Periodontology
What is periodontitis?
Periodontitis is a chronic inflammation of the entire periodontium caused by bacteria in dental plaque. The body’s own defenses react to this, causing damage to the jawbone and the fibres holding the tooth in place. As a result, teeth can become loose and eventually be lost. Periodontitis is the most common cause of tooth loss in adults.
Dr. Sabine
Baron, M.Sc.
Dr. Andrea
Wahl
Dr. Baron and Dr. Wahl are our specialists in periodontology
Warning Signs
- Bleeding gums when cleaning with a toothbrush or interdental brush
- Swelling of the gums between the teeth or at the gum line
- Darker color in contrast to pale pink, healthy gums
- Bad taste
- Bad breath
- Loose teeth: when teeth begin to “migrate”, become longer, or gaps form
- Receding gums
In all these cases, your gums should be examined.
Dental Examination Methods
A careful examination is carried out to determine whether a disease exists at all, and if so, which one. The gums are examined, among other things, for:
- Bleeding tendency, i.e. whether a careful touch is sufficient to cause bleeding
- The pocket depth, as a measure of how far the inflammation has already spread along the tooth surface under the gums
- The degree of loosening of the teeth, which is to be regarded as a measure of the extent of bone loss
- mit Röntgenaufnahmen wird der Knochenverlauf um die Zahnwurzeln herum untersucht und beurteilt in welchem Maße ein Knochenabbau stattgefunden hat.
Early detection of diseases of the periodontium
How does periodontitis develop?
The Periodontal Screening Index (PSI) can be assessed as part of your annual dental check-up. If you have statutory health insurance, the PSI can be billed to your statutory health insurance provider every two years. The examination only takes a few minutes and you will hardly feel it.
Therapy
Hygienically clean and smooth, even under the gums
Good domestic oral hygiene and participation in supportive periodontal therapy (SPT) are important for maintaining the success of the therapy. Without participation in a regular recall, the success of periodontitis therapy will not be permanent.
The therapy begins with preliminary treatments, which involve thorough cleaning above the gum line, as well as instruction in oral hygiene. The aim of this is to enable the patient to optimize their oral hygiene at home and thus contribute to the long-term success of the treatment. During pre-treatment, all clinical and radiological parameters required for diagnosis and assessment of the severity of the disease are recorded.
Depending on the findings, it is decided whether additional microbial diagnostics are useful.
Causes of Gingivitis
How does periodontitis develop?
- Inflammation of the gums and periodontium usually has several causes and is therefore multifactorial.
- This is triggered by bacteria in dental plaque (plaque/biofilm). If oral hygiene is inadequate, these harmful bacteria can multiply and cause inflammation.
- Initially, only the gums are affected (gingivitis). Without treatment, however, the inflammation can spread to the bone and the supporting fibers.
- Factors such as smoking, diabetes, an unbalanced diet or stress increase the risk and can worsen the course of the disease.
What you can do
Your Periodontitis Risk
On the trail of dangerous germs
Factors for an increased risk can be:
- Systemic factors (e.g. diabetes mellitus)
- Genetic factors (e.g. IL-1a/1b polymorphism)
- Stress (weakens the immune system)
- Nicotine consumption (the strongest risk factor of all)
Periodontitis Stop Program
Important: regular aftercare
After the successful treatment of inflammatory gum disease (periodontitis), regular aftercare is crucial to prevent a flare-up or re-infection. Periodontitis can only be stopped permanently through consistent, regular care together with careful oral hygiene at home!
“Critical zones” must be checked at regular intervals. Subsequent cleaning of hard-to-reach areas can then prevent the formation of a “periodontal pocket.”
Ask about our recall program: we will gladly call you when it’s time again – or, even better, schedule your next appointment immediately after a cleaning. Your healthy gums will thank you.
Reconstruction of Bone
Plastic periodontal surgery I
Guided tissue regeneration
This makes it possible to regain lost supporting tissue of the tooth and jawbone.
The existing defects are filled with the patient’s own or foreign bone, depending on the patient’s wishes. This freshly introduced bone is protected until it has completely healed by a membrane that covers the material and at the same time controls the tissue. The membranes can be resorbable or non-resorbable.
EMD, enamel matrix protein (Emdogain)
This is a protein obtained from tooth germ extracts from pigs. It is intended to promote the regenerative renewal of lost periodontal structures. It is therefore used in periodontal therapy to promote tissue regeneration.
Reconstruction of Gums
Plastic periodontal surgery II
Widening of the attached gingiva
Sufficient thickness and width of the attached gingiva delay the rate of spread of inflammation and ensure mechanical resilience of the gums. If attached gingiva has been lost, it is possible to regain it through a mucosal graft.
Recession coverage/connective tissue graft
This refers to the coverage of exposed tooth necks. This may be necessary if exposed tooth necks increasingly lead to unpleasant pain sensations due to mechanical influences (contact when brushing teeth), thermal influences (cold/heat) or chemical influences (sweet/sour).
On the other hand, an exposed tooth neck often represents a purely aesthetic problem, which can be corrected in this way.
A proven method is recession coverage with the help of a connective tissue graft. This is taken from the palatal side and transplanted onto the exposed tooth neck. The advantage of this method is the good prognosis, combined with an uncomplicated and rapid healing of the tissue.
Displacement/removal of disturbing or deeply attached ligaments
This procedure serves to prevent recessions (gum recession) and additionally facilitates effective oral hygiene.
Impact on the Body
Influence of gum disease on the whole body
Scientific research in the recent past has revealed connections and interactions between diseases of the gums and the entire organism. Examples of this are:
- Heart attack
- Stroke
- Premature births and low birth weight
- Respiratory tract infections
- Type 2 Diabetes Mellitus
Conversely, the severity of gum disease can be significantly increased by certain factors. These include:
- Smoking
- Stress
- Diabetes
- Nutritional deficiencies
Close cooperation with other specialists, such as internal medicine physicians, is then very helpful (www.mein-arzt-in-wiesbaden.de).
If you have any questions or would like an examination, please make an appointment. We help you to detect periodontitis at an early stage, treat it effectively and control it in the long term.
Further information and a self-test can be found on the website of the German Society of Periodontology DGParo: https://dgparo.de/gesund-im-mund/