Periodontology is a branch of dentistry that deals with the prevention, diagnosis and treatment of diseases affecting the hard and soft tissues that support and protect the gums and teeth. The hard and soft tissues that support the tooth, known as the periodontium, have very important functions: they bind teeth firmly to the jaws; acts as a shock absorber during biting and chewing and therefore helps prevent damage to teeth from excessive forces; keeps teeth in a fixed position in the jaws so that they can work together efficiently and comfortably while chewing. With periodontology, the health, function and aesthetics of these structures and tissues are preserved.
Why is periodontology important?
Periodontal diseases; They are bacterial infections of the gums and other tissues that support the teeth (bone and periodontal ligament – the fibers that support the teeth and hold them in the jaw) and destroy the support of the bones that hold your teeth in your mouth. As a result, teeth may loosen, fall out, or pull out, and edentulous areas may need to be treated with prostheses or implants. Periodontal diseases occur as gingivitis (gingivitis (inflammation and bleeding of the gum without affecting the bone) or periodontitis in which the destruction of the bone supporting the tooth occurs. If not treated in time, they can cause tooth loss.
According to extensive research in recent years, periodontal health is increasingly playing a larger role in systemic health. Periodontal diseases; It has been associated with an increased risk of cardiovascular diseases, diabetes, and adverse pregnancy complications. It is also linked to other diseases such as periodontal disease, respiratory disease, chronic kidney disease, rheumatoid arthritis, metabolic syndrome, and cancer.
The importance of periodontal health has come to the fore in recent years and more attention has been drawn to this important aspect of oral care. In many ways, the mouth can be seen as a mirror of your body’s general condition. Gum disease always occurs with plaque buildup in the teeth, but diseases known as systemic diseases that affect the rest of the body can affect the supporting structures of the teeth.
Also, some serious illnesses are known to manifest themselves in the mouth before they become apparent elsewhere in the body. For this reason, a periodontologist can sometimes detect signs of a general illness, such as diabetes or blood diseases, while examining a patient’s mouth.
What is a periodontist (gingival disease specialist?
The periodontist is a dentist specializing in the prevention, diagnosis and treatment of periodontal diseases and the placement of dental implants. Periodontists are knowledgeable about the latest techniques used in the diagnosis and treatment of periodontal disease, as well as the application of aesthetic periodontal procedures. Although all dentists are trained in the diagnosis and treatment of mild to moderate periodontal disease, it is customary to send severe or complex cases to a periodontist who has specialized training in this area. Periodontists who perform non-surgical periodontal treatments as well as periodontal surgery and periodontal plastic surgery procedures are also experts in the treatment of missing teeth with dental implants.
Periodontists can treat more complex periodontal cases, such as individuals with a severe gum disease or a complex medical history, using a variety of surgical procedures. In addition, periodontists have specific knowledge of the placement, maintenance and repair of dental implants.
Periodontists are knowledgeable about the latest techniques used in the diagnosis and treatment of periodontal disease. They can also perform aesthetic periodontal procedures to improve your smile. For these reasons, dentists often refer their patients with advanced periodontal disease to a periodontist.
As a specialist, periodontists can offer a range of treatments from minimally invasive practice to full oral surgeries. Depending on your particular situation, a periodontologist can find the treatment options that best suit your needs.
When should a periodontist be consulted?
Periodontal evaluation is particularly important in the following situations:
- If you notice the symptoms of periodontal disease,
- If you intend to have implants in place of your missing teeth,
- If you are thinking of becoming pregnant. Pregnant women with periodontal disease are more likely to have a very preterm or low birth weight baby. Also, about half of women experience gingivitis during pregnancy. However, women who have good oral hygiene and did not have gingivitis before pregnancy are unlikely to experience this condition.
- If you feel that your teeth are too short or your gums look excessively while laughing.
- If you have a heart condition, diabetes, respiratory illness or a systemic illness such as osteoporosis. Ongoing research shows that periodontal disease may be linked to these diseases. Bacteria associated with periodontal disease can enter the bloodstream and pose a threat to other parts of the body. A healthy body starts with healthy gums.
FREQUENTLY ASKED QUESTIONS
How should healthy gums be?
Aesthetic dentistry; It is the improvement of aesthetic appearance, speech disorders and lost functions with various applications on teeth and gums.
Why is brushing teeth necessary and how it should be performed?
It is performed in teeth with broken and discolored, crooked, irregular and deformed teeth, tooth deficiencies, color and deformities in gums.
The human mouth is sterile at birth. Microorganisms are included in the oral environment at the time of birth. Later, they reproduce in the mouth environment and form the natural oral flora. Some newborns even develop oral thrush. The reason for this is the rapid growth of fungi in the oral environment. The fungi are suppressed with the drugs given and the bacteria are given an opportunity to multiply. When bacteria multiply, there is no need for medication, they create a balance against martar. It gets better in discomfort. But we have to share the same body with these bacteria for a lifetime.
What we do by brushing teeth is to constantly remove these bacteria from the teeth. Otherwise, our aim is not to disinfect the mouth in some way.
It can generally be used for 3-4 months. You can tell that the toothbrush is damaged by the separation, dispersion and bending of the bristle bundles. Stiff bristle brushes can damage your teeth. Children, on the other hand, wear out the brushes more quickly as they cannot yet apply the correct brushing.
Which is the best brushing technique ?
First of all, the brush should be brought closer to the tooth at a 45 degree angle and brushed with back and forth movements in the direction of the width of the tooth. The process is completed with a downward sweeping motion from the last gum. Since the inner surfaces of the teeth, especially the front areas, are narrow, the brush should be brushed by inserting the brush vertically. It should not be forgotten that the back surfaces of the teeth, back teeth and tongue, where bacterial plaque and food residues are concentrated, should also be cleaned. Generally, since only the front surfaces of the front teeth are brushed, decays mostly occur in the posterior areas, and the tartar is in the lower anterior area, which is brushed very little.
Will teeth be damaged if an appropriate technique is not used?
Yes. Although the teeth are covered with a very hard layer of enamel, they can be damaged even by a brush that you apply only with a wrong technique. It may cause abrasions on both the upper part of the tooth and the layer covering the root, and recession in the gums. In this case, the teeth become more prone to decay. It should be avoided to brush your teeth with a force that will wear the teeth and the brush should be moved with gentle movements.
Why brushing the gums is necessary?
Another process that needs to be done is brushing the gums. “But doctor, my gums are bleeding…” Brushing should be continued, because the vessels feeding the gums have become plump as a result of circulatory disorder. This is called “conjuncture” in medical language. To treat, it will be necessary to open the capillaries, that is, to brush. Thus, the vessels of the gum heal and the bleeding stops spontaneously. Brushing the gum is one of the most effective remedies to prevent gum diseases.
Are there any other tooth cleaning tools other than brushes ?
These are tools such as electric brush, dental floss, toothpick, interface brush, water sprayer (water – pic), stimulator .. Electric, brush and water sprayers are becoming widespread in our country.
How can we protect our oral and dental health?
Early diagnosis is very important in terms of dental diseases and protection of dental health. Therefore, it is recommended to be examined by a dentist at least twice a year.
In the prevention of tooth decay, having enough fluoride in the water, regularly brushing the teeth, using dental floss, avoiding excessively sweet and sugary foods as much as possible are the basic practices of brushing the teeth when they are eaten, and going to dentist controls. Tooth brushing and regular dental check-ups are also important in preventing gum disease.
If there are developmental disorders in the teeth, the necessary treatment should be provided by applying to the units specialized in private dentistry branches in the early period.
Extremely acidic and sugary foods increase the effect of microorganisms. Teeth should not be mixed with hard objects, nuts, walnuts, etc. Shelled foods should not be broken by teeth. These cause cracking of tooth enamel and increase the effect of bacteria. The protective effect of tooth enamel is eliminated.
What are the things to do for your oral and dental health?
You should brush your teeth after every meal. Bacteria begin to reproduce 2 hours after eating. You should definitely brush your teeth before going to bed. As the salivary secretion decreases at night, the mouth becomes dry and an environment suitable for the reproduction of bacteria is formed.
You should brush the very back of your tongue. This water is the center of bad odors. You should thoroughly brush this part with a soft brush dipped in mouthwash water.
When your mouth is dry; Chew sugar-free mint gum. This activates the salivary glands.
If you do not have a toothbrush with you: rinse your mouth (with salt water) if possible. Wipe your teeth with a wet cotton ball or gauze. Drink milk or eat cheese before going to bed at night. Since these foods are basic, the acid in the mouth neutralizes the environment. The “casein” in it strengthens the tooth.
Even if you are doing a very good care, go to your dentist at least 2 times a year.
Should we use dental floss ?
The toothbrush cannot remove all of the bacterial plaque because it is very difficult to reach the teeth completely. There are many accessories produced for cleaning bacteria in difficult areas.
We can say that dental floss ranks first after brush and paste in terms of its function.
Cut 45 cm long floss (it is recommended to purchase the product produced for this purpose at the pharmacy) and wrap most of it around your middle finger. With your other middle finger, you will wrap the used part of the thread while you clean your teeth.
Keep the floss taut to leave 2. 5 cm of space and place it between your teeth with gentle movements.
When the thread is at the gum level, lean it against the tooth and form a C shape and place it in the space between the tooth and gum.
Slide the floss up and down along the lateral surface of the tooth, keeping it in contact with the tooth. Lean the tooth on the side tooth and repeat the same movement. In this way, plaque is broken down and bacteria are removed.
- Cut 45 cm long floss (it is recommended to purchase the product produced for this purpose at the pharmacy) and wrap most of it around your middle finger. With your other middle finger, you will wrap the used part of the thread while you clean your teeth.
- Keep the floss taut to leave 2. 5 cm of space and place it between your teeth with gentle movements.
- When the thread is at the gingiva, lean it against the tooth and form a C shape and place it in the space between the tooth and gingiva.
- Holding the floss in contact with the tooth, slide it up and down along the lateral surface of the tooth. Then lean against the side tooth and repeat the same movement. In this way, plaque is broken down and bacteria are removed.
Even with a correct technique, brush, paste and a brushing that takes 2-3 minutes as it should, the surfaces that your teeth are in contact with each other cannot be cleaned completely. Often, the starting point of caries is these difficult to reach, closed areas. For a healthy cleaning, it is necessary to floss after brushing (at least once a day).
After each meal, slide the floss between your teeth to remove food residue. Since wax threads are softer, they will reduce the risk of irritation. Misuse is harmful to the gums. Your dentist will give you more detailed information about usage.
How should oral care be in adults ?
Toothbrush selection and use:
Toothbrushes; They differ in size, shape and arrangement of bristles, hardness and length. Soft or medium hard brushes with small heads, dense bristles, rounded bristles, straight-cut bristle bundles should be selected. Thus, it is easy to reach and clean between the teeth and all parts of the mouth. It is recommended to change the brush every 4 months on average. With hard and wrong brushing technique, gingival recession, material loss and sensitivity on the tooth surface occur, and also decay and gum diseases cannot be prevented because the full cleaning effect cannot be achieved. Both teeth and gums should be cleaned with a toothbrush. For this purpose, half of the bristles should be positioned on the tooth surface and the other half on the gum surface during brushing. Generally, it should be performed in this position without applying excessive force, without removing the brush head and following a certain order. It is possible to effectively clean these areas where bacteria accumulate with tiny circular circular motions by simply moving the hairs. Teeth and gums should be cleaned by brushing twice a day (after breakfast and dinner in the evening). Peridontist may also recommend different brushing methods in different situations such as gingival recession and postoperative situations. Brushes with battery / power supply can be recommended in addition to the natural toothbrush if effective brushing cannot be performed with a normal toothbrush.
They are paste-like substances that support and polish the mechanical cleaning effect of the toothbrush. The toothpaste should be used as much as the chickpea grain. There are toothpastes of various ingredients and properties for various purposes. In recent years, plaque, caries, tartar and sensitivity preventive effects have been tried to be developed by adding various substances into pastes. The periodontist will recommend the appropriate one according to the case.
Cleaning the interdental area
Only the toothbrush and the facing surfaces of the teeth cannot be cleaned sufficiently. Since gingival diseases mainly start from the gums at the interface of the teeth, cleaning these areas is very important. For this purpose, various tools are used that can be placed between the teeth.
It cleans microbial dental plaque and food deposits between teeth and under the gingiva. There are waxed, wax-free, menthol, fluoride, and chlorhexidine tooth types. Flossing should be done after brushing. Dental floss is applied by wrapping and fixing the middle fingers of both hands and guiding them with two index fingers. In patients who cannot use it in this way, ready-made tools containing dental floss fixed on a carrier that is angled in accordance with the lower and upper jaws in the form of a sling can be used. While using, the relevant tooth surface should be descended to the subgum level and all tooth surfaces should be cleaned with up and down movements and care should be taken not to cut the gum. It should be performed once a day.
Is Cleaning Teeth Harmful?
Tartar Cleaning, Tooth Cleaning, Tartar Cleaning
The vast majority of tooth loss in adults is caused by the gums and the bone surrounding the teeth.
Gingival diseases are caused by bacteria called plaque in the thickness of a film that adhere to the surface of the teeth.
If the plaque is not cleaned, it turns into tartar called tartar (calculus). The accumulation of plaque and tartar causes destructive bacteria to grow in our mouth, and at the end of this, cavities called pockets and gingival recessions occur between the tooth and the gum.
Bacteria secrete enzymes that cause bone destruction around the tooth. And eventually the tooth is lost.
Dental cleaning is the basis of the fight against gum disease.
Because in order to cope with gum diseases, plaques, tartar and bacteria in the gum pockets must be removed from the oral environment. These harmful formations are removed as a result of interventions with ultrasonic devices or suitable hand tools. These tools do not harm tooth enamel because they are professional tools used by dentists. While cleaning tartar, air, water and a special cleaning powder sprayed are also used.
The first purpose of dental cleaning is to remove plaques, tartar and some diseased tissues. Therefore, it is a very useful treatment method, let alone its harm.
If the gums have receded due to tartar before, tooth roots naturally come out when you clean the tartar. People may think that their roots are exposed when they clean their tartar. In fact, they are the result of previous recessions caused by poor oral care and tartar. It is not a result of the cleaning process performed.
If the gingival recession cannot be fulfilled by the operation, good oral hygiene is essential to prevent further recession of the gums.
If tartar cleaning is done frequently, it means that your oral hygiene is not good. Your dentist, whom you visit every 6 months on average, will warn you about this.
Do not forget that it is up to you to prevent re-formation of tartar after tooth cleaning. You get the desired oral health by brushing and interface care as shown by your dentist. If you think that tartar is formed again quickly after cleaning your teeth, you should review your brushing style.
Considering that oral health is a part of general body health, do not neglect the care of your gums and have your teeth cleaned if necessary.