Treatment of Periodontitis

Is periodontitis curable?

Unfortunately, periodontitis is a disease that cannot be cured, only prevented . By treating periodontitis, what we achieve is to stabilize the progression of the disease and turn it from active to inactive. Unfortunately, “once a periodontitis always means a periodontitis” but the fact that with a difference we can keep it stagnant, despite all the flare-ups that will occur over the years, is particularly optimistic. In conclusion, we could underline the necessity of routines visits to our dentist after the end of the periodontal treatment for the best and longest maintenance of the therapeutic effect.

What is periodontitis? What is the definition?

Periodontitis is an inflammatory disease of the gums, of microbial etiology (often) which is most often a progression of gingivitis. It affects all the tissues of the periodontium and causes unpredictable and uneven destruction of the alveolar bone. Of course there are also periodontitis due to general diseases or taking specific medications.

What are the symptoms and signs to watch for?

The clinical picture of periodontal disease includes some signs and symptoms, the most basic of which are:

  • Presence of periodontal pockets
  • Presence of increased tooth mobility
  • “Migration” of the teeth, their movement from their original position
  • Alveolar bone loss
  • Loss of gum adhesion
  • Bleeding
  • Periodontal abscesses
  • Bad breath

Is periodontitis related to age? From what age does it most often appear?

According to the modern categorization of periodontics, there are forms of periodontal disease that appear at young ages, such as preadolescent and adolescent periodontitis. In general, perhaps arbitrarily we could say that from the age of 40 the appearance of periodontal disease is more frequent. It would be irresponsible to say that the onset of periodontal disease depends on age. Its appearance depends on many things such as the existence of a general disease, heredity, smoking, local factors, chronic gingivitis and others.

What are the effects of periodontitis?

The effects of periodontal disease are essentially its signs (see above). The most upsetting for patients is the loss of some teeth that are in the terminal stage. Also, from an aesthetic point of view, the survival and loss of interdental papillae are situations that cannot be corrected in the majority of cases. In addition, the mobility of the teeth and the sensitivity they acquire to cold and hot are particularly disturbing events.

Are there stages in periodontitis? Is everything treatable at your dental office?

In most patients, periodontal disease progresses slowly. A patient with chronic gingivitis certainly has several chances to develop into a patient with periodontal disease. Patients with general illnesses or patients with a family history of severe periodontal disease are definitely in the high-risk group. Periodontal disease is easily detectable by the dentist after a careful and thorough clinical examination.

What are the causes of periodontitis and how do we treat it?

The vast majority of periodontal diseases are caused by microorganisms. Microbial plaque is the main and primary cause!

Is there a chance that I will need an operation or any surgery on my mouth?

Often, especially when a periodontal disease is characterized as advanced, a surgical approach is needed in addition to conservative treatment. In the past, our only weapon after conservative treatment was surgical curettage of the follicles. Now, with the advancement of science, a large percentage of surgeries have been replaced with an almost painless treatment with a special soft tissue laser.

Can the treatment be done only with laser or must scraping be done?

With the help of the laser, we primarily achieve the maximum possible antisepsis, so it would be inappropriate to use it without a thorough root scraping first, since the tartar (stone) is the one that contains the largest percentage of microbes. So we conclude that root canals are simply necessary for the treatment of periodontal disease. The latest scientific protocols recommend subgingival scrapings mainly with ultrasonic scrapers to be a more tooth-friendly treatment.

What is the use of grafts and PRP | Platelet Rich Plasma |in periodontitis?

In the event of the need for surgical removal of some pockets, a bone graft placement will certainly be needed to reduce the damage as much as possible. Regarding PRP| Platelet Rich Plasma | it has been shown by many studies that it helps especially in the fast and good healing of soft tissues, so if we use it either after conservative treatment or after surgery we can only do good.

Periodontitis treatment & Methods of treatment in our dental office. What we do and what we don't.

In our dental office, in most cases, we do not need to carry out surgical treatment of the pockets because we always follow a specific laser application protocol after the conservative treatment (radical scraping). Of course, the cooperation of the patient and whether he follows the instructions we have given him contributes to this. The treatment of periodontitis aims to control the inflammation of the periodontal tissues, to create conditions that will favor the effective control of the dental microbial plaque by the patient.

So at the first appointment there is a detailed presentation of the treatment plan and teaching of oral hygiene. Then there is an extraction of teeth that are in the terminal stage, supragingival removal of the dental microbial plaque and root scrapings. The laser is applied and after waiting 4-6 weeks we reassess the situation and if we deem it necessary we will refer you to a fellow periodontist.

Does periodontitis treatment hurt?

No treatment in our office hurts because the necessary anesthesia is always performed. After the treatment there may be some discomfort with cold or hot drinks which are often easily treatable.

How many appointments will we need to make?

The number of sessions required depends on the severity of the case. We usually try to complete the treatment within two appointments because we follow the “full mouth disinfection” protocol, i.e. immediate complete removal of germs because it is ineffective to clean one quarter of the mouth and the remaining three are full of germs. Nevertheless, if the patient is heavy, we can complete the treatment in four appointments, which will ideally be very close every day. After the end of the treatment, after 4 weeks, another appointment is made to record and at the same time evaluate the effect of the treatment.

Is periodontitis contagious, contagious?

No , but surely each of us should have our own toothbrush!

Can periodontitis relapse and reoccur?

Unfortunately, relapses are a feature of periodontal disease. They appear when the oral hygiene instructions and recalls are mainly not followed by the patients and when there are periods of intense stress and anxiety.

How does periodontitis affect existing treatments in my mouth, such as trays, dental bridges and dental implants?

In periodontal disease, the gums change their morphology, they show protrusions, so in terms of tooth sockets and dental bridges, their boundaries may begin to be seen or “black triangles” can be seen between them. More generally, periodontal disease can affect implants as well as teeth.

If I have periodontitis, can I get braces or other orthodontic treatments?

Many times because the teeth have moved from their original position we need to put braces to restore them to their original position.

Are there home remedies for periodontitis?

Unfortunately, there are no special home remedies. The only thing that helps periodontitis is its specialized treatment and daily meticulous oral hygiene .

Can periodontitis occur in children or at young ages?

According to the scientific classification of the disease, there are the following categories: a) preadolescent localized and generalized periodontitis and b) adolescent localized and generalized periodontitis. The first category concerns neogylo and mixed obstruction, it is extremely rare and usually coexists with some diseases (this concerns the generalized form of the disease). The second category is more common and concerns permanent teeth and children who are in adolescence up to adults around the age of 30.

Should I take antibiotics to treat periodontitis?

Usually, we prefer to administer an antibiotic regimen to rapidly progressing cases. It is not necessary in all cases and especially when the treatment is also done with the use of soft tissue laser. Each case is different, so the therapist decides on a case-by-case basis.

Are there antibiotics that cause periodontitis as a side effect?

There are specific groups of drugs that create a strong swelling of the gums as a result of which the therapist detects “pseudo-follicles”. Essentially, if the administration of these drugs to patients could be stopped, we would find the absence of the follicles.

I use homeopathic medicines, is there a treatment method for me at your dental office?

Of course, since we always respect the wishes of our patients, after discussion we can choose the desired treatment regimen for everyone.

Can I use any herbs to improve or treat periodontitis in a natural or alternative way?

Of course. First of all, in pharmacies there are herbal toothpastes or toothpastes with herbal ingredients which have proven to be a powerful weapon in our quiver. Also, there are mouthwashes with propolis and chamomile that help to disinfect the oral cavity.

Are there special toothpastes to fight periodontitis?

Yes, there are toothpastes with specific active ingredients and antiseptic agents that are specially made for the complementary treatment of periodontitis.

I have read that vitamin supplements help treat periodontitis, is that true?

Research has only been done on vitamin C which has been shown to be especially helpful in treating gingivitis and swollen gums.

How is periodontitis connected to our diet and the foods we consume?

Periodontitis is not linked to the foods we eat unless we are severely deficient in vitamin C. Periodontal disease has been linked to smoking and alcohol consumption, there are studies in progress and we await their results.

Is periodontitis linked to menopause?

Very often in women, when menopause occurs, osteoporosis also occurs, which certainly affects the jaw bones, simply in every person completely differently.

Are there ways to prevent periodontitis?

Regular visits to our dentist for preventive reasons and regular teeth cleanings will certainly help and offer us an early diagnosis of the problem.

Is there localized periodontitis? Is its treatment the same as general periodontitis?

One of the divisions made in periodontal disease is that of localization: localized and generalized. Its detection does not change the fact that it is a periodontal disease, so it has the same therapeutic treatment.

Is there rapidly progressing periodontitis? Can I do anything to prevent losing my teeth?

Of course there is the rapidly progressing periodontitis and the only thing you can do to avoid losing your teeth is to see your dentist right away so that a treatment plan can be drawn up.

Is periodontitis linked to diabetes? How and what should I do and watch out for?

Unfortunately periodontitis and diabetes are two interrelated diseases and one aggravates the other. When, for example, we have a patient with uncontrolled diabetes, we cannot be sure that she will have a “stable” periodontitis without flare-ups

My cardiologist told me to go to the dentist, how do you connect that? Could my oral health be affecting my heart?

In patients with mitral prolapse or other cardiac problems, it is dangerous for a microbe to migrate to the heart and create endocarditis.

How much does periodontitis treatment cost? Is the price the same in each case?

Periodontitis treatment costs the same whether it is chronic or rapidly progressive. Certainly this cost rises in cases where we need to intervene surgically. The cost of conservative periodontal treatment at our dental office starts at €300 for all 4 quadrants of the mouth.