••••••>periodontal Disease And Its Treatment

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Periodontal disease is an infection of the tissues that support your teeth. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket: generally, the more severe the disease, the greater the depth of the pocket.

Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.

Some factors increase the risk of developing periodontal disease:

Tobacco smoking or chewing
Systemic diseases such as diabetes
Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers ...
... and oral contraceptives
Bridges that no longer fit properly
Crooked teeth
Fillings that have become defective
Pregnancy or use of oral contraceptives

Treatment:

Gingival Curettage:

Gingival curettage removes the soft tissue lining of the periodontal pockets in order to completely eliminate bacteria and diseased tissue. It may be used along with scaling and root planing, but achieves a deeper and more complete cleaning. Evidence indicates, however, that it does not contribute any additional benefits beyond simple scaling and planing.

Surgery (Open Flap Curettage):

Surgery allows access for deep cleaning of the root surface, removal of diseased tissue, and repositioning and shaping of the bones, gum, and tissues supporting the teeth. Surgical procedures vary depending on the individual diagnosis and needs of the patient. The basic procedure is known as open flap curettage. It involves:

The periodontal surgeon lifts, or flaps, the gums away from the tooth and surrounding bone.
The diseased root surfaces are cleaned and curetted (scraped) to remove deposits.
Gum tissue is replaced into positions to minimize pocket depth.
The periodontist may also contour the remaining bone and attempt to regenerate lost bone and gingival attachment through bone grafts and guided tissue regeneration or the use of enamel matrix protein derivatives.

The best way to stop the progression of periodontal disease is to mechanically remove the bacterial plaque and tartar that have accumulated in the periodontal pocket. Daily oral hygiene and supportive periodontal treatment is key to the success of scaling and root planing. Without treatment, the tartar and plaque buildup underneath the gums will continue to cause periodontal tissue breakdown, progression of periodontal disease, and eventually tooth loss and systemic complications.

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