Periodontitis is a critical infection of the gums, which is caused by the accumulated bacteria on your teeth and gums. With the progress of periodontitis, a patient’s bones and teeth are likely to be damaged. However, the damage can be taken care of if periodontitis is treated at an early stage, and proper oral hygiene is maintained. The periodontal examination includes evaluation of both soft and hard supporting tissues of the dentition. Soft tissue assessment is expected to identify the thickness of the fibrous connective tissue, the amount of attached keratinized tissue, and the symmetry of gingival scallop. The tissue biotypes are categorized based on the depth of supporting bone and gingival soft tissues. The thick and fibrous tissue is more forgiving, effortlessly manipulated, and also provides a predictable aesthetic outcome, as compared to thin fabric, which is more likely to compress.
To determine the disease and its severity, the dentist needs to review your medical history to determine whether any factors such as smoking or taking certain medications stimulate it. The dental professional is also trained to examine your mouth and measure the pocket depth of the groove between your gums and teeth through a dental probe. In a healthy mouth, the pocket depth is usually between 1 and 3 millimeters (mm). If the pockets are deeper than 4 mm, it may indicate periodontitis. And if pockets deeper than 6 mm, cannot be adequately cleaned.
Different Types of Periodontal Treatment
Periodontitis treatment aims to clean the pockets around teeth thoroughly and prevent the damage in the surrounding bone. This treatment is performed by a periodontist, a dentist, or a dental hygienist. Most importantly, to achieve a successful result, one needs to adopt a daily routine of good oral care and avoid tobacco. Depending on the severity, there are both nonsurgical and surgical treatments to deal with periodontitis. Surgery is typically very successful. The nonsurgical treatments are done if periodontitis isn’t advanced much.
There are mostly less invasive procedures which include:
- Scaling: It is a careful cleaning of the root surfaces to eradicate plaque and calculus/tartar from deep periodontal pockets by using instruments, a laser, or an ultrasonic device.
- Root planning: It polishes the root surface, discouraging the further build-up of tartar and bacterial toxins and by-products that restricts healing or reattachment of the gum to the tooth surfaces.
- Antibiotics: It helps to control bacterial infection. Topical antibiotics are inserted in the space between your teeth and gums or into pockets once deep cleaning is done. But oral antibiotics are essential to obliterate the infection-causing bacteria.
The surgical treatments are done when there are severe infections. Dental surgery is the only way out if a patient has advanced periodontitis. This includes;
- Flap surgery: It is also known as pocket reduction surgery. Here, the dentist makes tiny incisions in the gum, exhibiting the roots for more striking scaling and root planing. As periodontitis often causes bone loss, it needs the bone to be recontoured before the gum tissue is settled back in place. It is easier to clean the infected areas and maintain healthy gum tissue once healed.
- Soft tissue grafts: During the treatment, one may need to have some of the impaired soft tissue reinforced, where soft tissue graft helps. It is done by removing a small amount of tissue from the roof of the patient’s mouth or another