CRB CLINIC DIGITAL DENTISTRY
Periodontitis (periodontosis)
Treatment of gums without pain
License of the Ministry of Health of Ukraine AD No. 063321 dated 06.09.12.
CRB CLINIC
DIGITAL DENTISTRY
DIGITAL DENTISTRY
Periodontitis is an inflammatory disease of the periodontal tissues.
It definitely requires treatment. In advanced form it leads to tooth loss.
Periodontosis is a common name for periodontitis. They are the same disease, with the same symptoms: bleeding gums, tooth mobility and loss, and gum recession. Today, the term "periodontosis" has disappeared from almost all medical classifications and has been replaced by the more modern term "periodontitis," which is divided into stages 1-4. However, the term "periodontosis" is sometimes still used to describe a slow, chronic form of the disease without acute symptoms.
Symptoms we can help
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Periodontitis affects all periodontal tissues: gums, blood vessels, periodontal ligament, bone. Therefore, the symptoms are varied and are eliminated in a comprehensive manner during treatment.
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Bleeding gums - Purulent discharge
- Bad breath
- Swelling, redness, change in gum contour
- Teeth mobility (wobbliness)
- Reduction of gum height, exposure of tooth necks
CRB CLINIC
DIGITAL DENTISTRY
DIGITAL DENTISTRY
The main cause of periodontitis
The main cause of periodontitis:
Bacteria in the gum pockets
With periodontitis, due to infection, the gum tissue and periodontal ligament peel off from the tooth, forming periodontal pockets. Plaque gets into them, is compressed and turns into tartar. This tartar under the gums is an ideal environment for the reproduction of bacteria. It is impossible to clean the tartar and infection at home, since the tartar is attached to the surface of the root, growing into its pores. Even standard professional hygiene at the dentist affects only 1-2 mm of the subgingival space, while the pocket depth can reach 6 mm.
As a result, pathological growth of the bacterial colony occurs. Even if initially only one tooth was infected, the infection spreads to all teeth and gums.
Bacteria cause inflammation and intoxication of tissues, the gums become inflamed, swell, and the vessels become fragile. Because of this, with periodontitis, the gums are often painful and bleed even with light pressure.
As a result, pathological growth of the bacterial colony occurs. Even if initially only one tooth was infected, the infection spreads to all teeth and gums.
Bacteria cause inflammation and intoxication of tissues, the gums become inflamed, swell, and the vessels become fragile. Because of this, with periodontitis, the gums are often painful and bleed even with light pressure.
The main cause of periodontitis:
At stages 2-3 of the disease, the periodontal ligament that holds the tooth in the bone is affected. Teeth may become loose and eventually fall out. The bone tissue itself suffers. Due to the inflammatory process, its density deteriorates, and then its volume decreases. Due to bone loss, the gum tissue located on top of it also settles. Recession can be observed - a decrease in the height of the gum and exposure of the necks of the teeth. Since the necks of the teeth are not protected by enamel, sensitivity to cold/hot increases when brushing teeth.
Please note! The destruction of bone tissue and ligamentous apparatus in periodontitis is irreversible, so treatment should be started as early as possible. Already at the first symptoms, bleeding gums and bad breath, you should consult a doctor for timely diagnosis.
Stages of gum disease progression
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Gingivitis
The initial stage of gum inflammation. Occurs due to plaque and tartar accumulation in the gum area. There is no pathological deepening of the pockets yet.
Symptoms: bleeding gums when brushing, swelling, redness, and sometimes an unpleasant odor. -
Mild periodontitis
Inflammation from the cervical area spreads deeper and begins to destroy periodontal tissues: gums, ligaments, and bone. The gingival margin separates from the tooth, creating periodontal pockets up to 3 mm deep. Bone loss begins.
Symptoms: bleeding gums, foul odor, slight tooth mobility (can only be diagnosed by a doctor), and possible discomfort and mild pain when chewing. - Moderate periodontitisA severe form of periodontal disease. Periodontal pockets are deeper, approximately 4-5 mm. Bone loss can reach up to 30%. Periodontal fibers are significantly damaged.
Symptoms: inflammation and swelling of the gums, tenderness and bleeding even with light pressure, increased bad breath, tooth mobility upon palpation, and increased tooth sensitivity due to exposed necks. - Severe periodontitisA severe form of the disease in which the primary structures supporting the tooth are destroyed. Periodontal pockets are deep, more than 6 mm. Bone loss reaches 50% or more. Periodontal fibers are almost or completely destroyed. The gums are severely inflamed, with recession (root exposure).
Symptoms: constant bleeding, strong odor, pain when chewing, tooth mobility, sometimes a sensation of movement, and possible gum abscesses.
Stages of gum disease progression
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Gingivitis
The initial stage of gum inflammation. Occurs due to plaque and tartar accumulation in the gum area. There is no pathological deepening of the pockets yet.
Symptoms: bleeding gums when brushing, swelling, redness, and sometimes an unpleasant odor. -
Mild periodontitis
Inflammation from the cervical area spreads deeper and begins to destroy periodontal tissues: gums, ligaments, and bone. The gingival margin separates from the tooth, creating periodontal pockets up to 3 mm deep. Bone loss begins.
Symptoms: bleeding gums, foul odor, slight tooth mobility (can only be diagnosed by a doctor), and possible discomfort and mild pain when chewing. - Moderate periodontitisA severe form of periodontal disease. Periodontal pockets are deeper, approximately 4-5 mm. Bone loss can reach up to 30%. Periodontal fibers are significantly damaged.
Symptoms: inflammation and swelling of the gums, tenderness and bleeding even with light pressure, increased bad breath, tooth mobility upon palpation, and increased tooth sensitivity due to exposed necks. - Severe periodontitisA severe form of the disease in which the primary structures supporting the tooth are destroyed. Periodontal pockets are deep, more than 6 mm. Bone loss reaches 50% or more. Periodontal fibers are almost or completely destroyed. The gums are severely inflamed, with recession (root exposure).
Symptoms: constant bleeding, strong odor, pain when chewing, tooth mobility, sometimes a sensation of movement, and possible gum abscesses.
Types of periodontitis
Periodontitis doesn't always look the same. It's important to differentiate the different types of the disease to find effective treatment.
The most common form of the disease. It progresses slowly, with periods of exacerbation and remission. It destroys the deep layers of the periodontium.
It is characterized by the accumulation of purulent exudate in periodontal pockets, increased symptoms of pain and swelling.
The disease affects a significant part of the periodontium or the entire periodontium (all or almost all teeth).
It differs from chronic periodontitis in that it progresses more rapidly and is accompanied by more pronounced symptoms: severe pain, swelling, and redness.
Characterized by the appearance of ulcers and necrosis (tissue death) of the gums. It is characterized by rapid progression, pain, and a foul odor.
Also known as focal periodontitis, it affects a limited area rather than the entire oral cavity.
Symptoms of periodontitis
- Soreness of gums, redness, swelling
- It occurs due to the inflammatory process and tissue intoxication with bacterial waste products.
- Bleeding gums
- It appears due to thinning of the gum epithelium and destruction of collagen fibers responsible for the strength of blood vessels. As a result, capillaries become fragile.
- Bad breath
- Bad breath is caused by bacteria that multiply in the tartar under the gums. The larger the colony of bacteria, the stronger the smell.
- Deepening of gingival pockets
- Because of the tartar and the infectious environment around it, the gum tissue peels away from the tooth. A gap is created - a pocket, which increases as tartar accumulates in it.
- Tooth mobility
- When the fibers of the periodontal ligament are damaged, it can no longer hold the tooth in the bone. This can cause teeth to become loose and later fall out.
- Purulent discharge
- The body tries to fight the infection in the periodontal pockets. As a result of this process, pus is formed. It can flow out from under the gum or through a fistula on the gum.
- Bone loss
- Due to infection, bone tissue resorption occurs. Its density decreases, and then the width and height of the alveolar process decreases.
- Gum recession
- The decrease in the height of the gum is a consequence of the decrease in the level of bone tissue. The gums covering the bone tissue descend after it.
CRB clinic
Treatment of periodontitis
Treatment of periodontitis should be started at the first symptoms (bleeding gums and bad breath) to prevent loosening and loss of teeth.
Consultation for periodontitis
A periodontist conducts a consultation.
During the consultation, we assess the general condition of the oral cavity, identify affected areas, and locally measure the depth of periodontal pockets in areas of inflammation.
The consultation includes:
Consultation price: 850 UAH
During the consultation, we assess the general condition of the oral cavity, identify affected areas, and locally measure the depth of periodontal pockets in areas of inflammation.
The consultation includes:
- Oral cavity assessment – check for inflammation, microtrauma, ulcers, and visible foci of infection (affected teeth, fillings).
- Gum condition assessment – check for redness, inflammation, and swelling. Gum height is assessed (for signs of recession) and the condition of the papillae. The degree of bleeding and the presence of pus are determined.
- Plaque assessment – evaluate the presence of plaque, its quantity, and areas of accumulation.
- Consultation, appointments, and recommendations from a periodontist.
Consultation price: 850 UAH
CRB clinic
Treatment of periodontitis
Treatment consists of eliminating the infectious environment, relieving the inflammatory process and ensuring the maximum possible tissue regeneration. The complexity and duration of treatment vary at different stages of the disease.
The results of treatment can be seen at each stage, and after 6 months, a decrease in the depth of periodontal pockets can already be observed.
The results of treatment can be seen at each stage, and after 6 months, a decrease in the depth of periodontal pockets can already be observed.
Scaling is a procedure for cleaning the roots of teeth and periodontal pockets from bacteria, tartar and plaque. It is performed manually using special instruments - curettes. Due to the manual technique, the doctor feels every unevenness on the root surface and can remove all particles of tartar, including those that have grown into the pores of the root.
After cleaning, the roots of the teeth are polished to make it more difficult for plaque to stick to the smooth surface in the future.
Primary scaling is a rather complicated procedure, since the doctor removes dental deposits that have accumulated over the years.
After the main cleaning, there is no longer an infectious environment in the gum pockets, inflammation and swelling subside, the gums begin to heal. Thanks to this, the doctor can better see the remaining foci of inflammation. After 3 days, a control examination is carried out and, if necessary, local removal of the remaining deposits. Control and repeated cleaning are included in the price.
Additionally, medicinal treatment is carried out in several stages (baths, gels, rinsing). Antiseptic, anti-inflammatory and healing drugs are used.
After cleaning, the roots of the teeth are polished to make it more difficult for plaque to stick to the smooth surface in the future.
Primary scaling is a rather complicated procedure, since the doctor removes dental deposits that have accumulated over the years.
After the main cleaning, there is no longer an infectious environment in the gum pockets, inflammation and swelling subside, the gums begin to heal. Thanks to this, the doctor can better see the remaining foci of inflammation. After 3 days, a control examination is carried out and, if necessary, local removal of the remaining deposits. Control and repeated cleaning are included in the price.
Additionally, medicinal treatment is carried out in several stages (baths, gels, rinsing). Antiseptic, anti-inflammatory and healing drugs are used.
Three months after the initial removal of infection and tartar from the roots of the teeth, a repeated subgingival cleaning is performed, the purpose of which is to remove soft plaque. It is important to do this during this period, when the plaque has not yet hardened and turned into tartar.
At this stage, drug treatment continues in the clinic:
At this stage, drug treatment continues in the clinic:
- Baths, gels, rinsing with antiseptic, anti-inflammatory and healing drugs;
- PRP therapy - significantly accelerates healing and regeneration in tissues;
- Hyaluronic acid injections (prescribed individually) - have antimicrobial and anti-inflammatory properties, increase local immunity, enhance cell regeneration.
SPT - это протокол ведения пациентов с пародонтитом после окончания активной фазы лечения. Протокол направлен на поддержания здоровья десен и сохранение зубов в долгосрочной перспективе.
Поддерживающая терапия состоит из четырех этапов:
Поддерживающая терапия состоит из четырех этапов:
- Выдача пациенту инструментов для чистки зубов (зубная щетка, паста, ополаскиватель) и индивидуальное обучение домашней гигиене. При необходимости мы выдаем и медикаментозные средства для продолжения лечения десен.
- Домашняя гигиена - проводится пациентом самостоятельно.
- Периодический контроль (раз в 3-6 месяцев) и профилактическая чистка зубов, а также корней и поддесневого пространства. Основной задачей периодических чисток является удаление зубного налета до того, как он превратится в зубной камень и вызовет повторное воспаление.
- Ударно-волновая терапия в область пародонта. Основной целью процедуры является: уплотнение костной ткани, ангиогенез (прорастание новых капиляров), улучшение кровообращения и питания тканей пародонта. Рекомендованный курс: 5-7 процедур раз в год.
Treatment results
The photo shows the visible results of the treatment: no dental plaque, healthy pink gums, no signs of inflammation (swelling, redness), reduced gum recession.
Some cases were so severe that tooth extraction was recommended. However, if patients insist on preserving teeth, we do everything possible to achieve this. Even in such cases, a significant improvement in the condition of the gums and a reduction in recession are visible.
Some cases were so severe that tooth extraction was recommended. However, if patients insist on preserving teeth, we do everything possible to achieve this. Even in such cases, a significant improvement in the condition of the gums and a reduction in recession are visible.
Periodontist
Patients often ask similar questions.
Periodontitis is a condition that causes a lot of concern and questions. Below, I've compiled the most frequently asked questions from patients and briefly answered them.
Elena Koval, a leading periodontist and therapist, specializes in the treatment of gingivitis, severe forms of periodontitis, bone regeneration, comprehensive prevention and maintenance therapy, plasma lifting, and injection treatments. She has extensive experience with microinvasive technologies and functional gingival aesthetics. She has over 12 years of experience.
Elena Koval, a leading periodontist and therapist, specializes in the treatment of gingivitis, severe forms of periodontitis, bone regeneration, comprehensive prevention and maintenance therapy, plasma lifting, and injection treatments. She has extensive experience with microinvasive technologies and functional gingival aesthetics. She has over 12 years of experience.
Although professional dental cleaning is very useful, it only covers cleaning the surface of the teeth and no more than 1-2 mm of the depth of the gum pockets. While the depth of the gum pockets can vary from 3 to 6 mm.
If you have deep periodontal pockets, plaque and tartar can accumulate in them, and an infectious environment can develop. And regular cleaning will not help. Also, some systemic diseases or treatment with braces can accelerate the formation of plaque. In this case, you need to go to the dentist for cleaning more often.
To determine the depth of the pockets and the cause of the disease, you need to undergo diagnostics.
If you have deep periodontal pockets, plaque and tartar can accumulate in them, and an infectious environment can develop. And regular cleaning will not help. Also, some systemic diseases or treatment with braces can accelerate the formation of plaque. In this case, you need to go to the dentist for cleaning more often.
To determine the depth of the pockets and the cause of the disease, you need to undergo diagnostics.
Vector therapy is a hardware method for removing tartar. The method is popular among dental clinics, as it is easier to perform compared to standard manual scaling.
But Vector therapy has a number of disadvantages:
tartar particles that have grown into the root pores are not removed by the device, but are only polished from above. After polishing, they are difficult to remove even by hand. Bacteria remain there and the infection quickly resumes;
the method has no proven long-term effectiveness;
cannot be used in deep pockets and with severe inflammation.
We do not use Vector therapy and choose manual scaling:
The doctor removes all particles of tartar using special instruments (curette). Only after this, the root surface is carefully polished. Manual technique allows the doctor to feel even minimal irregularities on the root surface. This procedure is more effective than vector therapy, and the result lasts longer.
But Vector therapy has a number of disadvantages:
tartar particles that have grown into the root pores are not removed by the device, but are only polished from above. After polishing, they are difficult to remove even by hand. Bacteria remain there and the infection quickly resumes;
the method has no proven long-term effectiveness;
cannot be used in deep pockets and with severe inflammation.
We do not use Vector therapy and choose manual scaling:
The doctor removes all particles of tartar using special instruments (curette). Only after this, the root surface is carefully polished. Manual technique allows the doctor to feel even minimal irregularities on the root surface. This procedure is more effective than vector therapy, and the result lasts longer.
To a periodontist, as this is a specialist of higher qualification.
A periodontist is a doctor with a higher education (Master's degree), specializing in periodontology. A periodontist has a deep understanding of anatomy, diseases and treatment protocols. Has the right to conduct diagnostics, prescribe and administer treatment, write prescriptions, perform surgical interventions (gum plastic surgery, curettage, scaling, flap operations, etc.).
A hygienist is a mid-level medical personnel (junior specialist, junior bachelor). He can perform standard professional hygiene, without cleaning periodontal pockets. He also does not have the right to diagnose and prescribe treatment.
A periodontist is a doctor with a higher education (Master's degree), specializing in periodontology. A periodontist has a deep understanding of anatomy, diseases and treatment protocols. Has the right to conduct diagnostics, prescribe and administer treatment, write prescriptions, perform surgical interventions (gum plastic surgery, curettage, scaling, flap operations, etc.).
A hygienist is a mid-level medical personnel (junior specialist, junior bachelor). He can perform standard professional hygiene, without cleaning periodontal pockets. He also does not have the right to diagnose and prescribe treatment.
The standard is cleaning once every 6 months. However, everything is very individual. More frequent cleaning may be needed in case of systemic diseases (for example, diabetes), during pregnancy, during treatment with braces.
In case of periodontitis, cleaning is prescribed once every 3-6 months and additional cleaning of gum pockets is performed.
If you notice the appearance of symptoms of the disease (bleeding, odor) earlier than after 6 months, you should see a doctor and find out the reason for this.
In case of periodontitis, cleaning is prescribed once every 3-6 months and additional cleaning of gum pockets is performed.
If you notice the appearance of symptoms of the disease (bleeding, odor) earlier than after 6 months, you should see a doctor and find out the reason for this.
Of course not. Tooth loss is not a natural part of aging.
Tooth loosening and loss occur due to gum disease, primarily late-stage periodontitis. If you maintain healthy periodontal tissue and follow your dentist's recommendations, your teeth will last a lifetime.
Tooth loosening and loss occur due to gum disease, primarily late-stage periodontitis. If you maintain healthy periodontal tissue and follow your dentist's recommendations, your teeth will last a lifetime.
It's difficult to determine on your own what type of gum disease you're developing (gingivitis or periodontitis). You should schedule a consultation with a periodontist if you have two or more symptoms: bleeding gums, receding gums, exposed tooth necks, bad breath, or plaque or tartar buildup.
It's difficult to determine on your own what type of gum disease you're developing (gingivitis or periodontitis). You should schedule a consultation with a periodontist if you have two or more symptoms: bleeding gums, receding gums, exposed tooth necks, bad breath, or plaque or tartar buildup.