31 May 2018

How to treat the different types of periodontitis?

Periodontitis  is known as gum disease. Bacteria or bacterial plaque accumulates in the gaps between the gums and the teeth resulting, in the worst case, tooth loss. Although the majority of the population is not aware, it is a condition that it is suffered by 40% of adults, this figure increases to 65% of periodontitis in those over 55 years. Severe or advanced Periodontitis occurs in 12% of the adult population. And being the sixth most frequent infection according to the WHO (World Health Organization). This type of alterations, whether they are in an advanced phase or in an initial phase, it is necessary to treat them to avoid more serious problems, which can focus on the gums, the loss of bone and a tooth, or increase risk of other problems such as heart attacks, pneumonia or worse control of diabetes.

Types of periodontitis

To solve this dental condition, we must bear in mind that there are different degrees of periodontitis, with specific treatments for the more advanced stages.

Before being able to diagnose a case such as periodontitis, when we are in an initial phase where only the gingiva is affected, it can turn out to be a case of gingivitis. This precedent to periodontitis can be annoying, but not so dangerous since there is no involvement in the bone.

Initial periodontitis

The first level of this pathology is called initial periodontitis. In these cases,  a periodontal study will be performed in which a periodontogram and x-rays of the patient’s mouth will be made to see if the infection has arrived, or not, to the bone and in what form. In this way, a good diagnosis can be made, which will ultimately determine the specific treatment. Then, the specialist or periodontist will proceed to perform the basic phase in which prophylaxis or hygiene is done with oral hygiene teaching. A buccal cleaning is performed to eliminate bacterial plaque. Next, a scaling and root planing is done, removing the tartar from the root below the gums, usually with a little anesthesia.

Moderate periodontitis

The second stage, a little more severe than the previous one, is called moderate periodontitis. They should also perform periodontogram and x-rays, and a buccal cleaning to remove bacterial plaque, as well as information, motivation and radicular scraping, formerly called curetage. This treatment in general does not cause discomfort or inflammation.

Advanced or severe periodontitis

The third most serious level is advanced or severe periodontitis where the loss of bone reaches two thirds of the root of the teeth. It can be localized or generalized. The same procedure is continued as the previous two treatments combined with one or two systemic antibiotics. Sometimes a periodontal surgery is necessary that includes micrografts to recover the lost bone. In this way there is an improvement at the health level since the possibility of re-depositing the bacteria is not left. It is a minimally invasive method in which a small incision is made in the gum of the area to be treated and bone or gum grafts are introduced there.

Finally, the periodontist should tell the patient that they should go to the consultation to do reviews every 4 or 6 months approximately depending on their risk of suffering from Periodontitis. It is the revaluation and maintenance to have a control of the result of the treatment. The condition of the gums is followed to prevent bacteria from reappearing. Also, it is important to mention that all professionals should recommend to patients undergoing treatment a strict maintenance of their oral hygiene, to eliminate any risk of returning to have such diseases.

In case you notice bleeding in your gums, mobility in your teeth, bad smell, bad taste in the mouth or notice the longer teeth, do not hesitate to go to your clinic to treat your case as soon as possible. If you let this infection pass you can have difficulty chewing, stomach problems, pain, bleeding, aesthetic alterations and even tooth loss and general health deterioration, in the worst case.


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    Dr. José Nart Molina

    Dr. Jose Nart received his dental degree in 2001 from Universitat Internacional de Catalunya (UIC), Barcelona, Spain, and his Advanced Certificate in Periodontics and Implant Surgery from Tufts University in 2007. Dr. Nart was awarded Diplomate status by the American Board of Periodontology on May 2008, and he obtained his PhD in Dentistry in 2010 with the highest degree. Currently, he is Professor, Chairman and Program Director at the Department of Periodontology at UIC-Barcelona, and President for the Spanish Society of Periodontology and Osseointegration (SEPA). He maintains, with his family, a well-known multispecialty private practice in Barcelona, Nart Dental Clinic, as medical director. Dr. Nart is author of many international high-impact JCR publications (+110), worldwide speaker and reviewer of the highest impact factor Periodontology and Implant Dentistry journals.


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