Periodontology is a branch of dentistry that examines the health and disease conditions of the teeth and tissues around them, and aims to diagnose and treat the diseases that occur in these tissues and to protect the health obtained after treatment. Healthy gingiva is usually light pink in color, matte, has an orange peel-like surface, has a hard consistency (non-bleeding), and ends like a knife-edge without thickening on the tooth surface.
The primary cause of gingival diseases is the deposits called “microbial dental plaque”, which contain many microorganisms and accumulate on all surfaces of the teeth, in the tooth-gingival junction and between the teeth, as a result of not brushing regularly and effectively. If this plaque is not cleaned, microorganisms and the harmful substances they produce cause dental caries and gum diseases.
If this plaque is not cleaned over time, it becomes calcified and hardened and “teeth” is formed.
Gum diseases cover a wide area from simple gingivitis to severe infections (periodontitis) where the jaw bones
recession and teeth are lost by shaking. With diseases, the gums swell, redden, bleed, recede; teeth lengthen; bad
breath occurs; The teeth are displaced, spaced apart and eventually lost. Gingival bleeding, which is one of the
most important symptoms of gum disease and can be easily noticed by the patient, sometimes occurs
spontaneously while brushing teeth, eating hard foods.
The relationship between gingival diseases and systemic diseases;
The developmental mechanisms of heart diseases and periodontal diseases are similar, and both diseases occur more frequently in older age, sex, low socio-cultural level, smokers, high blood pressure and stressed individuals. Studies have shown that people with oral infections are 30% more likely to have a heart attack than people without the infection. Microorganisms that cause periodontal disease and the harmful substances they secrete play an important role in diabetes. It has been determined by scientific studies that more periodontal disease develops in uncontrolled diabetes patients than in controlled diabetes patients with the same oral hygiene level. With periodontal treatment, the control of blood sugar, thus the control of diabetes becomes easier.
Inhalation of microorganisms that are effective in periodontal disease or collection of these microorganisms in the respiratory tract leads to the development of lung diseases.
Drugs used for the treatment of various systemic diseases may result in enlargement of the gums.
Phenytoin, an anticonvulsant drug used in the treatment of epilepsy, may cause gingival enlargement on the anterior surfaces of the teeth, especially in the anterior areas and around restorations, in a firm, pale pink, nonbleeding appearance that encompasses the gingiva and the gingival margin between the teeth.
Cyclosporin A, an immunosuppressive drug used after organ-tissue transplantation, may cause gingival enlargement, which is more common on the anterior surfaces of the teeth, especially in the anterior areas and around the restorations, similar to Phenytoin. Growth begins with the formation of granules from the interdental areas, the surface is rough and prone to bleeding.
Nifedipine, Amilodipine, Nicardipine, Diltizem and Verapamil, which are calcium channel blockers used in heart and hypertension patients, may present with a more lobular growth and pale pink color compared to Phenytoin and Cyclosporin A.
The effect of smoking on gum diseases;
It is known that smoking is a risk factor in the increase of bone loss in periodontal diseases and decreases tissue response to periodontal treatments. It has been reported that the success rate in clinical outcomes decreases in patients who smoke more than 10 cigarettes per day. This is attributed to the effect of smoking on vascularity, impairing the function of defense cells, affecting collagen synthesis and altering the inflammatory response.
Treatment of gum diseases;
For this reason, the first step of the treatment is the removal of dental plaque, which is the main factor of the disease, and the deposits on the teeth by the dentist with special tools. This stage, called initial treatment, is the basis of periodontal procedures. It can be a stand-alone treatment
method in simple gingival inflammations, as well as in advanced cases, it is used to prepare for periodontal operation.
When new bone formation is targeted, auxiliary biomaterials (bone powder, membrane, etc.) The surgical procedures in which it is used are called “periodontal operations”. The necessity of the periodontal operation is decided by the physician after the initial treatment (scaling removal).
During and after the treatment, the patient is told how to care and what kind of brushes to use.