Treatment of periodontitis

In professional teeth cleaning, the dentist or dental hygienist conducts a systematic cleaning of all tooth surfaces. With periodontitis, it is especially important to clean and smooth the root surfaces below the gum line that are colonized by bacteria.

In addition, anything that could make good oral hygiene at home more difficult is removed. This includes tartar deposits above the gum line and protruding edges of crowns or fillings.

A first professional teeth cleaning can rarely be carried out in a single sitting. For patients with advanced periodontitis, several appointments for teeth cleaning are scheduled.

It is not always easy to implement the optimal regular oral hygiene at home. One big challenge, for example, is cleaning the spaces between the teeth. There are special oral hygiene aids for these spaces called interdental brushes. They are selected individually for each situation in the mouth and the patient is instructed in the correct use by the dentist or dental hygienist.

During their gum treatment, patients learn an oral hygiene technique adapted to their situation. Good compliance with optimal oral hygiene at home is decisive for the success of treatment.

For more information on oral hygiene instruction, see www.oralhygiene-instruction.com.

One to two months after the professional teeth cleaning, the outcome is checked. In this re-evaluation, the dentist also checks whether patients are able to clean their teeth well with oral hygiene at home.

If good oral hygiene at home is practiced, a clear decrease in gingivitis and shrinkage of the gums can be expected. Even if the surfaces of the roots are exposed, in an ideal case, fewer remaining gum pockets with probing depths of more than 3 mm will be measured. In these cases, the gum treatment can be concluded and the restored situation maintained with regular appointments with the dental hygienist.

If residual gum pockets more than 5 mm deep are still found after the first professional teeth cleaning, the tartar deposits that often remain can be better removed with surgical treatment. In addition, gum contours can be corrected and in certain cases, an attempt can even be made to build up lost tissue using what is called biomaterial (guided tissue regeneration).

More complex gum treatments often take more than a year. Affected patients need to understand the course of this treatment and what can be achieved. Good patient compliance with good oral hygiene at home, quitting smoking, or a modification of diet are imperative.

After gum treatment, long-term success for many years can be ensured only if patients practice optimal oral hygiene at home every day, thus preventing their gums from becoming inflamed again by new bacterial coatings.

For the optimal long-term success, it is also important to continue to have ongoing professional care by the dental hygienist so that any recurring problems can be detected and remedied in time.

The intervals for these appointments with the dental hygienist are usually three, four, or six months. The frequency depends on the quality of oral hygiene, the extent of gum inflammation, and the presence of what are termed residual gum pockets.

During the professional teeth cleaning, patients experience pain in very different ways. In general, an inflamed gum is more sensitive than a healthy gum. It is important to know that the entire gum treatment can be carried out under local anesthesia.

Another side effect of gum treatment is the shrinkage of the gum lines after the professional teeth cleaning. This shrinkage generally leads to the formation of open spaces between the teeth and greater sensitivity of the dental root surfaces to cold temperatures or acidic foods. This greater sensitivity usually goes away again after a few months.

Dentists will have had theoretical and practical training and testing in the detection and treatment of periodontitis during their study of dentistry. With this training, they can treat cases that are not too severe on their own. In advanced training courses and other events offered by Universities, National Periodontal Societies, and other institutions, this basic knowledge can be deepened.

The treatment of difficult cases – especially quickly progressing periodontal diseases in adolescents and adults – requires special knowledge and an infrastructure that ensures complete long-term periodontal care. The family dentist can refer such patients to a periodontist.