Periodontology
It is the branch of dentistry that examines the structure of the hard and soft tissues surrounding the teeth, diagnoses the diseases affecting these tissues, treats them, and then ensures the maintenance of the acquired health. Gum disease (Periodontitis) is called gingivitis in the early stages.
Symptoms of gum disease:
bleeding gums,
Dark red or purple colored gums
Swollen and sensitive gums,
Gums that can be easily separated from the teeth,
Inflammatory discharge between teeth and gums,
Teeth that are loose and gradually moving away from each other,
It is a constant bad breath.
Gum disease (Periodontitis) can be returned to its former health if diagnosed and treated at an early stage. Sometimes just better oral care and professional scaling may be enough for treatment. The type and stages of treatment may vary depending on the degree of gum disease. In addition to scaling, curettage and root planing may be recommended. Plaque and tartar are removed from the gum pocket using special dental tools. In cases where this treatment is not sufficient, gum operations are also performed. Gum diseases do not heal on their own or with treatments such as antibiotics, mouthwash, and vitamins. It must be treated by a dentist or gum specialist.
As with every disease, early diagnosis and treatment of gum diseases will protect both teeth and gum health. When these diseases are left untreated, they can result in tooth loss. Since it does not usually cause any pain, it is still one of the most common causes of tooth loss in our age. To prevent gum disease, proper tooth brushing at least twice a day, flossing at least once, and regular dentist visits every six months are required.
If there is not adequate and regular oral hygiene, bacterial plaque forms, which is the common enemy of teeth and gums. This bacterial plaque is a sticky and colorless layer of microbes that accumulates on the teeth and causes tooth decay and gum diseases.
Crooked teeth,
Factors such as mouth breathing and dry mouth
rotten teeth,
Poorly and poorly made fillings and prostheses,
They increase the accumulation of microbial dental plaque. Bacterial plaque is initially soft and can be easily cleaned by the patient by brushing. If it is not cleaned and accumulates, it hardens under the influence of calcium and phosphate ions from saliva and forms dental stones. Dental tartar causes bacterial plaque, which is the main cause of gum disease, to accumulate more easily on the teeth. The formed tartar can only be removed by the dentist with hand tools or ultrasonic cleaners. Having the tartar cleaned is not harmful, it is a necessary procedure for the teeth and gums.
Gum disease (periodontal disease) is an infectious disease that affects the tissues surrounding and supporting the teeth and can be seen in all age groups. However, it is seen much more frequently in adults. Even teeth that have no decay can be lost due to this disease. Since it is usually painless, its symptoms are difficult to notice by the patient, and in most cases, the doctor is consulted late.
gingivitis
The beginning of gum disease is gingivitis. This disease causes redness and swelling of the gums, as well as bleeding during tooth brushing and flossing. Healthy gums are pink in color, tightly adhered to the teeth, and have sharp edges like a knife edge.
Periodontitis
Gingivitis heals completely with dentist treatment and good oral care. However, if the disease is not treated, it turns into a more advanced form called "periodontitis" over a long period of time. In this disease, the fibers connecting the root of the tooth to the jawbone melt, thus creating a space called "pocket" between the gum and the tooth. More bacteria, bacterial toxins and food residues accumulate in the pocket, thus the infection spreads to the deep tissues, melting occurs in the bone supporting the teeth and teeth are lost. Research shows that periodontal diseases come first among the causes of tooth loss in the adult population, with a rate of 60-70%. Periodontitis may initially develop without visible symptoms. Therefore, regular examination by the dentist is very important for early diagnosis of the disease.
Common symptoms of periodontitis: red, swollen gums, gingival recession/growth, sensitivity of the gums, bleeding gums, sensitivity on exposed root surfaces, tooth root decay, inflammation between the tooth and gum, gaping in the teeth, elongation, rotation, shaking, abscess formation, bad breath and It can be listed as tooth loss. While initial and moderate periodontitis is treated with non-surgical methods, advanced periodontitis is treated with additional surgical methods.
Recent studies have shown that individuals with gum disease have an increased risk of developing some systemic diseases. There is a relationship between gingivitis and diabetes, cardiovascular diseases and some respiratory system diseases.
After periodontal treatment, patients should be examined regularly by the dentist, plaque control and new tartar accumulation should be removed from the environment. But it should not be forgotten that; To maintain what has been achieved with periodontal treatment, no procedure can be more beneficial than effectively implementing daily oral care procedures. However, despite ideal care, periodontal destruction continues in some cases. In these cases that do not respond to traditional treatments, a positive response is obtained with additional antibiotic treatment. In addition, against the risk of oral microorganisms spreading to the body through blood after surgical treatment and during periodontal treatment; Antibiotics can be used for preventive purposes in patients with uncontrolled diabetes, endocarditis, organ transplantation, coronary bypass, heart valve replacement and other risk groups. However, in the vast majority of cases of gingivitis and periodontitis, antibiotic use is not necessary. Unnecessary and incorrect use of systemic antibiotics causes serious bacterial resistance, creating a danger for the individual and society.
Gum Recession
It has been reported that different factors have an effect on gingival recession. These; They can be basically listed as structural factors, irritant factors, gingivitis and periodontal diseases. Structural factors such as long muscle attachments, morphology of tooth roots, improper dental closures, teeth being located outside the dental arch, as well as trauma, incorrect tooth brushing, brushing duration and frequency, abnormal orthodontic forces, bacterial plaque and tartar, bad habits (frequently placed between the teeth). Irritating factors such as frequent insertion of foreign objects such as toothpicks, pins, nail biting, pencil biting, etc.), faulty fillings and dentures also cause gingival recession.
Individuals with receding gums may experience various complaints due to recession. These,
Root/tooth sensitivity
root rots
aesthetic problems
Fear of losing teeth
pulp diseases
As a result of gingival recession, the clinical crown lengths of the teeth increase. Especially in the front area, patients feel as if their teeth have lengthened and aesthetic problems arise. For most individuals, this is more important than hypersensitivity and root rot.
In the treatment of gingival recession, treatment should be directed to the cause, and then, if necessary, gingival recession can be closed by resorting to various surgical methods. For example; When recession develops due to incorrect and hard brushing or various habits, these factors must first be eliminated, or if the causative agent is periodontal disease, the disease must be controlled and its progression prevented. In cases that are extremely problematic and cannot be treated surgically, restorative procedures such as fillings and crowns may be used.
FACTORS THAT CAUSE GUM DISEASE
Although the main cause of periodontal diseases is bacterial plaque, other factors such as smoking, stress, systemic diseases, medications and nutrition can also affect gum health. You should definitely inform your doctor about such situations before starting dental treatment.
Cigarette
In addition to its known general harms, smoking also increases the risk of periodontal disease. Studies have shown that smokers develop more tartar than non-smokers, smokers have deeper pockets, and have more loss in bone and tooth-supporting tissues. In addition, due to the chemicals in cigarettes and the heat effect, the symptoms of gingivitis are masked in many cases. For this reason, since the actually inflamed gum does not bleed, the patient is often unaware of periodontal disease and other problems.
Medicines
Some drugs have a negative effect on oral health by causing specific changes in the gums and affecting other tissues in the mouth. These; Birth control pills, antidepressants, some blood pressure and heart medications, immunosuppressive drugs, drugs used in the treatment of epilepsy, birth control drugs, some drugs in spray form containing cortisone used in the treatment of asthma cause an exaggerated response to local irritants in the gums. In such a case, the dentist and medical doctor should consult.
In some special periods (adolescence, pregnancy and menopause), the gum tissue is also affected due to changes in hormones. Therefore, it is of great importance to pay extra attention to daily tooth brushing and flossing to keep bacterial plaque under control during these periods.
Systemic Diseases
Some systemic diseases such as diabetes and diseases affecting the immune system also affect the severity of periodontitis and its response to treatment. Diseases that affect the body's defense system, such as leukemia and AIDS, can worsen the condition of the gums. In cases where people are highly susceptible to infection, gum disease is often much more severe and more difficult to control.
diabetes
Diabetes is a disease that causes special complications along with hyperglycemia due to the absence, insufficiency or ineffectiveness of the insulin hormone. The most typical change seen in the mouth of diabetic patients is dry mouth, which does not cause any significant difference in the rate or amount of saliva flow. Uncontrolled diabetics may experience dryness, burning in their mouths, and loss of taste sensation organs, the lingual papillae. In addition, when blood sugar increases in diabetics, the amount of glucose in the gum grooves doubles. Thus, with the increase of glucose in the salivary glands and gums in the mouth, the bacterial flora living in the mouth is also negatively affected. Patients with diabetes have a high risk of developing infection. For this reason, periodontal diseases may develop more easily in diabetics and cause more severe destruction. Especially in uncontrolled diabetes, the severity of periodontal disease and tissue destruction increases further. It has been shown that diabetes is a factor that accelerates and exacerbates alveolar bone destruction in individuals with periodontal disease.
Oral care in diabetics should be more than it should be under normal conditions. Diabetic patients should pay attention to their oral and dental care, as well as be under regular dentist control. If there is a problem in the mouth or many decayed teeth, this may create a focus of infection and increase blood sugar. Difficulties may be encountered in controlling and regulating diabetes, which causes severe and widespread oral and dental problems.
Stress
Studies have shown that stress is also a risk factor for periodontal disease. These studies have shown that stress makes it harder to fight infections and increases susceptibility to periodontal disease.
Not enought feeding
Inadequate and malnutrition negatively affects the body's immune system, making it difficult to fight infections. Periodontal diseases are also serious infections, and in case of malnutrition, the severity of gingivitis may increase.
BAD ODOR
Although bad breath is generally due to poor oral hygiene or an oral disease such as advanced gum disease, cavities, semi-buried wisdom teeth, it may also be due to a serious systemic disease that requires diagnosis and treatment. However, it often originates from the mouth. Treatment should be directed towards the underlying cause.
Bad breath affects a large segment of society and causes significant social and psychological distress in those affected. Reasons include:
Poor oral hygiene or dental problems such as advanced gum disease and cavities,
• Many foods and drinks, especially garlic and onion, can cause temporary bad breath.
• Anticholinergics, antidepressants, diuretics, antiparkinsonian and chemotherapeutic agents that cause dry mouth due to smoking and sometimes drinking,
• Many systemic diseases such as diabetes, stomach problems, liver diseases, throat infections, sinusitis,
• Faulty restorations (flooded restorations, leaky crowns) and food accumulation areas
• Many vitamin and mineral deficiencies, such as vitamin A, vitamin B12, iron or zinc deficiency, lead to dryness in the mouth and fissure in the mucosa, which contributes to halitosis due to the adhesion of food and tissue residues.
Treatment; It includes professional oral cleaning along with oral hygiene training, especially the treatment of periodontal diseases and, if necessary, referral of the patient to a medical doctor or specialist.
TOOTH STONE CLEANING
Is dental scaling a painful procedure?
There is usually no pain during dental scaling. Scaling is one of the simplest and painless treatments applied in dentistry. Usually there is no need for local anesthesia (numbing). However, in individuals with low pain threshold or severe gingival recession, a local anesthesia can be applied to eliminate sensitivity. Thus, the patient does not feel any pain.
Does dental scaling damage teeth?
No. Because in the scaling process, not tooth tissue but formations that do not belong to the tooth surface (plaque, tartar) are removed. In addition, hand tools or ultrasonic devices used in dental scaling do not cause scratches on the tooth surface.
Will there be bleeding during dental scaling?
It is natural for a very small amount of bleeding to occur during dental scaling, and most of the time the patient is not even aware of this situation. Bleeding is expected to be slightly more in individuals with advanced gum disease. However, there is no bleeding as in surgical procedures.
Is it okay if I don't have dental scaling?
Dental tartar is the causative factor of all gum diseases. Scaling is a necessary treatment for teeth and gum health. Thanks to a dentist check-up every six months; The tartar that forms in areas where we cannot brush well is cleaned by the dentist. There is no harm in this either. If tartar does not form very frequently, tartar cleaning should be done at the intervals recommended by your physician.
Should teeth cleaning or fillings be done first?
Fillings, prostheses, implants, etc. Before dental treatments, gum disease should be treated by cleaning the teeth.
Will tartar form again after scaling?
If you think that tartar is quickly forming again after having your teeth cleaned, you should review the way you brush. It is in your hands to prevent the formation of tartar again after teeth cleaning. You can achieve the desired oral health by brushing and performing facial care as instructed by your dentist.
Will there be gaps between my teeth after scaling?
Sometimes, in mouths with excessive tartar, large gaps can be felt after cleaning or the exposed root surfaces may cause sensitivity; In such cases, patients tend to falsely believe that cleaning harms them. However, such cases occur due to delay in treatment. Remember that scaling is not a cosmetic job, but a form of treatment. Failure to clean the tartar causes gum disease, gum recession, bad breath, and in the long run, teeth loosening and falling out on their own.