The area of dentistry that deals with the periodontal tissues surrounding the tooth and their treatments is called PERIODONTOLOGY. A healthy mouth is only possible and complete with healthy teeth and gums.
Healthy gums are hard and orange peel-like, and they wrap tightly around the tooth along the crown line. It is light pink in color.
Bacteria and food residues that accumulate in the mouth over time come together and form dental plaque. This plaque comes together with our saliva and forms the tartar. Against this structure formed over time, tissues increase blood circulation to defend themselves. This situation causes the gums to become more hyperemic (prone to bleeding, red and swollen).
If our gums bleed while brushing our teeth, this is one of the first signs of inflammation, which we call GINGIVITIS. Not feeling much pain until this stage actually camouflages the severity of the event. However, when our negligence continues, the tooth starts to be damaged due to the bacteria layer accumulated in the surrounding tissues.
Tooth tissue inflammation, which we call gingivitis, turns into PERIODONTITIS when precautions are not taken. In advanced stages, spontaneous bleeding in the gums, recession in the gums, position changes and shaking in the teeth begin. Irreversible damage occurs in the alveolar bone surrounding the teeth under the gingiva. The incident can lead to tooth loss.
In some people, the body defense mechanism can work inadequately in the teeth and gums, causing the formation and development of gum diseases. Genetic structure is also an important factor in the development of the disease.
In recent years, periodontal diseases due to smoking have also been encountered frequently. In smokers, although the gums seems to be healthy and without bleeding when first examined, oateolysis occur in the alveolar bone surrounding the tooth due to the systemically deterioration of the bone mineral tissue.
Nicotine and other by-products in cigarettes can slow down the blood circulation in the gum tissue and delay healing, increasing the damage and causing destruction in deeper tissues.
Another risk factor is stress. Stress increases the tendency of the development and progression of the periodontal disease as in any disease by affecting the person.
Another factor is hormonal changes and the disease can be seen during puberty, pregnancy, menstruation and menopause.
Diabetes affects wound healing and causes periodontal disease by increasing the risk of infection.
At the same time, according to recent studies, it has been revealed that there is a risk of periodontal disease as a result of cardiovascular diseases.
In addition, incompatible restorations (overflowing fillings, bad crowns) caused by dentists, crooked teeth, occlusal disorders, teeth grinding and squeezing, drugs such as antiepileptic, nifedipine, soiclosporine used in some diseases may cause gum diseases.
It is possible to minimize the formation of plaque and tartar by performing daily oral care effectively. In addition, the accumulated stone and plaque should be removed by your dentist with routine dentist controls.
In more advanced cases, in the treatment of the disease, depth of the gingival pockets formed between the tooth and the gum are measured with a special instrument and recorded. The amount and depth of these pockets play an important role in diagnosis and treatment. The aim of the treatment is to tighten the gums and to reduce the depth of gingival pockets as much as possible.
Routine cleaning and controls are normally done every 6 months. However, in people with periodontal disease or a tendency to it, cleaning process is performed at shorter intervals determined by the dentist. During the process we call as curettage, the stone and plaque cumulated on the root surface are removed with the help of special curettes to reveal the healthy root surface, and the gingiva is adhered to the root surface again. If the pockets cannot be tightened with these procedures, the gum that forms the pocket is surgically removed. In later stages, if the damaged bone needs to be supported, hard tissue grafts or bone fragments obtained from the patient’s own tissue are placed in the defect area to try to recover the lost tissue (flap operation).