Periodontal Disease

Periodontology is clinical oral hygiene (ultrasound cleaning of the plaque, calculus(tartar), tobacco and polishing with sodium – air-flow), treatment of gingivitis and periodontitis, personal oral hygiene motivation.

Gingivitis – The inflammation of the gums starts with the presence of tissue liquid, tissue damaging and swelling. The gingivitis can be primary and secondary.

Gingivitis appears due to the plaque, calculus, sharp edges of broken crowns, roots, incorrectly made fillings and false teeth. Symptomatic gingivitis appears together with many blood, infectious, allergic etc. disease. The inflammation can be acute or chronic. The acute inflammation is characterised by a slight itching, the gingival papillae are painful when touched, there is bleeding and increased saliva secretion. The chronic inflammation has less intensive symptoms. Rarely, there can be puss gingivitis as a bacterial complication, with swelling, appearance of small wounds and abscesses, swelling of the regional glands.

The ulcer gingivitis is quite common too. It has infectious origin. The acute ulcer gingivitis starts with night pain and the appearance of ulcers. The gingival papillae necrotises and are covered in grey-yellowish slough. Patients have fever (high temperature) and feel weak. This gingivitis most often appears together with a viral illness. Acute necrotising ulcerative gingivitis affects young adults, pregnant women and patients suffering from epilepsy. Red, swollen gums are present. Little knots are formed gradually, which start bleeding very easily. In the later stage of the illness the knots become compact and stop bleeding. Gingivitis is treated by thorough scaling and polishing, antiseptic agents, vitamins, suitable mouthwash, toothpaste. Gingivitis requires special treatment by a dental professional, which includes anaesthetic, scaling, applying medication on the ulcers, applying antibacterial medication.

Chronic Periodontitis is a disease of the supporting tissue and bone of the teeth. It affects the underlying periodontal ligament and the alveolar bone. They are destroyed and the teeth become very loose. The most common reasons for this disease are prolonged traumatic factors: accumulation of calculus, poorly-made restorations, crowns, bridges and partial dentures, abnormal placement of the teeth (malposition), etc.

All the above mentioned factors lead to the damage of the gums by food debris which get stuck between the teeth. The bacteria in the plaque and the calculus start feeding on it and start damaging the supporting tissue of the tooth. The gum recedes and part of the root becomes visible. Sometimes the gingiva my recede even to the tip of the root because the supporting bone has been eaten away. The tooth socket has disappeared.
Periodontitis sometimes has intermittent active phases followed by quiet phases of little bacterial activity.
Certain factors can make the periodontal disease worse although they cannot cause the disease themselves. These are:
- Smoking;
- Hormonal changes occurring in puberty and pregnancy;
- Mouth breathing;
- Diabetes;
- Leukaemia;
- Vitamin C deficiency.

Treatment of Chronic Periodontitis is done by a dentist. Calculus is mineralised plaque. Dental plaque is a sticky layer of bacteria forming on the outer surface of the teeth. When the plaque starts forming it is colourless and invisible to the eye. Calculus is commonly found in adults but not children. It is not harmful itself but its uneven surface allows pathogens to cling to it. This is why people in ancient times have tried to find ways of removing it.

According to the place it is located it can be: Supragingival calculus – forms above the gingival margin, on the crown of the tooth. It is yellowish or brownish in colour. It is darker in smokers’ mouth or when it has been there longer. It is softer and easier to clean compared to the subgingival calculus.

Subgingival Calculus – it is hard to detect in examination as it is beneath the gum margin. It is harder to clean and darker in colour. Regular cleaning of the calculus (by a dentist, dental hygienist or dental therapist) and making sure that plaque is not accumulated by regular brushing of the teeth guarantees healthy teeth, fresh breath and a charming smile.