PERIODONTOLOGY
What is Periodontology?
Periodontology is the branch of dentistry that deals with the diagnosis, prevention, and treatment of gum diseases. Teeth are surrounded by a complex tissue called the periodontium. This tissue includes the gum, the membrane surrounding the root canals, and the alveolar bone, and its function is to protect and support the tooth. Healthy gums appear coral pink, have an orange peel texture, do not bleed when brushed, and cover the neck area of the tooth.
What is Periodontal Disease?
Periodontal diseases are inflammatory diseases affecting the gums and the bone tissues supporting the teeth. According to statistics, after tooth decay, gum diseases are the leading cause of tooth loss. Moreover, the likelihood of tooth loss due to periodontal disease is 2 to 3 times higher compared to normal tooth decay. In adults, 70% of tooth loss is caused by diseases involving the gums and jawbone.
Periodontal diseases respond easily and successfully to treatment when diagnosed early. Therefore, it is important to visit your dentist for regular check-ups. Bleeding that occurs when biting hard food or brushing teeth is an immediate sign that you should see your dentist.
The inflammation and disease of the gums is called gingivitis. In gingivitis, the gums are easily bleeding, red, and painful swollen areas. If gingivitis is not treated, the disease progresses deeper into the jawbone and eventually leads to tooth loss.
Periodontitis
The most common cause of tooth loss in adults is not decay but gum disease. It is the next stage of untreated gingivitis. It involves the beginning and progression of loss in periodontal tissues and alveolar bone. The circular fibers connecting the tooth to the jawbone dissolve, creating pathological pockets called "pockets" between the gum and the tooth. The accumulation of microbes in these pockets causes infection to progress, damaging and dissolving the tooth root and alveolar bone.
During periodontitis, a bluish-red coloration may appear on the gums. As gums recede, the roots of the teeth become visible and appear longer. This is an urgent warning to visit a dentist immediately. If untreated, the bone holding the tooth dissolves, teeth become loose, and tooth loss becomes inevitable.
Types of Gum Recession:
General Gum Recession: If a person has gum disease, bacteria causing bone loss generally affect the entire mouth, leading to bone loss and the gum following the bone and receding. In this case, the person must receive gum treatment. Early symptoms such as bleeding and bad odor will help you recognize gum problems at an early stage.
Localized Gum Recession: These are recessions seen on individual, sometimes prominent teeth, sometimes canines or corner teeth.
What is the Treatment of Gum Diseases?
Even if you maintain ideal oral care, you may develop gum disease due to genetic reasons. The first step in treatment is a thorough cleaning of tartar by the dentist and the patient's attention to oral hygiene, which can completely heal the disease. In more advanced cases, scaling and root planing (removal of plaque and tartar deposits on teeth) and creating a smooth root surface are performed. Scaling removes bacteria and irritants causing inflammation in the gum. Usually, this treatment is sufficient to re-adapt the gum to the tooth or to shrink the pocket containing bacteria. In early stages of gum disease, cleaning tartar, removing plaque, and ensuring a smooth root surface followed by effective daily oral care are sufficient for successful treatment.
Surgical treatment includes flap operations for more advanced cases. If the dissolved bone needs support or bone grafts are needed to regenerate bone in the area, these grafts can be applied. This promotes new bone formation. However, the new bone never reaches the original level. Flap operations involve stitches.
After the operation, you need to come to follow-up appointments at the intervals your doctor recommends. Your doctor will monitor your gum condition, inform you about post-treatment care, and provide necessary instructions.
What is Gum Shaping (Gingivoplasty)?
Gingivoplasty is a minor surgical procedure applied when the gum shape is irregular. Under anesthesia, the dentist shapes the gum contour using a scalpel, laser, porcelain rotary instrument, or cautery device. This procedure is generally used to correct fibrotic tissues formed after inflammatory conditions, tissues around crowns or implants, or gum folds formed during orthodontic treatment. It is a relatively easy procedure and you can use your teeth on the same day. Activities such as eating, speaking, and brushing can be continued after the procedure.
How to Prevent Gum Diseases?
The primary responsibility for preventing gum diseases lies with the individual. To maintain healthy teeth, daily oral care must be done correctly and regularly. Teeth should be brushed regularly and floss should be used. Bacterial plaque on teeth must be removed. Regular dental visits for check-ups and treatments should be observed.
It should be remembered that the mouth is a whole during brushing. Therefore, gums should be brushed together with the teeth. The toothbrush should be placed at the junction of tooth and gum and brushed with circular motions. Horizontal or vertical movements are incorrect and harm the gums and cause tooth wear. This circular motion should be repeated by moving to clean each tooth surface. Not only the front surfaces but also the back surfaces of teeth should be brushed this way.
It is important to remember that teeth have 5 surfaces, only three of which can be cleaned by brushing. The remaining two surfaces, which face adjacent teeth, must be cleaned with dental floss. When using dental floss, always insert clean floss between the teeth and pull it from the gum toward the tooth (from red to white). The floss should never be moved sideways within the gap.
