Periodontal disease is an infectious case that affects the gum and the soft/hard tissues which surround the teeth.
Teeth are recessed in the jaw bone. Between bone and root surface of tooth there is a fibroelastic tissue called “periodontal ligament”. This tissue has a function to transfer the pressure on the teeth to the jaw bone through softening. These structures are covered with gum and mouth mucosa. The early period of gum disease is called “gingivitis”.
Gingivitis is the clinical picture that shows the situation of gum. The inflammation of the gum by the bacterias in the plaque is the beginning of disease.
Plaque is the sticky and colorless film sheet that continuously occurs on the teeth. In this period, there is redness, bleeding and swelling on the gum. Usually, the patient feels no pain in this period. It usually occurs because of insufficient oral care.
Through professional tooth stone cleaning or regular oral care at home, it’s obtained a quick recovery. This disease reaches the stage of periodontitis, if it is not treated. Periodontitis is the destruction of gum febrile and alveoli bone that support the tooth. It is an infectious process that begins in gum through the effect of bacterias. There is a 1-2 mm physiological sulcus between gum and tooth in the place where healthy gum meets tooth. In periodontitis, with time, this sulcus gets deeper, turns into periodontal pocket through attack of bacterias.
The most important purpose in gum therapy is the reduction and slowing of infectious reaction. In the first step of therapy, tooth stone, bacteria plaque and pockets are removed. To remove the tooth stones and bacteria plaque, ultrasonic devices (cavitron) are used. It is very important to begin the therapy early as in the other diseases. By the therapies with hand- and ultrasonic devices, periodontal destruction can be slowed or stopped.
* If the gum disease is in the stage of gingivitis, tooth stone cleaning and professional oral care are enough. If the disease is in the stage of periodontitis, that means, if being of pocket and bone destruction begin, tooth stone cleaning and the treatment of smoothening of root surface are necessary. This therapy is made in 2-4 treatments by periodontist. This kind of therapy requires skill, sensitive touching and experience. After this process, root surface turns into a bright and slippery surface. So it’s obstructed that tooth stone and bacterias hold onto the surface. In the stage of recovery, there must be a connection between gum and bone. The recovery period is 4-6 weeks.
* In addition to the mechanic therapies by the dentist, the use of mouth rinse and the systemic use of antibiotic can be necessary.
* Since diagnose, beside all these therapies, the oral care of patient is very important. The chance of success of therapy methods gets lower, if the patient doesn’t cooperate with dentist.
* Because the patients with periodontitis are in the risk group, and because of the possibility of repetition of illness, the watching of illness is very important. The patient must be checked regularly, the effectiveness of therapy must be observed.
* It must be seen, if the patient cooperates with the dentist or not, he has to be motivated for oral care in each treatment. The dentist must remind the patients that the therapies are painless, that they take short time.
* Bad, old fillings and prosthesis that cause the beginning and development of gum infection in mouth, must be changed.
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