What is periodontal disease?
Periodontitis is a disease of the Zahnhalteapperates, that is, the tooth is healthy, but the gums are sick. How do you recognize that??
- There are gum bleeds on individual teeth, e.g. whilst brushing one’s teeth.
- The gums go back, it feels like the teeth are getting longer or the gums are slightly swollen, inflamed and a bit thicker.
- When measuring your periodontal pockets, your dentist will determine that they are deeper than 3mm.
How is this disease??
First, only the gums are inflamed. If you recognize it in time and treat it, the disease can be stopped. If the disease progresses, the bone is broken down, the teeth become loose and eventually they fall out. However, this process continues for years. With the treatment of periodontitis, no bone can be rebuilt, but you can stop the progression of periodontitis and stop the bone degradation with regular control.
How is the treatment??
- Three pretreatments are given once a week, and the hard deposits on the teeth above the gums are removed by ultrasound.
- On the third day of treatment X-rays are taken from the teeth and the depth of the periodontal pockets is measured for each tooth. This finding is submitted to the health insurance and must be approved. Only then begins the actual periodontal treatment, which is paid in full by the health insurance.
- The periodontal treatment is carried out in 2 sessions. The gums are a little stunned and each tooth is then cleaned in the depth of the pocket of tartar and plaque. Finally, the bags are rinsed with a disinfectant solution.
- In the after-treatment (about a week later) is rinsed only once and controlled.
- The most important thing after this treatment is the regular check (also called Recall). So that the inflammation does not become acute again and progresses, it is very important that the teeth “clean” after the treatment do not re-accumulate deposits. In the first year after the periodontal treatment you should come to control every 3-4 months.
From the second year on, a semi-annual check is sufficient. At these follow-up appointments it must be checked if the inflammation has improved. A professional cleaning of all teeth will be carried out in this session. The cost of this cleaning is not borne by the health insurance. But only by consistently adhering to this cleaning program can you defeat your illness and keep your teeth as long as possible.
Targeted antibiotic use during periodontal treatment
Periodontitis is a chronic inflammation of the periodontium consisting of gums, collagen fibers (periodontal) and the jawbone. This inflammation is triggered by bacteria, which are located in the soft (plaque) and the hard (tartar and calculus) deposits on the tooth and tooth root surface. In general, in any form of periodontitis, the basis of the therapy is a thorough cleaning of the entire tooth surface above and below the gingival margin.
In the case of severe chronic as well as the form of aggressive periodontitis accompanying by specific antibiotics is inevitable. The use of antibiotics is rightly considered very critical and controversial. There are a few reasons that speak against the routine use of antibiotics. The main topic is the resistance formation after antibiotic therapy in consequence of which a loss of effectiveness of the antibiotic can occur in possibly later occurring infections in life.
Side effects and consequences
Antibiotics often cause nausea and diarrhea when given systemically, ie via the digestive tract. At times, they damage the healthy intestinal flora of our digestive tract and this intestinal flora must then be rebuilt by our body only in the weeks following the antibiotic administration. The patient can support this by taking probiotics in the form of probiotic drinks, yogurt or powder / capsules from the pharmacy. However, use of an antibiotic is in some cases essential for the successful course of therapy of periodontitis and prevents the loss of teeth.
Identification of the inflammatory bacteria
Before an antibiotic is used, it is important to identify the inflammatory germs / bacteria due to the mentioned resistance problem. If the periodontal disease is particularly aggressive in the course or shows no improvement despite conventional measures of repeated thorough cleaning of the periodontal pockets, this suggests that one or more of the periodontitis causing bacterial strains are found to be more than average in the pockets.
About the periodontal treatment
To be able to treat specifically with an antibiotic, a so-called germination test is performed. For this purpose, a smear from the inflamed gum pockets is removed by means of small paper tips. This smear is then laboratory-tested and evaluated. The dentist will then use according to the evaluation of the laboratory result, an antibiotic, which is tailored to the diagnosed, causative bacterial strains. After 4-6 weeks after administration of the antibiotic, the germination test is carried out again and the treatment result is evaluated.
Alternative treatment with PerioChip
A promising alternative to the antibiotic in mild “cases” or in individual inflamed pockets is the antiseptic, a chemical that fights infection, prevents or mitigates – the gingival pockets thus “disinfected”. Here in particular the PerioChip shown great success in the clinical studies of recent years. His field of application is the local treatment of periodontal pockets in the context of periodontal treatment. Of the PerioChip is a 4 x 5mm mm Gelantineplättchen containing the active ingredient chlorhexidine and is introduced into the inflamed periodontal pockets. The chip continuously releases the antibacterial agent chlorhexidine for up to 2 weeks, thus disinfecting the inflamed bag around the clock. Of the PerioChip Dissolves in this period without residue in the periodontal pocket. In scientific studies it could be shown impressively that a bacterial resettlement of the thus treated gingival pocket can be completely suppressed up to 12 weeks, which led to the reduction of the pocket depth.
For the treatment of local inflamed gum pockets is the PerioChip quite a real alternative to the use of antibiotics as adjunctive therapy in gum treatment
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