Periodontics and dental implants
What is Periodontics?
Periodontics is the dental specialism concerned with the prevention, diagnosis and management of diseases of the gums and supporting apparatus of the teeth. These diseases are known as periodontal diseases, the most common being gingivitis and periodontitis ("pyorrhea"). The professional who specialises in the diagnosis and treatment of these diseases is the periodontist.
What are periodontal diseases?
Periodontal disease affects 90% of the population and is the world´s leading cause of tooth loss. Periodontal disease is an infectious inflammatory disease that affects the gums and the supporting structures of the teeth. It is caused by the build-up of bacteria and plaque ("scale") around the teeth. When it only affects the gums it is known as gingivitis and when it affects the gums and the bone supporting the teeth it is known as periodontitis ("pyorrhea"). There can be genetic susceptibility to periodontal disease as well as risk factors that can create a predisposition to it, the major ones being tobacco and diabetes.
What are the signs and symptoms of periodontal disease?
Many people are unaware that they have gum problems because these diseases are usually painless except in very specific cases. In fact due to its high prevalence and the fact that it often goes unnoticed, it known as the invisible epidemic. If you suffer from more of these symptoms you should see a gum specialist or periodontist:
- Red gums.
- Inflamed gums.
- Gums that bleed when you brush them.
- Bad taste in your mouth or bad breath (halitosis).
- Movement of the teeth.
- Hypersensitivity of the teeth (sensitive teeth)
- Receding gums.
- Abscesses or boils on the gum.
- Separation of or gaps between the teeth.
What is the treatment?
The aim of the treatment is to eliminate the build up of bacteria and tartar from around and inside the gums (in what is called periodontal pockets or pyorrhea pockets). In order to achieve this, a mechanical treatment is carried out to remove the infection and inflammation using manual tools (curettes) and/or sonic and ultrasonic devices. The treatment is not painful and is usually performed under local anaesthetic. Minor surgical procedures will be necessary in moderate and/or advanced periodontitis in order to access the very bottom of the pockets. In some cases we use techniques to regenerate bone destroyed by periodontal disease. Being a chronic disease (like diabetes), once periodontal disease is treated maintenance visits are required and periodic reviews should be carried out every three to six months to prevent relapse and recurrence of the disease. Smoking should also be avoided to prevent recurrence.
What is your prognosis?
The long-term prognosis is usually excellent provided the patient performs oral hygiene techniques correctly (brushing, interdental cleaning, mouth-washing); attends maintenance visits and avoids or significantly reduces smoking. A small percentage of cases (> 5%) do not respond to treatment but these are usually smokers or patients with a strong genetic disposition.
Is periodontal disease contagious?
Although periodontal diseases are infectious diseases caused by bacteria, they are not contagious in the same way as flu or pneumonia for example. However, the bacteria causing these diseases can be passed from one person to another and if a person (host) is particularly susceptible or has certain risk factors the disease may appear. It is recommended that the partner and children of patients with periodontal disease attend a periodontal examination.
What are the treatment options for a missing tooth?
When periodontal disease is detected in advanced stages, one, several or all teeth may be lost. In these cases the best solution is to replace them with dental implants, a reliable technique offering highly aesthetic and effective long-term results. If it is not possible to fit dental implants other alternatives are available such as fixed bridges or removable dentures.