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Periodontitis

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Periodontitis is an insidious disease that is the leading cause of tooth loss in 99% of people.

Based on research, more than 2/3 of adults over 35 years old, suffer without knowing it from periodontitis, which in its initial form is expressed as gingivitis. In the progression of gingivitis, periodontitis, the inflammation is not only limited to the gums, but we also have destruction of the supporting bones, which, when it progresses, causes the teeth to initially wobble and eventually fall out.
Characteristics of periodontitis are:

  • It affects 99% of people over the age of 35, everyone will go through this stage.
  • It is the most devastating disease, as it is responsible for infinitely greater damage than tooth decay (broken teeth).
  • It’s a slow disease, it doesn’t act quickly, it works for years.
  • It does not give strong symptoms at first, such as severe pain, the bone is slowly and insidiously lost.
  • The teeth seem to be getting longer, which is because the gums are pulling away.
  • Patients are sensitive to hot and cold, as the roots are not protected by enamel and are therefore more sensitive.
  • Gaps are created between the teeth, in which food is implanted and patients start using toothpicks.
  • Another characteristic is bad breath. Bad breath is caused by the deep concentration of microbes, which cannot be removed by brushing.
  • Another characteristic is root caries, due to the loss of bone and the infestation of the roots, which are not protected by enamel enamel.
  • Periodontitis has no cure, that is, the bone that has been lost can only be preserved, and the disease can be frozen, that is, stopped.

The sole cause of periodontal disease is one: dental plaque, that is, microbes, which are either not removed properly by brushing or cannot be removed even though we brush properly, because they are trapped in the tartar-dental mass that only the Dentist – Periodontist can remove. Aggravating factors that affect the aggression, as well as the speed of spread of periodontal disease are:

  • Heredity:

Periodontitis also has to do with our body’s defences. Some patients have weaker defence cells than others.

  • Smoking:

The nicotine in cigarettes causes vasoconstriction, i.e. it clogs the blood vessels, making them smaller, thus weakening the body’s defences against germs.

  • Angiopathy
  • Stress
  • Avitaminosis
  • Fatigue
  • Diabetes

Prevention

To avoid periodontitis, we can take care of our oral hygiene ourselves.
More specifically:
Proper tooth brushing at least twice a day (with fluoride toothpaste).
Flossing regularly to remove dental plaque from between the teeth.
Regular visits to the dentist for oral check-ups and teeth cleaning.
Stop smoking

Brushing techniques

Food debris or incorrect brushing technique can lead to infections or an increase in dental plaque, which is a cause of gingivitis and periodontitis. You may have a toothbrush in your hand… but that doesn’t mean you’re taking good care of your oral hygiene! Brushing teeth is ineffective if it is not done properly and according to the methods recommended by dentists. Random and simple brushing, without technique, removes minimal dental plaque, can injure the gums and cause abrasions to the tooth enamel over time.

The secret is not strength, but technique

For a thorough brushing of the teeth, at least a period of 2-3 minutes twice a day should be dedicated. There are many ways of brushing. But the most effective brushing method recommended by dentists is the so-called «BASS method«. The method in simple terms: A prerequisite for effective brushing is that there is no tartar on the teeth.

1. Use a medium or soft toothbrush and place it at a 45-degree angle on the part of the tooth that “joins” the gums, first on the outer surfaces of the teeth. Press the toothbrush a little so that the fibres penetrate gently into the gums. Attention: Too much pressure can injure the gums.

2. Brush with gentle and small repetitive movements back and forth (vibrations), without moving the toothbrush from its position. The large movement will not remove more plaque, as the logic of the technique is to clean one group of three teeth at a time and then move on to the next.

3. We clean the outer surfaces of the teeth and when we are done, we clean the inner surfaces of the teeth with the same movements.

4. To clean the inner surfaces of the front teeth, hold the toothbrush in an upright position so that the tip is in contact with the teeth and brush with gentle up and down movements.

5.We also brush thoroughly the surfaces of the back teeth that chew the food, i.e. the chewing surfaces.

Finally, brush the surface of the tongue with movements from back to front. The reason is that too many bacteria are “hosted” on the tongue and it is one of the causes of bad breath. Watch a video by Dental Crete-Dental Smile on proper brushing and techniques for maintaining good oral hygiene. The most important thing for a periodontal patient to maintain the results of periodontal treatment is to maintain proper oral hygiene. Apart from the daily brushing of the teeth, it is also necessary to clean the interdental areas, i.e. the area between the teeth. A simple toothbrush cannot clean this area. That’s why we use the interdental brushes. The interdental brushes make it easier for us to remove bacteria between the teeth to ensure better oral hygiene. They come in various sizes, depending on the width of the gap between the teeth. The brush should not be completely loose between the teeth, because it does not clean effectively, but it should not be completely tight either, so as not to cause injury to the gums. Prefer brushes that are cylindrical rather than conical, as they clean better. The interdental brushes are not disposable. Wash them after each use with water and use them again, and no toothpaste is needed for their use.

Instructions for Use

Place the brush on the outside of the teeth until it penetrates the interdental space. Then make horizontal movements on the brush, 6 to 7 times for each interval. For its proper use it is important that it comes from the linguistic side. If the brush retains large amounts of plaque, rinse it and continue with the other interdental intervals. Repeat their use every day, once a day, before brushing in the evening.

Periodontal Treatment

What periodontal treatment does is to stabilize the condition of the periodontium where it is, so that no further damage is done to the bone and the patient does not lose his teeth. The stages of periodontal treatment can be summarized as follows:

Cleaning Hyperullate plate and stone. In the section Oral Hygiene and Prevention removal of dental plaque and tartar as well as the most important learning of oral hygiene (brushing – threading – interdental brushes). This stage is very important as it allows the objective measurement of the inflammation – and the pockets* – and the painless continuation of the periodontal treatment.

*enclave or pocket is any distance greater than the maximum normal-acceptable distance of 3mm between the gumline and the bone level.The existence of pockets means Periodontitis.The patient at depths of 5-6-7 mm cannot remove the germs, but neither can the dentist remove the calculus with the usual cleaning. So, it must be eliminated and made 3mm(normal gingival cleft).

Periodontogram or “map” of the teeth. The periodontist measures the tooth sockets at 6 different points for each tooth. Based on the periodontogram, the individualized treatment plan of each patient is drawn up.

Subcutaneous radical curettage and debridement. A few days after the first ultra-oral cleaning and after the gums have “calmed down”, the specialized Periodontist removes the stone through the gums, in the depth of the follicles.This is done in 1-2 or even 4 sessions, depending on the severity of Periodontitis. In this way the scar tissue is healed.

Recheck. After the end of the periodontal treatment and if 4-6 weeks have passed, we do the “recall” which is a re-check to see if the original millimeters have been reduced. If the original millimetres have not been made <5 then the treatment is repeated.

Periodontal surgery. The periodontist surgically intervenes in the periodontal pocket to remove the stone. Usually, in modern dentistry, the surgical method is avoided for the simple reason that every time we surgically intervene in the gums, we inevitably lose some millimeters of bone, something we obviously want to avoid.

Maintaining the result. A periodontal patient needs lifelong systematic control and regular-cleanings after finishing his periodontal treatment, something that is taken care of by the specialized staff at the Dentistry of Crete.

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