Periodontics

F.A.Q.

About Periodontics

Periodontics is the specialty that diagnoses, prevents and treats the supporting and surrounding tissues of teeth and their substitutes (implants). These supporting tissues that periodontics is responsible for are called periodontium and include the gums, the periodontal ligament (cells and fibers that cushion the contact between tooth and bone), cementum (internal part of the tooth and lining of the root, a structure different from that of dental enamel) and the alveolar bone (bone responsible for supporting the tooth, if the tooth is lost this bone is reabsorbed).

Periodontal diseases are usually caused by the accumulation of bacterial plaque. When only the gum is affected by excess bacterial plate on the surface of the teeth, we call inflammation gingivitis. When treated, gingivitis is reversible and when not controlled, other structures besides the gum are also affected, we call it periodontitis. There are other periodontal diseases associated with habits, such as smoking, hormonal dysfunction, nutritional and metabolic deficiencies and genetic factors.

For a few years now, medicine has become aware of the relationship between oral problems and problems in the rest of the body. It is known that bacteria from the mouth can reach the bloodstream and cause damage to organs such as the heart and lungs. The oral cavity must always have its microbiota under control, and this must be done with daily oral hygiene habits and regular visits to the periodontist for procedures such as scaling and prophylaxis.

Periodontal treatment

Periodontal treatment is done with specific materials, products and techniques in the dental office. The scaling and smoothing of dental structures is carried out. This step involves removing plaque and subgingival and supragingival calculus. Next, a thorough polishing is performed on all teeth, ensuring a smooth surface free of roughness and reducing plaque aggregation.

In addition, the periodontist gives guidance for impeccable hygiene that will be carried out by the patient. It is very important that the professional guide the patient regarding the correct brushing technique, which may vary according to the degree of gum involvement, the position of the teeth in the arch, the presence of prostheses or restorations.

This practice ensures gum and periodontium health. When scraping instruments do not reach the entire compromised root area, surgeries are indicated to facilitate access.

After prophylaxis, swelling, altered coloration and gum bleeding tend to regress within 7 to 10 days in the case of gingivitis. Periodontitis is controlled for 30 to 45 days, restoring the pink and firmer appearance of the tissues. With the control of periodontal disease, the patient improves his social life since this is one of the main causes of halitosis.

Frequently asked questions about periodontics

How do I know if I have Periodontal Disease?

The most characteristic sign is bleeding, but we should also be aware of changes in the position of the teeth, tooth mobility, gum recession, food retention, changes in the color and texture of the gums, swelling, etc. The only way to monitor gingival health will be during hygiene, so it’s very important to do careful brushing and use the floss correctly to check for bleeding and not ignore this very important sign. If the patient has difficulties in brushing or does not feel his mouth is clean, he should look for the specialist to be able to guide him. It is important not to interrupt the use of the thread if there is bleeding, as many people think, as long as you are passing the thread correctly. Bleeding denotes the presence of bacterial plaque in this region and, therefore, it is convenient to continue using the thread in an attempt to remove it.

What are the most common signs and symptoms of periodontal disease?

Halitosis
Bleeding while brushing and flossing
Receding gums, giving the impression of longer teeth
Tooth mobility
Gums texture smooth and shiny
Bite changes
Redness of the gums
Pus between the gum and tooth
Abscesses around the tooth

Once the disease is treated, do the tissues fully recover?

No, there are always sequels, with the exception of gingivitis, which are reversible. Periodontal disease leaves bone loss as a sequel, which favors the sensitivity of the roots, and aesthetic changes due to tooth movement and gingival retraction. There are surgical and prosthetic procedures that can minimize this defect.

What is the deadline for maintenance returns after treatment?

Maintenance visits should ensure the stability of the health condition achieved with the treatment and thus prevent both disease progression and relapse. Its prevention can only be done by removing the bacterial plate in periodic visits to the dentist. The return time depends on each individual’s stage of periodontal disease, but it can be every 6 months or once a year in milder cases and in patients with excellent controls. In more advanced cases, in patients with hygiene difficulties due to motor impairments or the use of orthodontic appliances, a periodicity of 3 months is recommended.

How does periodontics contribute to the correction of gummy smile?

The gummy smile is known for the excessive exposure of the gum during the smile, and this can cause aesthetic discomforts. Currently there are several techniques to solve this situation, which are used according to its cause. In gummy smile, when caused by excess gingival tissue covering the tooth, periodontal plastic surgery is indicated. It is a simple procedure, performed under local anesthesia with a smooth postoperative period and a totally favorable prognosis. Like any surgical procedure, it requires planning prior to execution, with a careful and aesthetic eye, building the architecture of the new smile in the most natural way possible.

The technique consists of positioning the gingival margin, based on some details: the line that the lips form when the patient smiles, the existing gingival contour and the proportion between the length and width of the tooth. For a harmonious smile, we obey the Golden Ratio, well known and used in dentistry.

Our Experts

Bachelor’s Degree in Dentistry, UnB
Specialization in Periodontics, UnB
Laser therapist, ARIA Institute – DF
Invited Professor in Periodontics at Clínica Integrada, UnB 2018 – 2020
Course Lasers of High and Low Power in Dentistry, Prof. Ana Cecília Aranha (iKnow)