Periodontics
WHAT CAN WE DO FOR YOU?
HOW DO WE DO IT?
HOW DO I KNOW IF I HAVE GUM DISEASE?
Bleeding is the first and most visible sign. It can occur when brushing your teeth or eating.
INFLAMMATION
Inflammation also appears in the initial phase. It causes the gums to enlarge and invade part of the tooth, to a greater or lesser extent.
REDNESS
Another characteristic symptom of gingivitis. It causes the gums to acquire a more intense and shiny color.
SENSIVITY
In the early phase of the disease, the gums become more sensitive to the touch of the toothbrush but do not hurt at other times.
RECEDED GUMS
Recession is typical of advanced periodontitis. It causes the gum to “move away” from the tooth, exposing its root and creating spaces.
BAD SMELL/TASTE
This can appear at any stage and may be due to other reasons. However, combined with other symptoms, it is characteristic of pyorrhea.
what is gingivitis?
WHAT IS PERIODONTITIS?
how is gingivitis treated?
how is periodontitis treated?
OUR STAR TREATMENTS IN PERIODONTICS FOR YOUR GUMS
gingivitis treatment
periodontitis treatment
gum graft
GINGIVECTOMY AND CROWN LENGTHENING
FAQS
THE MOST COMMON QUESTIONS ABOUT PERIODONTOLOGY THAT OUR PATIENTS ASK
It is crucial to have annual dental check-ups to detect any oral and gum pathology as early as possible. Periodontal disease often does not cause significant discomfort until it reaches advanced stages with a worse prognosis.
Healthy gums do not hurt, do not smell, and do not bleed. To avoid gum problems, it is essential to be consistent with daily dental hygiene.
There is indeed a genetic factor that we cannot change with our habits, and if our close relatives have had gum problems, we are more likely to have a higher predisposition to them. However, the factors that most influence the progression of periodontal disease are the accumulation of bacteria and smoking. Thus, we can reduce the risk of periodontal disease and gum inflammation by maintaining good dental hygiene and not having a smoking habit.
Teeth are not fixed in the same position forever; over the years, they tend to move and crowd if we do not use any type of appliance to prevent this movement. However, sometimes patients notice that their teeth are separating in a short period. Teeth separation or increased mobility should be a warning sign to visit a professional because this movement can result from active periodontal disease, which, if left untreated, can progress to the loss of one or more teeth.
As we know, untreated periodontal disease causes the destruction of the bone that supports the teeth. If this bone is destroyed, the teeth have less resistance to movement, and factors such as the absence of molars or the muscular force of the tongue against the teeth will result in the movement of the remaining teeth, often producing a fanning out of the anterior teeth.
Yes and no. To start orthodontic treatment, it is very important that the mouth is healthy. When a patient visits the clinic with active periodontal disease, we must treat and control the disease before applying forces to move the teeth. If periodontal disease is not treated, it will result in higher-than-desired bone destruction, and we may end up losing teeth.
On the other hand, a patient with good periodontal maintenance and controlled periodontal disease can undergo orthodontic treatment just like a patient without a history of periodontal disease. Moreover, orthodontic treatments in periodontal patients help position the teeth, making hygiene much easier and reducing tartar accumulation due to better dental positioning. This way, if it is easier for the patient to clean their teeth, maintaining periodontal disease also becomes much easier.
A gum graft is a part of the gum taken from the palate or a synthetic substitute used on different occasions to improve prognosis and provide long-term stability for some dental treatments.
We use gum grafts in different situations:
Recessions: These occur when the gum margin has shifted toward the root of the tooth, leaving it exposed. Recessions are caused by a lack of resistant (keratinized) gum around the teeth, dental misalignments, traumatic brushing, strong muscle attachments (such as frenula), and excessive occlusal forces.
Volume increase: When we lose teeth, there is a modification in bone volume, i.e., bone resorption in both width and height. Often, this resorption creates ‘depressions’ in the bone contour, which in aesthetic areas look dark and in posterior areas can favor food retention. To avoid this, we perform gum grafts to compensate for the bone volume loss that will occur.
Increase in resistant gum (keratinized gum): To have healthy teeth, they must be surrounded by at least 1-2 mm of keratinized gum and, in the case of implants, 2-3 mm. If we do not have this thickness of gum, it is likely that recessions will appear in both teeth and implants, and brushing will be uncomfortable. If brushing is uncomfortable, patients tend to avoid it, leading to more plaque accumulation, inflammation, and increased recession. In these cases, gum grafts are also necessary to improve the gingival stability of teeth and implants.
The post-operative period of a graft is not painful but can be uncomfortable because the grafted area must remain stable and immobile. This means the patient cannot brush the area or make abrupt movements. The donor area, usually the palate, is also uncomfortable during the first week of healing after the treatment, and we should avoid hard and very hot foods.
Over the years, smaller grafts have been performed, reducing post-operative pain.
In general conditions, the patient should take anti-inflammatory medication for the first 3-4 days after the procedure.
For proper graft healing, the most important factor is the stability and immobility of the graft.
Post-surgery care includes not touching the graft area under any circumstances, not brushing the area, maintaining a soft diet, not smoking, and applying chlorhexidine gel 3-4 times a day. The stitches will be removed after 14 days, and then brushing of the area will begin with a surgical brush for another two weeks.
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