Few things about periodontitis

(Conservative (non-surgical) treatment)

Periodontitis is a problem which is solved by hygienic formula "RT" (regularity and thoroughness)

Periodontitis is a disease of supporting structures of the tooth. Its extension is around 90-95%. High-risk group consists of people aged over 35 years. This disease results in atrophy of tooth support and holding apparatus to its complete destruction and tooth loss. The atrophic process extends to the gums, jawbone (into which teeth are anchored) and a system of ligaments, by which tooth is "suspended" in the bone – periodontium.

Almost always this process is accompanied by various forms of gingival inflammation, although sometimes there are exceptions. Generally, the disease progresses slowly, over a number of years, but in some cases the disease can develop very quickly and aggressively – such cases are typical for this disease on the background of common diseases, especially of endocrine and immune systems.

The main signs of the disease – edema and hyperemia (redness) of the gums, their bleeding, "settling" of the gums, baring of dental necks and later roots and, therefore, visual extension of the teeth.

All of these problems arise due to the action of the microflora, which forms accretion on the tooth surface and on periodontal tissues (gums and tissues surrounding the tooth). The functional unit of the accretion is so-called "plaque". It is a colony of saprophytic (opportunistic) microorganisms and under certain circumstances it becomes the direct cause of the development of two major dental diseases – dental caries and periodontitis. "Certain circumstances" include a lot of internal and external factors that we do not consider here, but which facilitate or impede the action of the main causal factor – accretion microflora. The effect of this microflora on periodontal tissues occurs in two main directions:

1. toxic effect on periodontal tissues (tissues surrounding tooth)

2. where the accretion previously was, dental tartar is formed, which irritates the gums (gingiva) mechanically, amplifies their inflammation and on the other hand – significantly affects oral hygiene, i.e. promotes the deposition of accretion.

Thus the pathological range is formed, i.e. described above causal factors result in and support each other.

This layout of periodontal disease development provides for the proper concept of its treatment and prevention, which are practiced in the First Private Dental Clinic Odontopractica. So the main point of the modern concept of treatment and prevention of periodontitis is the accretion control.  

To put it simply, oral hygiene, both professional (in the dental office) and personal (at home), is the primary method of treatment and prevention of periodontitis. It is important to emphasize that in this issue (hygiene) there are two main aspects where non-compliance will result in loss of all efforts being made. They are   thoroughness  and  regularity . This treatment concept, widely recognized in the world, defines our approach to the problem as well.

In this connection it should be noted that we do not share widespread use of antibiotics, anti-inflammatory, stimulants in the form of injections (Lincomycin, Traumeel, etc.), common in Poltava city. This approach, in our view, shifts focus illogically and doesn’t correspond to the mechanism of the disease formation. For this reason, usage of certain drugs injections in our clinic is resorted to only exceptional cases and exclusively on prescription, not at the request of the patient.

Hygiene procedures in the treatment of periodontitis

As it has been already noted hygienic methods are the basis of treatment and prevention of periodontal disease and consist of the dental accretion control – or rather, control over the microflora that forms it. Hygienic effects are used in two main ways:

  1. mechanical cleaning of all surfaces of the teeth from accretion and tartar.
  2. local antiseptic and anti-inflammatory treatment of gums.

Professional hygiene products (in the dental office of Odontopractica Clinic)

Mechanical removal of dental deposit (accretion and tartar) is performed in the Dental Clinic Odontopraktika by using ultrasonic devices – scalers that allows to carry out this procedure more efficiently, thoroughly and carefully towards the gum. After removal of dental accretion tooth surface is polished using pastes and brushes to slow further deposition of accretion. Introduction to extensive dental practice of ultrasonic method of dental accretion removal significantly increased the efficiency of professional oral hygiene and it was a considerable achievement of the dentistry practice. Further development of the ultrasonic technique by the famous German company «Durr dental» led to the creation of "Vector" – the most advanced to date and fundamentally different from existing devices. The essence of the revolutionary improvement of the ultrasonic method (with "Vector" therapy) is to change the oscillation direction of the working tip of ultrasonic tool. These oscillations of the "Vector" device occur along the axis of the tooth, unlike the chaotic oscillations in all directions in conventional scalers.

This tool allows the working tips penetrate atraumatically to all areas of dento-gingival space, that is hard to get to (periodontal pocket – see Picture) that was previously impossible due to high injury risk arising when applying disordered, chaotic ultrasonic vibrations in the narrow aisle. Thus the problem of removal of all the bacterial film in the subgingival area is now attainable. This is a key moment to eliminate or significantly reduce the toxic effect of microflora on the periodontium (tissues surrounding the tooth).

The second important point in the "Vector" therapy is polishing of tooth surface, previously released from dental plaque and bacterial film, with the help of the same ultrasound device, but using softer tips. This polishing is carried out much more carefully because of the availability of all subgingival surfaces of the tooth root and through the use of a special agent on the basis of calcium compounds, sealing the roots surface and making it much more smoother. This fact is clearly confirmed by electron microscopy. Such polishing is a highly effective preventive measure and it significantly reduces the deposition of accretion in the future.

Thus, quite obvious advantages of "Vector" therapy over conventional ultrasonic means of professional hygiene give grounds for believing that it is the main treatment and preventive measure in the curing of periodontitis and in dental prophylaxis on the whole.

From the beginning to the very end the process of mechanical removal of dental plaque is accompanied by compulsory antiseptic and anti-inflammatory treatments of local application using locally acting medications in the form of solutions, suspensions, medical pastes, gingival dressings, etc.

Personal hygiene products (preventive measures at home)

Personal dental hygiene procedures in periodontitis are not fundamentally different from the usual ones, but they need to be more thorough and regular. That is, if the usual brushing time is 2 – 3 minutes, in the case of periodontitis this time can be extended to 5 – 7 minutes. If the frequency of regular tooth brushing is twice a day, in the case of periodontitis it should be recommend to use of this procedure three or even four times a day (if possible).

Also because of peculiarities of dental hygiene in periodontitis selection of specific products is defined:

  1. toothpastes
  2. toothbrushes
  3. rinses and elixirs.

Making a choice among a large number of firms producing similar products is a very difficult task. The only advice here might be the choice of the most trusted firms (by a buyer, a large number of people or experts on the subject). We, as all professionals, who are directly connected to this issue, prefer products of the company «Am Way». Arguments in favor of this manufacturer is that "hygiene" concept of treatment and prevention of periodontal disease coincides with the concept of dental hygiene of company «Am Way». Mechanical removal of plaque with the help of paste «Glister» (firm «Am Way») is facilitated as compared to other pastes due to the active influence of the paste on plaque, loosening of it and weakening of its fixing force towards the tooth surface. Under these conditions, there is no need any more to use rigid toothbrushes. This characteristic feature, which distinguishes paste «Glister» among others, contributes to more efficient cleaning of teeth and allows you to take care of gums, which is especially important when they are inflamed.

An important component of the sanitary system «Glister» is a rinse. This rinse consists exclusively of natural ingredients and has a strong antiseptic and anti-inflammatory effect. Due to this tooth brushing effect significantly lengthens. Firm «Am Way» declares that combination of the toothpaste and rinse «Glister» prevents the deposition of dental plaque for the time period of 12 hours. That is, if using twice during the daytime the preventive antiplaque effect is reached.

Toothbrush «Glister» is soft, form of its bristles, which have "laser sharpening", is atraumatic, the working part of the toothbrush and its handle are ergonomical. In our opinion it is one of the most advanced among peers in the highest quality segment.

An important addition to the basic hygiene products are tools for processing of interdental spaces – interdental flosses and interdental brushes. In periodontitis hygiene of interdental spaces is particularly relevant due to their increase because of bone resorption and displacement of teeth. (PICTURE 3)

In the end, it makes sense to emphasize once again the importance of hygiene procedures in the treatment of periodontitis. Only by overcoming the problem of dental plaque for quite a long time (several months) it is possible to achieve tangible improvements in the condition of patients with this disease. Solving this problem is largely in the hands of the patients, who should adhere to the "RT" rule:

  1. regularity

Regularly (at least twice a year) implement the professional hygiene measures in the dental office.

  1. thoroughness

To adhere to personal hygiene measures regardless of the weather, mood, general state and other external and internal influences on the life course.

And the most reliable assistant in this case for you will be products by «Am Way» company – i.e. program «Glister».

The First Private Dental Clinic in Poltava Odontopraktika wishes you success in the difficult struggle for health (dental and general).

Administration of "Odontopraktika" Clinic