Periodontal treatment (periodontology): process, costs, painless

periodontal disease treatment
(Periodontics)

Periodontitis (dentistically correct: periodontitis) is a real widespread disease, which affects about 80 percent of people over 40 in their lifetime in this country. It is initially a painless and basically easy to get hold of bacterial inflammation, but it can have far-reaching consequences if left untreated. The most important thing is regular check-ups at the dentist: he recognizes periodontitis early on and can start treatment immediately.

Only when periodontitis progresses will there be a comprehensive one periodontal Therapy necessary. It focuses on two things: On the one hand, it has the unconditional goal of stopping the progressive inflammation; on the other hand, it is an important measure for the long-term preservation of the tissue that supports the teeth.

What is periodontitis?

It is an inflammatory reaction of the so-called tooth bed. The tooth bed connects the tooth with the jawbone and is made up of connective tissue, gums and bones.

Periodontal disease is triggered by bacteria that accumulate in the oral cavity if they find suitable conditions there. They settle on the teeth, which consist of saliva and food remnants, and multiply there, but over time they secrete acids that are so aggressive that they can cause inflammation of the gums.

Inflammation of the gums (medically called gingivitis) is something like a preliminary stage of periodontitis (periodontitis), but is usually still painless. Instead, gingivitis often occurs with symptoms such as discoloration of the gums and ">bleeding gums. Only when this inflammation has progressed to the tooth bed is it called periodontitis.

Risks from periodontitis

If the inflammatory disease remains untreated and progresses to the jawbone, it can gradually recede. Along with the bone, the gums also begin to retreat, so that the teeth appear longer in the further course due to the exposed tooth necks. If the periodontal disease is not stopped and reaches a severe stage, symptoms such as loose teeth indicate that the decline (and possibly later loss) of the jawbone is already underway.

If the bacteria reach the bloodstream, they even become a danger to the entire organism, because in the worst case they increase the risk of secondary diseases such as diabetes, stroke and heart attack.

Periodontal treatment: classic therapy or surgical measure?

If the periodontitis is recognized early by the dentist, conventional basic therapy can already be the successful means to an end in order to control the inflammation. Only when the periodontitis has progressed strongly or the basic therapy has not started does a surgical intervention have to be planned. The decision of the dentist for a conventional measure or surgical therapy depends on the symptoms: how large is the number of bacteria that have successfully spread in the mouth, whether and if so how much has the teeth loosened and whether the gum pockets are already a few millimeters deep.

However, careful follow-up care, both in the dentist’s office and at home, is essential for long-term recovery and gum health in every case of periodontitis.

Periodontal treatment: course of conventional treatment

The first step in classic periodontal therapy is to remove bacterial deposits from the teeth. Because only if the bacteria are prevented from multiplying in the oral cavity can periodontal treatment be successful in the long term. The dental step is primarily the removal of the inflammation; the subsequent thorough dental care at home is just as important.

For classic therapy, the gum pockets are first cleaned manually by the dentist: This way, he can remove both soft and hard deposits. It then smoothes the accessible areas of the tooth roots so that no new aggressive plaque can form there as well.

This basic therapy is often successful and stops the inflammation. If periodontitis is more serious, concomitant treatment with antibiotics may be advisable. For this purpose, the germs responsible for the inflammation can be located using a laboratory test and their type determined. Antibiotics are either taken in the form of tablets or put into the gum pocket by the doctor as a gel.

Periodontal treatment: course of surgical treatment

If, for example, very deep gum pockets are the case or if conventional therapy has not been successful, surgical periodontal treatment may be necessary. One possible reason for this is that periodontitis affects not only the gums, but also the jawbone. There are several surgical treatments that can be used, which we will explain below.

Surgical periodontal treatment: cleaning the gum pockets

If the periodontal pockets that are affected by periodontitis are very deep and also difficult to access, the dentist can open them with a small amount of surgery with local anesthesia, thereby clearing the root surfaces. In this way, deposits that have accumulated in the depth can be removed and irregularities smoothed, in which otherwise bacteria could continue to settle.

The most important effect of the treatment: during this periodontal surgery, the bacteria responsible for periodontitis are removed and the teeth have a firm hold in the teeth again.

Surgical periodontal treatment through "controlled tissue regeneration"

With the so-called Guided Tissue Regeneration (GTR) it is possible to significantly support the regeneration of the periodontium that is affected by periodontitis. This “controlled tissue regeneration” requires a small amount of surgical intervention. The goal is to attach a special membrane between the jawbone and gums to stop the deep growth of the gums. This "barrier" gives the entire tooth retention apparatus enough time and the space needed to start from scratch.

Surgical periodontal treatment with bone / bone replacement

If jawbone has already regressed due to severe periodontitis, the transplantation of natural bone material extracted from the body can bring considerable success. For the reconstruction of the bone, some bone is removed from the area of the back jaw and then placed in the affected area. If the extraction of own bones is not possible, artificial materials can have a similar effect. Both the former and the latter procedure often result in an improved bone structure.

Surgical periodontal treatment with plastic periodontal surgery

Since periodontitis affects health on the one hand, but can also become an aesthetic problem depending on the severity, periodontal treatment using plastic periodontal surgery is a useful option in some cases.

Because the decrease in gums ensures that the teeth appear optically "long", and it also affects the course of the gums, which subsequently no longer looks regular. If the bulges of the gums, which are normally clearly visible, decrease with the course of the periodontitis, this is a considerable aesthetic limitation for many patients.

To treat this optical blemish, the dentist can replace the gum-free area between the teeth with small pieces of tissue that he takes from another part of the oral mucosa.

Following this treatment, as in the case of every periodontal treatment measure, it is advisable to pay more attention to thorough daily oral hygiene in order to rule out a new infection and to maintain the gum health that has been achieved.

Periodontal treatment is painful?

The dentist will anesthetize the relevant areas locally in order to carry out the procedure required for the individual periodontosis treatment without any pain. Painful treatment is usually completely excluded under local anesthesia.

Duration of periodontal surgery

Such a treatment not only has to be prepared individually and precisely by the attending dentist, it can also be quite extensive, depending on the severity of the periodontitis. It may be the case that several therapy sessions are necessary before the desired success can be achieved.

Periodontal treatment: what you can do yourself for preventive and follow-up care

It is important to know that periodontitis is a chronic disease of the gums and the periodontium that you have to take care of for a lifetime once it has occurred – despite and especially after the medical treatment.

In order to avoid the spread of bacteria and prevent periodontal disease with daily hygiene, a thorough routine is absolutely advisable, for example with dental floss or interdental brushes. Regular professional tooth cleaning also helps to keep the entire mouth clean.

In particular, if the disease has already led to gum recession at the time of periodontal treatment and is accordingly associated with exposed tooth necks, the teeth are also more susceptible to caries.

Regardless of the severity and duration of treatment for periodontitis, it is of the utmost importance for sustainable results to pay attention to thorough oral hygiene at home and regular check-ups in practice – otherwise there is a risk of a new infection. However, both measures together open up the best opportunities to permanently maintain the results after periodontal treatment.

Summary – How to Get Successful Periodontal Treatment:

Brush your teeth thoroughly at least twice a day (preferably about half an hour after meals)
Teeth every day >Periodontal treatment costs

Statutory health insurance covers both the costs for twice-yearly checks at the dentist and every two years for a special check for periodontitis. The benefits provided by the health insurers are also intended to cover the relief of acute inflammation and the spread of the infection in the oral cavity. However, prophylaxis such as professional tooth cleaning are usually private services that are only subsidized by the health insurers in exceptional cases.

Periodontal Treatment Costs: Requirements and Details

In addition, periodontal treatment is often taken over by the statutory health insurance companies. However, the prerequisite for this is that, among other things, there is no tartar in the teeth, the dentist has informed you about thorough oral hygiene and, if necessary, trained the patient in it.

Important: If the cash register is to bear the costs, this must be applied for before the periodontal treatment begins.

On the other hand, the laboratory test, for example, must be carried out completely privately, with which germs that cause periodontitis can be precisely determined and then treated with antibiotics. The same applies to periodontal surgery, which can be used to regenerate and reconstruct tissue and bones. Your dentist will be happy to provide you with detailed information about the possible costs on request.

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