Periodontics
Periodontics is a branch of dentistry that deals with the supporting structures located around the teeth which are known collectively as the periodontium.
These periodontal structures include:
The gingiva or gums, The alveolar or jaw bone, The cementum which connects the tooth to the jaw bone by anchoring it to the periodontal ligament, The periodontal ligament which holds the tooth in place in the jaw bone
Preparation, oral hygiene instruction, motivation:
We can teach you proper oral hygiene and effective tooth brushing techniques. We also teach you how to incorporate special cleaning devices and methods into your daily oral hygiene practice, and offer regular check-ups and professional tartar removal by our dental technician every six month
Screening for periodontal disease, microbiological testing and full mouth disinfection
If you have gum disease we follow a special cleaning protocol. There is scientific evidence that gum disease is caused by special bacteria. If your symptoms suggest aggressive periodontitis, we take tissue samples from the pockets around your teeth and send it to the lab to be examined. If the test confirms the presence of bacteria in your mouth, we start a full mouth disinfection protocol (Quirynen protocol). Non-surgical treatment of periodontitis usually involves a series of appointments on a weekly basis. We will give you oral antibiotics targeted at the type of bacteria found in your mouth and perform professional dental cleaning to remove bacteria deposited in tartar on your teeth.
The cleaning protocol also involves a curettage, in which we remove inflamed tissue from under the gum and infected tooth material from around the root. This procedure is performed under local anaesthesia, which means we make the gum numb and you won’t feel any pain. We will use a special sterile instrument (Gracey hand piece) which has a sharp edge to scrape the surface of the root and a rounded tip to gently remove the diseased tissue responsible for the inflammation in the gums from the pockets.
The purpose of this treatment is to clean all pockets in your mouth, which together with the use of oral antibiotics can prevent the recurrence of bacterial infection. Regular use of Chlorhexidine rinse and daily brushing of your tongue is also part of the treatment. As part of our so called Recall Program, you will be asked to come back for a check-up in one month
Examination & Treatments
Closed curettage: cleaning under the gum in which we remove inflamed tissue and pocket lining, as well as infected tooth material from the root with special Gracey instruments.
Evaluation:
You will be asked to come back in 3-4 weeks for a follow-up examination of your gum and the pockets so that we can check the recovery process and the effectivity of your oral hygiene. We can also decide about further treatment. If it is required we will correct faulty edges of fillings, polish rough surfaces or replace unsound fillings in order to eliminate further causes of gum disease. It might also be necessary to grind your teeth to balance the forces that exert pressure on your teeth when you are chewing.
Splinting:
Splinting may be required at various stages of your treatment. You may require temporary or permanent splints. Splints prevent the mobility of your teeth, therefore they facilitate the healing process. Splinting involves attaching glass fibre strips on the back surfaces of your teeth using aesthetic liquid bonding materials. Such splints can fix the position of your teeth aesthetically. Splints are also required before regenerative surgical interventions.
Open flap debridement:
Pockets that are deep or cannot be accessed by closed curettage are cleaned under direct visualisation, which means that we perform open surgery. We do it under local anaesthesia (numbing) using state-of-the-art dental instruments. We make little cuts in the gum on the external and internal sides of your teeth (flapping) to see under the gum and clean the area thoroughly. We close the site of the operation with stitches which we clean regularly and remove after one week.
Re-evaluation: This phase is very important because we can monitor how your gum responds to the treatment and decide what further treatment is necessary. We measure pocket depth, look for the presence of bleeding and signs of inflammation, and check your oral hygiene. Finally, we do single tooth risk assessment again. With this careful approach we can find the most beneficial treatment for you so that you can retain your teeth in the long run.
Single tooth risk assessment:
We evaluate each tooth and classify them according to the expected prognosis. Tooth risk assessment means evaluation of tooth position within the dental arch and testing the furcation involvement of teeth with multiple roots, as well as assessment of iatrogenic factors, residual periodontal support and mobility.
Gingivitis
Gingivitis is a curable inflammation of the gum around your teeth. At an early stage the disease only affects the margin of the gum, and it can be reversed by proper cleaning and local medications. However, if it is left untreated, the inflammation spreads to deeper tissues and causes severe periodontal diseases. The inflammation is usually caused by the build-up of dental plaque, a hardened deposit accumulating at the gum margin. There are other causes as well, such as certain medical conditions, hormonal imbalance, medications, bacterial, viral or fungal infections, or an ill-fitting crown. There is an increased risk of gingivitis in pregnancy.
It is essential to treat gingivitis, otherwise the inflammation spreads to deeper tissues leading to recession of your gum and bone loss. Your teeth become loose and finally fall out.
The cornerstone of treatment and prevention is good oral hygiene. We help you learn proper brushing techniques, and our personal oral hygiene program can help you to have healthy teeth.