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Avoiding, recognizing and treating periodontitis

How can periodontitis be avoided and treated? This article shows you what it’s about, why it’s important and gives 3 tips for treatment.

It is well known that a bright smile with two rows of flashing white teeth is the best business card. The fact that it helps to keep the heart healthy, on the other hand, is new for many.

The life expectancy of people in Germany is constantly increasing and the risk of periodontitis (tooth bed inflammation) increases with age. It has been known for some years that the pathogens responsible for this disease can damage the heart via the bloodstream, especially the inner wall of the heart and the heart valves (endocarditis). Good oral hygiene and thus a reduction of germs to a minimum in the oral cavity can demonstrably prolong life with this disease.

Periodontitis- a widespread disease

Around 70-80% of the population will develop periodontitis with increasing age, although there are genetic differences in its degree.

Usually the inflammation of the periodontium is discovered too late because it is chronic for many years without showing noticeable symptoms. Gum bleeding is considered harmless by many patients and slight loosening of the teeth is not noticed. Only strong bad breath, tooth migration or even tooth loss make the disease visible to the patient. It is therefore important to make regular appointments for dental check-ups. The latter can determine the individual risk by means of a short screening test and, if necessary, initiate prophylactic measures and corresponding therapies. Periodontitis is not yet curable.

How does periodontitis develop?

The basis of this disease are special bacteria. Normally the oral flora consists of a huge number of different species of bacteria, most of which are rather harmless. However, if this ratio of good to bad germs shifts or if too much plaque and tartar remains on the teeth due to lack of care, gingivitis develops. This leads to the formation of more blood vessels. At this stage, the gums bleed. If no measures are taken now, the inflammation can spread to the periodontium. This can no longer fulfil its function of holding the tooth firmly in the bone and increased mobility of the teeth is often accompanied by strong bad breath.

At this stage, germs may carry over into the bloodstream. If the immune system does not become aware of the intruders, they can settle on the inner wall of the heart and the heart valves. This inflammation of the heart valves (endocarditis) can be treated with antibiotics, but untreated leads to death.

How To Avoid Periodontitis

Brushing teeth does not depend on quantity but on quality. It is important to thoroughly clean all tooth surfaces, including the spaces between them. These offer with increasing age much place for plaque, therefore it is necessary to clean these daily.  Numerous aids such as silk, raft and brushes are available for this purpose. In addition, rinsing solutions such as Chlorhexamed can contribute to further germ reduction. Of course, dentures must also be cleaned thoroughly. This can be particularly difficult for older people and they therefore need help. Furthermore, teeth should be cleaned professionally 3-4 times a year.

How To Treat periodontitis

The treatment can be performed by a periodontist, dentist or dental hygienist. The aim of periodontal treatment is to thoroughly clean the gum pockets and avoid damage to the surrounding bone. You have the best chance of successful treatment if you also introduce good oral hygiene and stop smoking.

non-surgical treatments

If periodontitis is not advanced, treatment can be performed with less invasive procedures, including:

  • Scaling. Scaling removes tartar and bacteria from the tooth surfaces and under the gums. It can be performed with instruments, a laser or an ultrasound device.
  • Root planing. Root smoothing smoothes the root surfaces, prevents the further formation of tartar and bacteria and removes bacterial by-products that contribute to inflammation and delay healing or reattachment of the gums to the tooth surface.
  • antibiotics. Topical or oral antibiotics can help to control bacterial infections. Topical antibiotics can be antibiotic mouthwashes or the insertion of antibiotic-containing gels into the space between the teeth and the gums or into the pockets after deep cleaning. However, oral antibiotics may be necessary to completely eliminate infectious bacteria.

Surgical treatments

If you have advanced periodontitis, treatment may require dental surgery, such as:

Flap surgery (pocket reduction surgery). Your periodontist will make tiny incisions in your gums so that part of the gum tissue can be raised again, exposing the roots for more effective scaling and root smoothing. Since periodontitis often leads to bone loss, the underlying bone can be reconstructed before the gum tissue is sutured back in. After healing, it is easier to clean these areas and maintain healthy gum tissue.

Soft tissue grafts. If you lose gum tissue, your gum line will recede. You may need to reinforce some of the damaged soft tissue. This is usually done by removing a small amount of tissue from the palate or other donor site and applying it to the affected area. This can help reduce further gingival recession, cover exposed roots and give your teeth a more beautiful appearance.

Bone grafting. This procedure is performed when periodontitis has destroyed the bone around your tooth root. The graft can consist of small fragments of your own bone, or the bone can be synthetic or donated. The bone graft prevents tooth loss by holding the tooth in place. It also serves as a platform for the regrowth of natural bone.

Guided Tissue Regeneration. This enables the re-growth of bone that has been destroyed by bacteria. Your dentist will place a special piece of biocompatible tissue between the existing bone and your tooth in one operation. The material prevents the penetration of unwanted tissue into the healing area and instead allows the bone to grow back.

Tissue-stimulating proteins. Another technique is the application of a special gel to a diseased tooth root. This gel contains the same proteins as enamel and stimulates the growth of healthy bone and tissue.

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