Periodontology

Periodontology is the field of dentistry, that covers the treatment of teeth and tissues surrounding the tooth. Periodontal diseases are generally divided into two categories, as gingivitis and periodontitis (inflammatory diseases accompanied by bone loss along with gingivitis). Periodontal diseases are the cause of 70% of tooth loss in adults. In gingivitis, only the gums are affected. During this period, gums bleed, redden, and swell. Gingivitis can be reversed with regular oral care and dental cleaning. If simple inflammation of the gums progresses, it can cause a gum disease called ‘periodontitis’, which leads to the loss of the jawbone. Smoking, genetic factors, hormonal changes, stress, medication use, bruxism, some systemic diseases, malnutrition, and improperly performed restorations are also causes of periodontal disease.

Types of Periodontal Treatment

Scaling:

It is the process of cleaning tartar, dental calculus, and similar residues on the teeth. During the procedure, dental calculus and stains on the surface of the teeth are removed, and the patient is trained in oral hygiene. For special cases, it is recommended to perform a dental calculus cleaning every 6 months.

Scaling & Root Planing:

If dental calculus and inflammatory tissues cover the gum and tooth root; the gum is anesthetized with local anesthesia and the area is curetted. Dental calculus and inflammatory tissues on dental root surface are removed, reshaping of the gum above the root surface is awaited.

Flap Operation:

The depth of the gum pocket on a healthy gum is about 1-2 mm. In cases where the inflammation of the gums progresses, the depth of the pocket increases. If these formed pockets cannot be shallowed by other methods, the gum forming the pocket is surgically removed. The gum is removed as a whole and the necessary root surface straightening operations are performed under it, it is then closed and fixed in place with sutures. If at this stage it is necessary to support the bone with loss or it is thought that bone may be formed in this area, hard tissue grafts or bone particles obtained from the patient’s own tissue are placed in the defect region to try to restore the lost tissue.

Tissue Grafts

Soft tissue grafts:
They are the procedures of covering the gum recessions that have happened due to misuse of toothbrush, gum diseases, or bruxism (tooth grinding) in one tooth or multiple teeth with a piece of tissue that is extracted from a different region of the mouth (usually the palate). It is usually done for aesthetic purposes or, in some cases, for preventive purposes so that the gum disease does not progress.

Hard tissue grafts:
Bone construction is stimulated by artificial or natural bone meal applications in regions with advanced bone loss.

Gingivectomy and Gingivoplasty:

Gum growth is observed due to inflammatory, drug-induced, or hereditary reasons. To eliminate these gingival growths, we can excise and extract the soft tissue wall of the pocket between the tooth and the gum. This procedure is called Gingivectomy. After this procedure, Gingivoplasty is usually performed to restore normal physiognomy by correcting the gums with surgical methods.

Bad Breath Treatment (Halitosis):

Although most (90%) of bad breath is due to an intraoral reason, some of it may also originate from extraoral sources. Oral infections, sulfur compounds formed by bacteria living in tooth cavity, advanced gum disease, or bacteria that settle in food residues left inside the mouth for may hours may cause certain odor.

Other systemic problems that cause bad breath are: sinusitis, diabetes (acetone smell), gastrointestinal disease, renal failure (the smell of freshly mown grass), postnasal discharge, liver and metabolic disorders. First of all, the cause of bad breath should be diagnosed and treated accordingly. Halitosis can be prevented with the treatment of gum diseases and the extraction of extraction-indicated teeth, change of restorations that need to be renewed, and increased oral hygiene.