Successful treatment of periodontal disease
A thorough diagnosis of periodontitis is essential for the success of the treatment. This includes special examination procedures such as measuring the depth of the gum pockets. This provides information on whether the inflammatory processes in your mouth are gum inflammation (gingivitis) or already periodontitis. An additional bacterial test can also be useful. It enables – especially in the case of aggressive, therapy-resistant forms of periodontitis – an accompanying therapy with antibiotics. The test result enables the dentist to perfectly match the selection of the antibiotic used to the harmful bacteria that have an individual effect on the patient.
After the diagnosis “periodontitis” we clarify which measures promise the best success in your personal case! As a rule, periodontitis treatment is divided into several phases:
- the initial therapy with
- Hygiene phase and
- actual periodontitis treatment
- If required, tissue regeneration, for example through
- Recession cover to build up gum tissue
- bone development
- lifelong supportive periodontitis therapy (UPT) to maintain the long-term success of the treatment
initial therapy
The initial therapy aims at the most urgent measure: to treat the bacterial infection. It is divided into hygiene phase and periodontitis treatment.
hygiene phase
An initial removal of the periodontitis bacteria on teeth and in the gum pockets takes place through professional tooth cleaning. This is carried out by our trained dental hygienists. For this purpose, our specialist cleans the tooth and root surfaces, the gum line and the interdental spaces with special equipment. After cleaning, the teeth are smoothed with a polish. Finally, the dental hygienist applies a fluoride gel, which ensures that the roughened tooth surfaces close again.
If it is only gum inflammation and not already periodontitis, there is a good chance that the gums will recover, swell and reattach to the tooth necks. If good oral hygiene at home and regular professional tooth cleaning are maintained in the long term, gingivitis can be a serious problem.
Periodontitis treatment (periodontal therapy)
Periodontitis treatment follows the hygiene phase if this alone is not sufficient to control the inflammation. This is always the case with advanced inflammatory processes which already show the clinical picture of periodontitis. In these cases, the gum pockets are usually already very deep, i.e. deeper than 4 mm. The periodontal therapy or also periodontitis treatment for cleaning the gum pockets is carried out exclusively by the dentist under local anaesthesia.
The removal of soft plaque and tartar from the gum pockets is done gently with special hand instruments. After cleaning, the root surfaces are smoothed as with professional tooth cleaning. This is important because plaque adheres much more easily to rough tooth surfaces.
In the case of particularly pronounced periodontitis, treatment with antibiotics and / or chlorhexidine preparations is administered afterwards. Chlorhexidine oral solutions have an antibacterial effect.
Anxious patients can also opt for general anaesthesia or sedation prior to treatment.
Laser therapy, which you will learn more about below, is an optimal supplement to the classical periodontitis treatment.
In particularly severe cases, open periodontal treatment may be necessary. This is connected with a small surgical intervention.
Tissue regeneration after initial therapy
Structure of the gum tissue
After the initial treatment has provided an inflammation-free environment, the gums gradually reattach to the tooth necks. Problematic: Normally, the tooth and the bone compartment are connected by a stable fibre apparatus. This connection can no longer be made after periodontal treatment without external help. Instead of the original fibre apparatus, connective tissue (scar tissue) is formed between the tooth and the bone compartment and the so-called muzzle epithelium. This not only leads to functional losses in the periodontium, but also to easier colonisation of the gum pockets by harmful bacteria.
Here the dentist for oral surgery can intervene by offering the body support in the reconstruction of the periodontium. There are various methods available for tissue regeneration in the case of pronounced periodontal defects as a result of periodontitis, such as recession coverage. Here the free mucous membrane transplant (FST), free connective tissue transplant (BGT) or the sliding flap have proven themselves. In addition, there are a number of other regenerative measures that we would be happy to discuss with you in person.
Bone reconstruction after bone loss due to periodontosis
If periodontitis has already led to bone resorption, bone augmentation may become necessary after periodontitis treatment. The dentist for oral surgery inserts artificial bone replacement material or the patient’s own bone into the bone pocket of the tooth. Over time, bone replacement materials are broken down or converted into the body’s own bone tissue.
Supportive Periodontitis Therapy (UPT)
After the periodontitis treatment has been completed, professional cleaning of the teeth and gums should be carried out at regular intervals throughout the patient’s life in order to ensure the long-term success of the treatment.
Periodontitis treatment with laser
Minimally invasive laser treatment prior to periodontitis treatment (periodontosis treatment) is a very modern and extremely gentle procedure for treating inflammation in the gum pockets. We dentists at the Herne Dental Clinic have already had many good experiences with this option.
How does the laser treatment work?
First we moisten all soft and hard plaque (plaque and concretions) in the gum pockets with a special dye. We then direct the light of a soft laser at the corresponding areas to activate the dye. This procedure does not burn and is absolutely painless. The heat generated by the laser destroys a large part of the bacteria in the gum pockets prior to the following classic periodontitis treatment. Accordingly, the subsequent treatment involves far fewer active bacteria entering the bloodstream. This is particularly important because the bacterial load in periodontosis is closely related to other internal diseases.
What are the advantages of lasers in the treatment of periodontosis?
- The gentle treatment is completely painless and lasts a maximum of one hour per session.
- Gum bleeding often stops completely after a few sessions.
- The laser treatment decimates the periodontitis bacteria even before the actual periodontitis treatment. As a result, fewer bacteria enter the body.
- The laser therapy favours a lasting treatment success.
Laser therapy is an affordable private service that pays off particularly well.