From the greek περί (around) and ὀδούς (tooth), periodontics is the branch of dentistry that deals with the diagnosis and treatment of diseases affecting the periodontium, supporting organ of your natural teeth, consisting of alveolar bone, cement root, the periodontal ligament and gingiva.
Depending on the depth of periodontal disease can be divided into superficial gum disease (gingivitis) or deep gum disease, periodontitis (pyorrhea). It has been amply demonstrated that the lack or an inadequate oral hygiene causes gingivitis in all subjects, while the chronicity of the disease (due in some cases to an individual genetic predisposition) is due to rupture of the periodontal ligament resulting in deep penetration (and therefore involvement of the bone) of special forms of bacteria, due to the fact that the patient has not undertaken a proper therapeutic procedure.
Scaling and root planing
There are a number of factors that contribute to the manifestation of the disease, both acute and chronic:
a. hormonal (pregnant women and teenagers for example, have shown a higher incidence of gum disease)
b. genetic (the people who have in their household a person with the disease have a greater chance of developing periodontal disease).
c. traumatic (occlusal trauma of the first type, that is, those injuries caused by abnormal forces in intensity or direction applied on the teeth) or prosthetic interventions and / or conservative incongruous that predispose to a greater accumulation of bacterial plaque.
d. systemic (systemic diseases such as cardiovascular disease, or diabetes have shown a close correlation with the onset of the disease)
Early symptoms of periodontitis should not be underestimated:
a. gingival inflammation, bleeding gums when brushing your teeth everyday or while chewing food very solid and tough;
b. swell and intumesce of the gums, which become more and more sensitive to even contact with toothbrush or food;
c. halitosis and alteration of taste sensitivity;
d. the apparent lengthening of teeth determined by the retraction of the gums (gingival recession)
The steps for a correct therapeutic approach are:
• periodontal probing or diagnosis by clinical examination of the soft tissues: it evaluates the extent of periodontal pockets, the consequent loss of support of the teeth, the degree of bleeding and recession in the gums Through the use of millimetric sensor it is possible to determine the depth of the pockets, while a series of x-rays allow the doctor to estimate the structure and the status of the residual bone. The information collected is annotated in the medical record in order to be used for the formulation of the correct treatment plan, and to be compared with the data collected during the progress of the treatment, to evaluate their effectiveness and outcome. Functional tests can be conducted in all patients suffering from disorders such as bruxism or malocclusions
• etiology: scaling and root planing (curettage) to remove all agents that cause disease (plaque, tartar, necrotized tissue, granulation tissue) and allow reattachment of the supporting tissues to the tooth surface. At this stage the patient is provided with all the signs and the rules for proper oral hygiene, which is essential observance for the success of the treatment plan.
• maintenance phase: it is important that the patient maintains a constant contact with the specialist for the control of possible recurrence of periodontal disease and to pursue a proper oral hygiene according to the methods learned from the dentist.