maintenance and check-ups with the periodontist every 3 months, 6 months, or once a year, depending on each patient’s periodontal condition.
What are the most common causes?
Periodontal diseases can be classified as infections caused by multiple bacteria located beneath the gums, specifically between the gum and the tooth. If this bacterial dental plaque is not removed daily, it calcifies over time and turns into tartar.
In the case of gingivitis, the accumulation of bacteria (dental plaque or tartar) causes inflammation of the surrounding tissues, which manifests as redness, swelling, spontaneous bleeding or bleeding when brushing, spongy consistency of the gingival tissues, and no radiographic evidence of bone loss.
In addition to the presence of pathogenic bacteria and poor oral hygiene or the use of an incorrect brushing technique, there are multiple risk factors that also contribute to the development of periodontal problems, such as:
A parte de la presencia de bacterias patógenas y de una higiene oral
deficiente o el uso de una técnica de cepillado errónea, existen múltiples factores de riesgo que también ayudan a que aparezcan problemas periodontales, cómo:
Environmental Factors:
- Tobacco (the main factor), stress, and overweight;
- Genetics (family history), systemic diseases (diabetes, immunosuppression, blood disorders, osteoporosis, viral infections such as herpes);
- Hormonal changes (pregnancy, menstrual cycle, puberty);
- Some medications (anticonvulsants, antiepileptics, immunosuppressants, calcium channel blockers for hypertension, and oral contraceptives);
- And anatomical factors of the mouth, such as misaligned teeth or foreign objects like poorly fitted prostheses and overhanging restorations.
How do periodontal problems affect oral health, and what long-term effects can they have?
The presence of gingivitis or periodontitis causes a series of clinical manifestations that can alarm and bother the patient in their daily life.
In the case of gingivitis, if treated properly, it is a reversible condition, unlike periodontitis, where the destruction and loss of attachment of the tissues surrounding the tooth are irreversible.
The main oral clinical manifestations that we can observe are:
- The presence of persistent bleeding, pain, and gum recession;
- Bad taste in the mouth or halitosis;
- Tooth hypersensitivity and gum sensitivity;
- Problems chewing properly;
- Tooth mobility;
- And the worst negative consequence would be the total loss of the tooth.
Periodontitis, being an inflammatory disease, has also
been linked to endocrine and cardiovascular diseases, such as diabetes mellitus.
Having active periodontitis during pregnancy can also increase the risk of a possible premature birth.
We must pay close attention to periodontal diseases, as if left untreated in the long term, they can affect all the teeth and compromise our overall health.
Treatment
Los tres objetivos principales del tratamiento de las enfermedades
periodontales son los siguientes:
- Reduce or eliminate the bacteria responsible for causing the disease.
- Attempt to suppress, reduce, or modify the potential risk factors that worsen the condition;
- Provide favorable conditions so that it remains stable over time and under control.
The most common treatments we perform in the clinic are the following:
- Dental hygiene or prophylaxis – cleaning accumulated bacteria by removing plaque and tartar deposited on the gums;
- Scaling and root planing or curettage – has the same objective as hygiene, but in this case also aims to remove bacteria located beneath the gums;
- Periodontal access surgery – in cases where tartar is very deep, or there is an infrabony pocket that the curette cannot reach, or tartar is located between the roots of multi-rooted teeth, it is necessary to open the gum to remove this subgingival tartar and inflamed tissue, restore proper anatomy, and, if possible, regenerate the existing defect.
- Alargamientos coronarios, Gingivectomía o remodelado estético de las encías - pretende recortar y remodelar el contorno gingival de alrededor del diente y así poder exponer más superficie;
- Papilla amputation for gingival overgrowth – removing the enlarged gum tissue that affects proper hygiene and aesthetics;
- Mucogingival surgery – aims to correct defects in the shape, position, and amount of gum tissue surrounding the tooth.
CLINICAL CASES
Triclosán, qué es y sus posibles efectos
