Periodontics (gum treatment)

Periodontics is the area of dentistry that treats the gums and the bone supporting the teeth. When those tissues become diseased, a tooth can be perfectly healthy and still start to move, because what is failing is the support around it.

Gum disease almost always progresses without pain. That is why many patients come in once there is already mobility or recession, rather than when the first bleeding appeared.

This treatment is for you if your gums bleed when you brush, if you have persistent bad breath, if your teeth look longer than they used to, or if you have been told you have calculus below the gum line. At Higienista Oral we begin with a full periodontal assessment.

Gingivitis and periodontitis are not the same thing

Gingivitis is inflammation of the gum caused by a build-up of plaque and calculus. The gum looks red, swells and bleeds. It is reversible: with a professional clean and good brushing technique at home, the tissue returns to normal.

Periodontitis develops when that inflammation persists and starts to involve the bone. Periodontal pockets form between the gum and the tooth, bacteria keep accumulating in them, and the bone that holds the tooth is gradually lost. Lost bone does not come back on its own, but the process can be stopped and controlled.

Smoking, uncontrolled diabetes, certain medicines, hormonal changes and genetics all mean the disease progresses faster in some people than in others.

Warning signs

• Bleeding when brushing or flossing, however slight.
• Persistent bad breath or a bad taste in the mouth.
• Red, swollen or tender gums.
• Recession: teeth look longer and the necks of the teeth become exposed.
• Sensitivity on the exposed root, particularly to cold.
• Teeth that feel loose, that move, or that gradually shift position.
• A change in the way your teeth meet when you bite.

Bleeding is not normal. It is the first warning, and the easiest one to deal with.

The treatment: scaling and root planing

Before treating, we measure. Pocket depths are recorded tooth by tooth with a periodontal probe, bleeding and mobility are noted, and X-rays are taken to check bone levels. That map is what the plan is built on.

• Hygiene phase. Scaling and plaque control, together with instruction in brushing technique and the use of floss or interdental brushes.
• Scaling and root planing (curettage). Under local anaesthetic, the calculus and plaque below the gum are removed and the root surface is smoothed so the tissue can reattach. This is usually done quadrant by quadrant, over several visits.
• Reassessment. Some weeks later everything is measured again to see how the tissue responded.
• Periodontal surgery, if needed. For pockets that persist or areas with recession, there are surgical procedures and grafts, assessed case by case.

After root planing it is common to feel cold sensitivity and to notice the gums looking different: as the swelling goes down, the tissue shrinks back and the spaces between teeth can become more visible. That is a sign the inflammation has settled.

Periodontal maintenance

Periodontitis is controlled rather than cured once and for all. Once the active phase is finished, you move on to a maintenance schedule, with regular visits where the critical areas are cleaned again and the pockets re-measured. Your dentist sets the interval according to how your case responds.

Between visits, much of the work is yours: brushing two or three times a day with the right technique, cleaning between the teeth every day and, if you smoke, cutting down or stopping makes a substantial difference to the outlook.

If your gums bleed or a tooth feels loose, book a periodontal assessment at Higienista Oral. We measure, show you the state your gums are in and explain the options before anything begins. Call us on 0312 4869987, message us on WhatsApp at 0312 4869987, or email penaerika4872@gmail.com.