What is periodontitis?
Is an infection caused by bacteria that destroys the attachment of the teeth, which is composed by the gums and bone. The final result of the untreated disease is tooth loss.
Which is the cause?
It is a chronic disease caused by bacteria. There is a genetic component that has a great impact and environmental factors which modulate and affect periodontitis. The most important environmental factors are the level of gum inflammation, tabacco and certain systemic diseases such as diabetes. Although the genetic component can not be modified, we are able to control many of the environmental factors to stabilize the disease and avoid the lost of the tissues which support the teeth.
How does it start?
The initial symptom which is identified more easily is the bleeding gums or gingivitis. In this stage there is not lost of attachment yet and then it is important to act at this time (in smokers there may be no bleeding gums and active pathology). Other symptoms that can be identified are the loss of gingiva (exposed root and the tooth appears longer), suppuration, halitosis (bad breath) and tooth mobility due to bone loss.
Which is the treatment?
The treatment can be divided in three parts. A first phase in which environmental factors are evaluated, oral hygiene instructions given and scaling and root planing performed to reduce inflammation and stabilize the disease. The second phase (may not be necessary in all cases) consist in performing minimally invasive interventions to reduce inflammation and regenerate bone or gingiva loss. Finally the third phase consists of maintaining the results obtained. In this phase, level of inflammation is assessed and hygiene protocols performed depending on it. This phase is probably the most important, it is known from studies that periodontal treatment without maintenance does not work.
How often do I have to do maintenance?
The interval between maintenance is individualized for each patient. The frequency depends on factors such as age, plaque index, attachment level, level of gum inflammation and tabacco among others. The maintenance period is usually carried out every 4,6,9 or 12 months depending on this factors.