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Periodontics

Periodontics is a Dentistry specialism that deals with diseases of the gum and the bones that support teeth.

There are two large groups of periodontal diseases: gingivitis and periodontitis.  The gingivitis group includes diseases that only affect the gums, in other words the soft tissue which protects the teeth.  On the other hand, periodontal diseases are a group of infections that not only affect the bone that supports the teeth, but also affects other tissue such as the periodontal ligament and the radicular cement.  

The main cause of periodontal disease is the bacteria that inhabit the mouth and that are deposited on teeth and gums. When these bacteria grow too much, they can cause injuries to the tissue. There are other aggravating factors such as tobacco and certain illnesses like diabetes, etc.

Symptoms

The most frequent symptom of periodontal disease is a reddening of the gums and either spontaneous bleeding or bleeding when brushing.  Other symptoms can also appear such as an unpleasant smell or a bad taste in the mouth, sensitivity to cold and heat, a change in the original position of teeth, elongated teeth, pain or even mobility.

If periodontal disease is not treated, it normally progresses until teeth are lost progressively. Before reaching the extreme of dental loss a series of events occur which lead to a loss of the tissue that supports the teeth and lead to a greater risk of having tooth sensitivity and therefore chewing problems or problems when eating or drinking cold or hot drinks. Edentulism can cause chewing, aesthetic or even psychological problems.

Treating periodontal disease

In the case of gingivitis, the treatment generally consists of undertaking a cleaning process in the clinic with the correct instruments, good oral hygiene at home using correct brushing methods and correcting other factors which encourage an accumulation of bacteria.  The use of antimicrobial substances can occasionally be necessary.

In the case of periodontitis, the treatment generally consists of undertaking a deep cleaning process in the clinic with the correct instruments, good oral hygiene at home using correct brushing methods and correcting other factors which encourage an accumulation of bacteria and which make the progression of the disease worse. Sometimes, after an initial evaluation it will be necessary to undertake surgical treatment in order to slow down the progression of the disease and to correct any aesthetic defects that may have appeared.

Good management of periodontal disease requires a programme oriented towards maintaining and improving the results of the initial treatment, as well as preventing the appearance of new diseases.  This is an essential stage of the periodontal treatment and the only way to ensure that the periodontitis is under control in the long term.

Questions and answers

What is the solution if one of these symptoms appears in my implants?

In the event that the symptoms coincide with mucositis, in other words, only the soft tissue is diseased, then treatment based on cleaning in the clinic with the correct instruments, as well as correct oral hygiene at home based on using a specific brushing technique and the use of anti-microbial substances prescribed by your periodontist, will be enough to treat this type of disease.

If the infection is not only limited to the soft tissue, but instead the bone which supports the implant is also affected, in other words, you have peri-implantitis, then a series of surgical treatments aimed at slowing down the progress of the disease in order to avoid it worsening exists. In some cases, part of the lost bone can be recovered, although this latter type of technique is less predictable nowadays.

Additionally it can also be necessary to undertake surgery which allows the quality of the soft tissue around the implants to be changed, in such a way that it allows the oral hygiene around them to improve, or even correct aesthetic defects which may have arisen.

How can I prevent problems occurring around my implants?

Firstly it is fundamental to ensure correct oral hygiene around the implants.  In the University Dental Clinic the students who treat you will explain how to do this correctly in order to ensure that they are clean and healthy. However, there are other significant risk factors.  If you have suffered from or are suffering from periodontal disease it is necessary to attend periodontal treatment appointments as frequently as indicated to you by Periodontal students.

Some metabolic disorders such as diabetes along with bad oral hygiene and the presence of pyorrhoea can mean that the implants fail more often.  Therefore it is important to ensure that the disease is controlled correctly.  Another significant enemy of implants is tobacco.  It is important that you know that if you smoke the risk of your implants failing is much higher.

What are the rules for good hygiene?

Each type of restoration will require specific oral hygiene rules.  In other words, a mouth with only one implant to replace a missing tooth will not require the same brushing technique as an oral cavity which has been restored with multiple implants fitted strategically and which can be fitted at a certain distance to each other.

How often should I go for a check-up if I have implants?

During the first year after the implants have been fitted it is recommended that you have a check-up every 4 months.  Subsequently, if you are a healthy periodontal patient, in other words, you have no gum disease, and then every 6 months will be sufficient.  If you have periodontitis or pyorrhoea then you need to have a check-up.  This tends to be every 3 to 4 months.

Recommendations from our specialists after a periodontal intervention

  • It is highly possible that the injury may bleed a little, and that the part of the face close to the area operated on may become inflamed and you may notice excessive salivation.  If you notice any haemorrhages, place a small piece of gauze over the operated area for half an hour. If you want, you can put ice in a plastic bag and apply it to the part of your face that has been operated on. Put pressure on it for 15 minutes every hour for the first three hours after the intervention
  • For the first few nights after the intervention, make sure that you sleep with your head a little higher than the rest of your body.
  • Eat soft food at room temperature.
  • Apply vaseline or another type of lubricating ointment to the corners of your mouth, three or four times a day if you notice any discomfort in this area (the feeling that your lips have split).
  • As is the case after any surgical intervention, resting the operated area is very important in order to encourage scarring and reduce the possibility of pain, haemorrhage and inflammation. Please avoid any excessive effort of any type.  You can live your life as normal; however you should try to reduce your physical activities for the first few days.
  • It is recommended that you limit the use of tobacco or don't smoke at all for the first 7 days after the intervention, as well as limit your alcohol intake for the first four days.
  • We hope that you have no problems over the first few days after the intervention. If this is not the case, please don't hesitate to contact us.
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