Periodontics is the specialty of dentistry that studies the supporting structures of teeth, their diseases, conditions that affect them, and promotes oral health. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament.
A periodontist is a fully qualified dentist who’s specialized in the field. The level of expertise of a periodontist allows him to provide a higher level of care in the field of diagnosis, prevention, treatment of gum diseases and gingival aesthetics.
Periodontal disease is usually a slow disease and most people are not aware that they have it. The most obvious warning signs of periodontal disease are:
- Bleeding gums
- Red or swollen gums
- Receding gums
- Bad breath or bad taste in the mouth
- Loose teeth
- Sensitive teeth
GINGIVITIS E PERIODONTITIS
The two most common forms of periodontal disease are:
Gingivitis is the inflammation of the gums and this occurs when the bacterial plaque that forms on our teeth is not removed by proper tooth brushing and flossing. Gingivitis results in red, swollen, tender gums which bleed easily when brushed or when examined with the periodontal probe. If Gingivitis is not treated, it may lead to a more serious disorder referred to as Periodontitis.
Periodontitis is the destructive inflammation of the gums and tissues that support the teeth, it is caused by the presence of Dental Plaque (bacterial biofilm) and the host response to it. If it continues unchecked the infection will spread to the bone in which the teeth are rooted. The bone then resorbs and the teeth slowly become detached from their supporting tissues, the teeth become loose and eventually are lost. Within the infected crevice around the tooth the bacterial biofilm becomes calcified to form a material called “Calculus, Deposits or Tartar”. Periodontitis is the major cause of tooth loss after the age of 35.
TREATMENT OF PERIODONTAL DISEASE
The treatment of periodontitis is to scale and clean the roots of the teeth to remove the plaque and calculus from below the gum line. This is called debridement. The procedure is done under local anesthesia, with minimal discomfort. The end result is a smaller periodontal pocket, healthy, firm gums and fresh breath.
Crown lengthening (gum lift) is a surgical procedure performed to expose more tooth structure for aesthetic and/or functional (restorative) reasons.A crown lengthening procedure may be performed to correct short teeth, excessive gingival coverage (gummy smile), or uneven gum contouring (aesthetic reasons). It may also be performed to correct subgingival caries (decay) or subgingival tooth/restoration fractures, both of which cause inflammation of the surrounding tissues and make oral hygiene more difficult.
Under normal circumstances, the root surface is surrounded by the overlying alveolar bone and gingival tissues (gums). Gingival recession often results from a normal physiological process (aging). Other causes such as periodontal disease, trauma, aggressive tooth brushing, high frenum (muscle attachment) or misaligned teeth can all lead to receding gums. People who have very thin gum tissue (thin periodontal biotype) are more prone to gingival recession. The exposed tooth/root surfaces are prone to caries (decay) and increased tooth sensitivity. The recession itself acts as a predisposing factor to retain dental plaque causing further inflammation and recession.Gingival grafting improves aesthetics, covers the tooth/root surface previously exposed, prevents further root exposure and facilitates oral hygiene by removing the cleft.
Surgical Tooth Exposure
This procedure is often performed on unerupted permanent (adult) tooth/teeth prior to orthodontic treatment. Frequent causes for tooth/teeth uneruption include: loss of space within the dental arch; over-retained deciduous (baby) tooth/teeth; blocked path of eruption; lack of eruptive force; or unknown reasons. The solution is to expose the unerupted tooth so that the orthodontist can move the tooth into the correct position.
This procedure is performed to remove an abnormally positioned frenum (muscle attachment). In some people, a frenulum may interfere with routine oral hygiene, may cause gingival recession, diastema formation, increased plaque accumulation and limited tongue movements.