GUM RECESSION, PERIODONTAL DISEASE – A WIDE-SCALE PROBLEM IN THE POPULATION
Periodontal disease – often called receding gums – affects more people nowadays than you’d think. It’s almost endemic in Hungary. Close to 70% of the population is experiencing one of the stages of gum recession. The development of the disease is completely painless – that is why it’s so dangerous. It can be hard to detect in the beginning, but it will have severe consequences later. It’s important to know that untreated periodontal disease can even lead to loss of teeth.
THE DEVELOPMENT OF PERIODONTAL DISEASE
Poor oral hygiene paves the way for plaque formation, which will always lead to gingivitis, inflammation of the gums, if present for a prolonged period. A thin layer of plaque is continuously formed on the surface of the teeth, which should be regularly removed by thorough oral hygiene. Without proper cleaning, this plaque crystallizes and creates tartar, which will constantly be covered by plaque, leading to permanent inflammation. Scaling (tartar removal or dental hygiene treatment) and a proper cleaning routine will help to cure the inflammation, and the gums will become taut and healthy pink again. Without this, inflammation will spread deeper into the supporting structure of the tooth in genetically predisposed patients, therefore regular scaling is advised every six months. The loss of bone leads to the formation of inflamed foci, pockets filled with special anaerobic bacteria. Due to the continuous decay of bones, the teeth become mobile.
SYMPTOMS OF PERIODONTAL DISEASE
The gums become red and swollen from gingivitis, with a shiny surface, often accompanied by bleeding – which is usually seen during brushing but can occur spontaneously. The gums feel softer than normally but are usually not painful. The swelling can sometimes reach extreme proportions, even covering part of the teeth. The inflammation is accompanied by an increasingly unpleasant breath caused by bacterial infection. This is a warning sign to watch out for, so if your breath feels unpleasant despite a regular tooth care routine, you should see your dentist. If the spaces between the teeth become wider, the teeth start shifting position, which means that the inflammation has spread to the support structure of the teeth and the bone. At this point, deep pockets form between the teeth and the gums, full of special, Gram-negative bacteria, which cause direct damage to the bone, while also spreading toxins throughout the whole body via your circulatory system.
IMPORTANT TO KNOW! PERIODONTAL DISEASE AFFECTS THE WHOLE BODY!
This chronic inflammation process can become the focal source of disease, causing inflammation of joints, hair loss and skin problems. In some cases, it might contribute to premature births and cardiovascular diseases. Periodontal inflammation can exacerbate diabetes or complicate its therapy – treating periodontal disease therefore makes the management of diabetes much easier.
WHAT SHOULD YOU DO IF YOU HAVE PERIODONTAL DISEASE?
It’s important to know that the outcome of the disease depends on continuous and professional care.
If you have already developed periodontal disease, noticed either at home or diagnosed by one of our colleagues, you should book an appointment with our periodontist, Dr. Emese Szilágyi as soon as possible. Bone loss is often irreversible, but in some cases even this can be countered with surgical treatment. Nevertheless, the treatment of periodontal disease is definitely recommended in order to return the previous non-inflammatory state. Without therapy, the affected teeth will sooner or later be lost.
The outcome also depends on regular, thorough, professional oral hygiene treatment and daily dental care at home.
What can you expect at our clinic?
Testimonials from our patients
As gum recession can have several different causes, the course of the disease and its development can vary from person to person, treatment must therefore be individually planned. The course and duration of the therapy depends mainly on which stage of disease the patient seeks medical help. Learning proper oral hygiene is the first step in the treatment of gum recession: your dental hygienist will help with this during an oral care consultation. They will teach you how to use the toothbrush, the interdental brush and the dental floss the proper way, and recommend the right mouthwash product to complement the mechanical cleaning steps. Curettage is also a type of periodontal treatment, carried out by a periodontist. It is an intervention done under local anaesthesia, during which the inflamed tissue under the gumline is removed, effectively destroying the harmful bacteria living there. At the end of the treatment, the periodontal pockets are injected with antiseptic medication to prevent further bacterial growth. In some cases, a course of antibiotics is prescribed to complete the treatment. Curettage is followed up by a control examination 3-4 weeks later, during which your dentist will evaluate the effectiveness of your personal oral care and the effectiveness of the initial treatment, and may recommend further therapy, periodontal surgery or removal of a tooth.
With regular scaling, dental hygiene treatments and proper oral care, the inflammation will clear up and the gums will become taut, pink and healthy again. Without this, inflammation can spread deeper into the supporting structure of the tooth in genetically predisposed patients, leading to inflammation and bone loss. The loss of bone leads to the formation of inflamed foci, pockets filled with special anaerobic bacteria. Inflammation of the supporting structure of the teeth can cause tooth mobility and subsequent tooth loss.
PHASES OF THE PERIODONTAL TREATMENT
The course of the disease and its development can vary from person to person, treatment must therefore be individually planned.
THE USUAL COURSE OF THERAPY
We start by treating acute periodontal inflammations: teeth beyond repair are removed so they cannot have a negative impact on the periodontium of the teeth which can be saved. Wisdom teeth are sometimes removed at this point if this makes the posterior region easier to clean.
The next stage is the elimination of the disease-causing factors, that is, scaling (the removal of tartar) by our dental hygienists. At this point, if necessary, we continue by treating the cavities and correcting any factors that could compromise the health of the periodontium. This may require the involvement of specialists from other areas, such as conservative dentistry or orthodontics. The treatment plan may involve the placement of temporary restorations while the prognosis of a tooth is uncertain, or when this is needed to support the periodontium. Such temporary restorations (which can sometimes last for quite a long time) include plastic bridges, or they may necessitate dental splinting. Temporary restorations can unfortunately fall off sometimes, in which case we are always happy to see our patients – following a consultation by phone – in order to bond them back in place.
If the disease takes a more aggressive course, you might need a prescription for antibiotics. It is important to “finish the whole course” of antibiotics, and complement it with a probiotic product, as this kind of medication can cause gastrointestinal complaints as a side effect.
Following this, we need to wait 6 weeks and reassess the situation. At this time, surgical intervention might be considered if some areas have not improved sufficiently with conservative treatment.
Cleaning unusually deep periodontal pockets can be difficult and painful, this treatment is therefore carried out under local anaesthesia. It is advised to eat before the procedure, as the effect of the anaesthetic will last for hours afterwards, and the numbness might cause patients to bite their mouth or tongue. In the case of severely advanced periodontitis or periodontal disease, the gums need to be explored – which is considered a surgical procedure – to access the deeper inflamed areas. In some cases, regenerative materials, bone substitute or enamel matrix derivative are implanted, and at the end of the surgery the gum is sutured in its original position. One of the main goals of the procedure is to eliminate deep pockets in the gums completely.
Unfortunately, this often means that the neck of the tooth becomes slightly more exposed after the intervention, and its surface can become sensitive to heat for a time. This sensitivity can be treated, but it will also disappear by itself in most cases. Patients may often feel that their gums have “contracted”, which is actually the healthy, non-inflammatory state.
The next stage involves tooth restorations.
The final phase is periodontal care, which continues “for life”. Based on the individual case, you should visit your dental hygienist or dentist every 3-6 months to maintain this healthy condition.
After recovery, it is important to keep the condition achieved by the specialist interventions, so you should schedule a check-up appointment at least every six months. This visit should include scaling, individual oral hygiene advice and an X-ray whenever necessary.
ORAL CARE ADVICE FOR HOME
We provide oral hygiene advice based on individual needs, demonstrate how to clean the tooth gaps with dental floss, interdental brushes and mouthwash products.
CERTAIN SURGICAL INTERVENTIONS MAY BE NECESSARY FOR THE TREATMENT OF PERIODONTAL DISEASE
Cleaning unusually deep periodontal pockets can be difficult and painful, this treatment is therefore carried out by the periodontist under local anaesthesia. In the case of severely advanced periodontitis, the doctor needs to explore the gums in order to access the deeper lying inflamed areas. In some cases, regenerative materials, bone substitute or enamel matrix derivative are implanted, and at the end of the surgery the gum is sutured in its original position. One of the main goals of the procedure is to eliminate deep pockets in the gums. This often means that the neck of the tooth becomes slightly more exposed after the surgery. The exposed surface can become sensitive to heat for a time. This sensitivity can be treated, but it will also disappear by itself in most cases. It’s important to replace any missing teeth with implants or with restorations made accurately to the specific periodontal requirements.
Read more about periodontal surgery here.
In the case of non-inflammatory gum recession, the neck of the tooth becomes exposed, which is not only an aesthetic issue, but can also cause long-term loss of functional stability, extreme sensitivity to heat or cold, brushing difficulties and cavities. In case of such indications (whether they involve a tooth or an implant), plastic surgery can correct the silhouette, shape and thickness of the gums, often by implanting a lobe graft taken from the palate. Corrective surgery can also be used for gum sculpting in the case of extreme gum swelling or a high gumline / gummy smile.
In some cases, the lower or upper labial frenulum forms a thick, banded attachment, which can cause gum recession or gaps between the teeth on the long term. In such cases, we recommend to have this cut, either in early childhood or later, combined with orthodontic therapy. The attachment of this connective tissue can cause speech impediments and phonation difficulties, we therefore recommend to address any such issues relatively early in childhood. We use a surgical laser for this intervention, which has the advantage of eliminating bleeding, and healing without scarring.
Our clinic has a special role in residency training. At present, two periodontist residents are undergoing their training at our practice, under the professional guidance of periodontist and implantologist Dr. Emese Szilágyi.
At our dental clinic we attach great importance to a compassionate approach to our patients, painless and fearless methods of treatment, as well as education and information on the prevention of gingivitis and periodontal diseases.
OUR DOCTORS WHO CAN HELP YOU TREAT YOUR PROBLEM
Periodontology – oral hygiene package prices
22 000 Ft
- 15 perces
Professzionális komplex csomag
45 000 Ft
- Parodontológus által végzett
140 000 FtRégiónként
50 000 FtOldalanként
12 000 FtFoganként
We believe in the importance of patient information, as giving accurate instructions to follow can make a big difference to the outcome of a procedure.
You can read and download our patient information leaflet here, which will hopefully be helpful.