Periodontology

Periodontal disease, popularly known as "periodontosis", is an inflammatory reaction of the tissues supporting the teeth, consisting of the gum, jawbone and periodontal ligaments, to generally infectious stimuli.

The teeth are fixed in the jawbone in a cavity called the dental alveolus. There is no direct contact between the outer wall of the tooth and the inner wall of the tooth socket, but a network of ligaments (fibres) called periodontal ligaments is made of a special elastic tissue that anchors the tooth inside this socket. The elasticity of these ligaments makes this connecting network work as a shock absorber, giving the tooth increased reliability over time.

Periodontitis (periodontal disease) primarily affects these fibres, which are destroyed, causing bone resorption (disappearance) around the teeth until they become mobile and can no longer perform their function.

The main reason why these ligaments are destroyed is the infectious attack made by micro-organisms that develop in the tartar and bacterial plaque present at this level. Often, tartar is covered by the gum which swells and masks it, so the only effective method to avoid this problem is scaling and professional hygiene at the doctor once every 6 months minimum, accompanied by personal hygiene performed by brushing, flossing, supplemented by the use of a mouthwash or, more recently, by commercial mouthwashes.

It must be understood that with advancing age these ligaments, as well as the jawbone, undergo a process of degeneration anyway, but in the case of periodontal disease this process is greatly accelerated, and there are also hereditary situations, unfortunately very difficult to control, such as juvenile periodontitis.

It is also very important to understand that this condition is not curable, but only controllable, in the sense that doctors can achieve certain ameliorations, and mainly delay the progression of the disease, but it all depends on when we go to the doctor. The later we present the more difficult it is to treat and control, sometimes even impossible.

• Gingivitis - is the initial stage of periodontal disease in which only the gums are affected. It is manifested by inflammation of the gums, redness and frequent or even spontaneous bleeding when brushing. The bone is not yet affected.
• Periodontitis - if gingivitis is not kept under control almost complete gum recession occurs with bone loss and uncovering of the tooth root. This can lead to tooth mobility and loss of teeth from the arch.

Treatment consists of removing the tartar and infected tissues due to its presence and bacterial plaque.

This can be achieved by:

• Professional hygiene: involves removal of supra- and subgingival tartar and plaque. In certain situations, decontamination of the gingival grooves using laser.
• Periodontal surgery: open-field curettage, flap surgery with or without bone addition, gingivoplasty with connective tissue grafts.