Periodontology is the science that deals with the supporting tissues around the teeth and gum disease and oral tissues.

Healthy gums?

Healthy gums can be recognized by a beautiful pink color, the presence of papillae (gums between the teeth), the characteristic specks on the gums and the absence of bleeding when brushing.

What is dental plaque?

Plaque (and the contained bacteria) were already described in the 17th century. Plaque consists out of bacteria (for more than 70%). These bacteria are packed very closely together. In one milligram of plaque (as big as a pinhead) about 100 million bacteria occur. Furthermore, it contains also bacterial secretions, dissolved substances from food, proteins and water. 
Plaque itself adheres firmly on all surfaces in the mouth, but in particular on the hard surfaces. This also explains why dental plaque can NOT be removed by rinsing.
People can acquire and develop plaque quickly or  slowly. This is 'inter alia' determined by the state of the gums, the use of sugar, the salivation, the presence of retention sites, the composition of the saliva,...

Gingivitis - Gingivitis

Prevalance 

Gum disease is a disease with a high prevalence and can already occur at an early age. Their occurrence increases with age, reaching, according to studies from the 70s, a peak around puberty. According to US data, the prevalence in the adult population would be around 50%.

What causes gum disease?

Overall, we can describe a gum disease as an imbalance between attack and defense. The attack is triggered by the bacteria in dental plaque. The defense is provided by a number of biological processes. We can assume that an adequate oral hygiene is the main form of defense against these bacteria.

In 1965 Professor Loë could show this connection (between bacterial plaque and gingivitis) for the first time. In patients with a healthy gums all forms of oral hygiene was interrupted for 3 weeks, causing dental plaque could form undisturbed. This created gum disease (gingivits) in most individuals.

How can I recognize gum disease?

Gum disease is characterized by:

  • Bleeding during brushing, eating and sometimes even spontaneously
  • Swollen and red gums
  • Disappearance of the characteristic specks of the gums

How can gum disease be treated?

The inflammation of the gums is a bacterial reversible infection. This means that after treatment, the gums can return to a normal state. This treatment consists of a thorough professional dental cleaning and an individualized oral hygiene instruction. Of course, the patient himself has a major contribution. Inadequate oral hygiene, after all, will once again result in a new gingivitis.

Periodontitis

The term "periodontium" corresponds to the surrounding tissues of the teeth (the periodontal ligament, cement and jaw bone). The term "periodontitis" means an inflammation of the surrounding tissues. When an inflammation of the gums is not treated for a long period of time, this will at a certain time (depending on individual) pass into periodontitis. The oral bacteria will create "pockets" around the teeth. 

Ultimately, this will result in damage to the surrounding tissues and its degradation, by which in other words SUPPORTING JAW BONE TISSUE around the teeth is lost.
Usually periodontal disease in the early stages will not yield real complaints. In many cases, at the initial stages  symptoms are comparable to gingivitis. There's no real pain or discomfort involved. Only in later stages, recession of the gums (accompanied by a loss of the papillae) will occur. This will eventually result in loosening of teeth, abscess formation, and often a bad oral odor and taste.

it is important to realize that this is an irreversible bacterial disease. Despite a periodontal treatment (which will be able to bring the infection under control), the loss of supporting tissue will not recover.

Before starting a treatment, it is important that the situation per tooth is analysed. In this way a complete treatment plan can be prosposed. It goes without saying that this is depended on the patient.  
Again, the patient himself has a very large share in the success of periodontal treatment, as the cornerstone of it remains a good oral hygiene.

A periodontal treatment includes:

  • an "intake" consultation in which the situation is analysed individually, on the basis of X-ray images, pocket  measurements and a microscopical assessment of the plaque. Together with the patient a treatment plan is proposed.
  • initial periodontal treatment, also called 'scaling and rootplaning'
  • an evaluation, three to four months after the initial periodontal treatment. This involves determining the possible need for additional treatments.
  • aftercare phase, through regular recall visits, tailored to the patients needs. 

Below you can find an animation on periodontal disease.

 

 

Is there a link between periodontal disease and general health?
Numerous studies have demonstrated that there is a link between periodontal disease and the general health, including:

  • diabetes
  • cardiovascular disorders
  • premature birth and low birth weight
  • respiratory diseases
  • rheumatoid arthritis.

Furthermore,  studies have shown a possible association between obesity, dementia, erectile dysfunction, COPD and pancreascancer.
2014 was the year where "European Federation of Periodontology ' put her main focus on these associations between periodontal disease and general health. The following movie gives an overview.

 

 

Aesthetic periodontal surgery

Periodontology is primarily focussing on the treatment of an infectious disease (periodontitis). Completely diametrically opposite periodontology also consists out of a variaty of "aesthetic - cosmetic surgery".  Aesthetic corrections of the gums are made through various techniques. The most common procedures are:

  • the clinical crown extension: in which the crown of the tooth is extended as a function of a later recovery by means of a crown.
  • the treatment of gingival recessions: lost tissues are restored by grafting
  • ponticbed structure: when working with crowns and bridges, the tissues are made as natural looking as possible.

The result to be achieved is always discussed in advance with the patient. In some cases it is impossible to obtain a complete result.