Periodontics and Dental Implants


Treatment

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.

Dental implantology

What is a dental implant?

Dental implants are artificial roots that are inserted within the jawbone under local anaesthetic. Once the area has healed and the implant has integrated into the surrounding bone it is connected to a prosthesis or crown.

The replacement of missing teeth with dental implants offers a number of advantages including:

Replacing missing teeth without damaging or adversely affecting neighboring teeth.

Restoring the ability to chew all food including hard foods.

Maintaining and preserving the bone height, thus preventing collapse of the soft tissue (gums).

Improving function and aesthetics.

What happens when you lose a tooth or several teeth?

When you lose one or more teeth the gum and bone that surround the tooth lose volume and height, resulting in loss of function (mastication) and aesthetics. Alignment of the teeth in the dental arch can also be lost. A lack of teeth is called edentulous. This may be total, in which all the teeth are missing or partial, in which the patient is missing one or more teeth.

What is the success rate of dental implants?

Numerous scientific and clinical studies have shown that dental implants have a long-term success rate of over 95%.

There is no rejection of the titanium dental implant by the body?s immune system. Titanium is completely biocompatible with the body.

If an implant fails it results in movement, discomfort and swelling in the surrounding area. When this occurs the implant is extracted and, following a short period of healing, can be replaced with another of equal or greater diameter.

Same-day teeth

Our unit offers patients the use of new technology that can replace missing or severely damaged teeth with a crown or dental prosthesis within 24 to 48 hours.

This technique has a success rate of over 93% and avoids the need for removable dentures during the traditional period of ossointegration, which usually lasts from three to six months.

This technique is not suitable for use on all patients. Clinical and radiographic examination is used to determine whether a patient is a suitable candidate for this technique.

Guided implant surgery

Up-to-date technology enables us to plan and program your procedure with a computer program using a three-dimensional model obtained from digital radiography of the skull.

This computerized three-dimensional model is an exact copy of the maxilla and mandible jawbones. Using computer software, implants can be placed virtually in the jawbone. A surgical guide is then fabricated that mimics exactly the virtual position of the implants. This guide is used during surgery to insert the implants, providing for a minimally invasive, sutureless procedure with hardly any postoperative discomfort or swelling.

Dental and gingival aesthetics

AESTHETIC PROBLEMS OF THE GUMS

For a healthy and pleasant smile, the aesthetics of the gums are as important as the aesthetics of the teeth. Despite having beautiful teeth, the overall appearance of a patient’s smile may not be satisfactory or as they would wish due to changes in the form, contour and color of the gums. These may include:

GINGIVITIS AND PERIODONTITIS OR PYORRHEA

GINGIVAL SMILE (EXCESS GUMS VISIBLE WHEN SMILING)

RECEDING GUMS (GINGIVAL RECESSION)

GINGIVAL ASYMMETRY (ASYMMETRIC SMILE)

DEFORMITIES OF THE GUM AND BONE

ABSENCE OF TEETH

GINGIVITIS AND PERIODONTITIS OR PYORRHEA

Inflammation of the gums (gingivitis) and loss of supporting bone (periodontitis or pyorrhea) may cause redness and gingival tissue deformations that alter the natural appearance of the gum. Correct periodontal treatment returns the patient?s smile to one that is healthy, natural and pleasing.

GINGIVAL SMILE (EXCESS GUMS VISIBLE WHEN SMILING)

Gingival smile occurs when the gum is excessively enlarged, visibly covering the teeth when the patient smiles. This may be unsightly and/or create difficulties with oral hygiene. A simple and relatively gentle treatment is used to remove the excess gum and restore the normal form of the teeth, resulting in a natural and aesthetically pleasing smile.

RECEDING GUMS (GINGIVAL RECESSION)

In the case of narrow gums, gingival recession can occur as a result of periodontal disease, over-vigorous brushing, incorrect dental treatment or mechanical trauma (biting pens, piercings, etc..).

The receding gum exposes the root of the tooth, increasing the possibility of hypersensitivity to cold and heat, root decay, progressive loss of the gum and bone supporting the teeth and even tooth loss.

Treatment for receding gums involves the use of periodontal microsurgery techniques to cover the roots, restoring the shape, colour and contour of the gums to create an attractive, healthy smile.

GINGIVAL ASYMMETRY (ASYMMETRIC SMILE)

Asymmetric smile occurs when certain teeth are longer than others and the gum line is not at a uniform height, creating an unsightly appearance. This can be corrected using delicate periodontal techniques to re-contour the gum line.

In cases where the teeth are badly damaged, these periodontal procedures often accompanied by restorative or prosthetic treatments.

DEFORMITIES OF THE GUM AND / OR BONE

Tooth extractions usually result in the collapse ("sagging") or recession of the gum and bone. This is unsightly and can make hygiene and mastication difficult. Plastic periodontal procedures can reconstruct and/or preserve both the gum and bone.

ABSENCE OF TEETH

The loss of one or several teeth creates an aesthetic problem that is especially apparent if it occurs in the front teeth of the smile. One of the most reliable and attractive solutions is to insert a dental implant. This restores the missing tooth without damaging neighbouring teeth and results in a natural and pleasant smile.

HALITOSIS OR BAD BREATH

Halitosis is an oral condition characterised by persistent bad breath. It is different from transient oral bad breath such as that which may appear upon waking or after eating a meal.

CAUSES OF HALITOSIS

Contrary to widespread belief that the stomach is the main cause of halitosis or bad breath, 90% of cases actually originate in the oral cavity and can be associated with periodontal diseases such as gingivitis or periodontitis.

Oral causes

Periodontal diseases (gingivitis and periodontitis).

Insufficient oral hygiene.

Inadequate cleaning of dentures.

Dry mouth or xerostomia.

Incorrect fillings and prostheses.

Extraoral causes:

Diseases and disorders of the stomach and intestine.

Pulmonary respiratory infections.

Infections of the nose, trachea, or tonsils.

Acute and chronic sinusitis.

Diabetes.

Kidney or liver disease.

Tobacco.

TREATMENT OF HALITOSIS OR BAD BREATH

If the cause of the halitosis is oral, the treatment will be targeted at the direct cause that is producing it. In the case of periodontal disease, treatment should be performed by a periodontist. In the event that the cause is of extraoral origin, the periodontist will refer the patient to the most appropriate medical specialist, usually an otolaryngologist, gastroenterologist, endocrinologist or pulmonologist.

Prevention

Clínica Planas recommends that patients maintain appropriate day-to-day oral hygiene in order to maintain optimum dental health. Regular visits to the dentist or periodontist are vital for the prevention and diagnosis of all types of oral diseases. Dental visits are also aimed not just at maintaining a healthy mouth but also at achieving the highest possible aesthetics. Furthermore, preventing dental problems will save you money in the long term by drastically reducing your treatment costs.

Prevention begins with correct daily oral and dental hygiene but must be supplemented by regular visits to the dentist or periodontist. If you have not visited the dentist for some time, please contact us and we will be delighted to carry out a comprehensive dental and oral health review.

We provide instruction in the following daily oral hygiene techniques:

  1. Brushing technique. 
  2. Interdental hygiene technique. 
  3. Use of oral irrigators. 
  4. Use of mouthwash or mouth rinses. 


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