Periodontology

It is the most common and protective method among gum diseases. Tartars and plaques are removed at the teeth cleaning. The plaque is an adhesive substance, and the majority of it consist of bacteria. Tartar are formed when plaques hardens in time. Plaques and tartars adhere to the tooth surface, especially on the root surface below the gingival border. Root surfaces need to be leveled because the plate tends to attach to the rough surface. All the tooth tartars are cleaned and the irregularities on the root surface are removed at this process.

To remove plaques and tartars which cause gum disease, cleansing and root surface straightening are performed. In the early stages of the disease, especially in order to control the gingivitis condition, this treatment is sufficient. However, this may be the first step of treatment in severe cases.

Local anesthesia can be applied to the area to be treated in some patients because these patients may feel uncomfortable at this treatment session. Ultrasonic tools and hand tools are used in dental tartar cleaning and root surface straightening. Ultrasonic tools work with air pressure or electricity. They have two components. The first one is relatively non-sharp metal tip. This tip vibrates at high frequency and removes the plaques and tartars from the surface.The second component is the water washing system which helps to cool the metal tip while it is running and to remove residues from the tooth. The hand tools have sharp edges, and these edges lean against the tooth and remove the tartars from the tooth surface.

In case of early stage of gum disease (gingivitis) or severe gum disease localized in a part of the mouth (localized periodontitis), tartar removal and root surface straightening are usually completed on a single appointment. If the patient has periodontitis, one half of the single jaw is treated on a single appointment. Therefore the treatment is completed in four appointments.

There will be hot-cold sensitivity and mild pain that will disappear after two to three days of treatment. Pain killers can be used to eliminate the pain. Antiseptic oral mouthwashes can be used when there is pain that makes oral hygiene difficult after tartar removal and root surface treatment. You should also continue to use tooth brushing and dental floss. There may be slight bleeding from the first day after tartar removal and root surface treatment.

There will be hot-cold sensitivity and mild pain that will disappear after two to three days of treatment. Pain killers can be used to eliminate the pain. Antiseptic oral mouthwashes can be used when there is pain that makes oral hygiene difficult after tartar removal and root surface treatment. You should also continue to use tooth brushing and dental floss. There may be slight bleeding from the first day after tartar removal and root surface treatment.

Gingivectomy is the procedure of surgical removal of gingival tissue. Gingivoplasty is the shaping of healthy gingival tissues around the teeth. These processes are carried out by periodontists who specialize in tooth tissues and gingival diseases.

Gingivectomy is a treatment which has been improved for gum disease. Today, it is also used for aesthetic purposes.

There are two reasons to remove gingival tissue. The first reason is the presence of gingival pockets formed between the teeth and gums. In time difficulty of cleaning with the accumulation of food residues and bacterial colonies becomes a problem n these areas. These pockets may be removed by gingivectomy if they only contain gingival tissue.

In some cases there may be large amount of gingiva around the tooth. This is a condition that avoids the teeth and gums from being kept clean. It is also a cosmetic problem. In severe cases, it may become a point that may affect chewing and talk. Some drugs may cause excessive gum growth such as epilepsy medications. But sometimes there is no obvious reason for that.

With the help of gingivoplasty, the reshaped gums reflect more natural appearance. Deformed or asymmetric gums from the genetic disease or trauma can be corrected by this procedure. This treatment can also be applied only because of cosmetic requirements. Gingivoplasty is usually applied as a single treatment. However, in some cases it can be applied after gingivectomy or graft application to the gum at the gum line.

Your periodontist will inform you about how to perform oral hygiene after the procedure and other procedures to be followed. It may be necessary to clean the teeth and smooth the root surface in order to remove tartar from existing gum pockets.

Gingivectomy and gingivoplasties are usually performed with hand tools. But it can also be performed with electrosurgical tools, laser and / or rotary tools.

Local anesthesia is applied to the gums. Gingivectomy may take a few minutes or an hour. It depends on the amount of tissue to be removed. Gingivoplasties take a few minutes.

A protective  bandage is placed over the gums after gingivectomy and gingivoplasty. This bandage should stay on the gums for 10 days after the procedure. During the 10 days that the bandage is on your gums, you should eat soft foods and avoid spicy and crunchy foods. Your dentist or periodontist will recommend you to use chlorhexidine mouthwash with pain killer.

The intraoral should be kept clean during the recovery period. The teeth in the surgical area should not be brushed while gum protective bandage is on them. However, the teeth in all other areas should be brushed and flossed. After the bandage is removed, the bleeding in the healing tissues is normal during brushing and flossing. The bandage is removed 7-10 days after the procedure. The gums get their normal appearance in three or four weeks, but the tissue needs two or three months to fully heal.

These operations do not have a great risk. There may be bleeding rarely. The risk of infection is also very low. Bleeding may occur within the first 24-48 hours.

Gingival recession can be seen because of the reasons such as Gingival disease (periodontal disease), physical trauma (brushing the teeth with a stff brush or frequent brushing), the position of the teeth and aging. If gingival recession is severe then some of the teeth roots may be exposed. This may cause hot-cold sensitivity, as well as root caries. It can also cause problems in terms of appearance.

In soft tissue grafts, more gum tissue is added to these areas to prevent future withdrawal. With the help of this process the root surface is covered and the sensitivity is stopped. At the same time, the appearance of the tooth is also improved.  People who have very thin gums are quite likely to experience gingivitis more than others. Soft tissue grafts can be applied to prevent future problems for these people.

The gums are temporarily folded away from the teeth in gingival flap surgery. Thus, the dentist can see the tooth root and bone.

The aim of gingival flap surgery is to treat gingival disease (periodontitis). This procedure is recommended for people with gum disease from mild to severe. Gingival flap surgery is used if the gum infection cannot be eliminated by a non-surgical method. Gingival flap surgery can also be performed in conjunction with another procedure  bone surgery.

First of all, all plaque and tartar around the teeth are removed and oral hygiene is improved. Your dentist or periodontist checks whether your general health or the medicines you are using allows surgical procedures.

The area is first anesthetized by local anesthesia. The gums are separated from the teeth by a hand tool. Thus, periodontist can directly reach roots and the supporting bone tissue. Then infected tissues are removed from the teeth and the holes in the bone (defects). Tartar cleaning and root surface straightening are applied. Bones can be remodeled if there are defects in the bone. During this process, the bone corners can be softened using Er: YAG laser or rotary tools.

After these procedures, the gums are placed back on the teeth and fixed with sutures. The surgical area is covered with a protective bandage.

It is possible to feel a little discomfort after the procedure. Painkillers prescribed by the periodontist can be used after the procedure. This will make you comfortable.

It is very important to keep this area as clean as possible while the surgical area is being healed. You should continue to brush and floss your teeth in the other areas. If the periodontal bandage is used to protect the surgical area, the plaque should be removed gently from the teeth. Generally, chlorhexidine antimicrobial mouthwashes are prescribed after periodontal surgery. These mouthwashes do not remove the plaque but help the bacterias eliminated and improve the mouth recovery.

There may be a little amount of swelling. In order to avoid it, applying ice compresses to the treated area on the outside the mouth may help. Antibiotics may be prescribed to avoid the infection. The treated area is controlled by the periodontist in 7-10 days.

There may be a little amount of bleeding and swelling after the surgery. There is also a risk of developing infections. Gingival recessions can be seen in the area where surgery is performed. The treated teeth may become more sensitive to hot and cold. At the same time the root surface cavities at the the treated area may show further development.