Faq
WHAT IS THE MAIN CAUSE OF TOOTH LOSS?
In spite of what is normally believed, the main cause of teeth loss is not tooth decay, but periodontal deisesase. Periodontal disesase affects the tissues which surround the tooth: gingiva, bone and periodontal ligament.
It is a widely spread disease which affects, at different degrees, about three quarters of the adult population. Periodontal disease affects the gingiva around the tooth, at first: this is the reversible stage called GINGIVITIS.
If left untreated, gingivitis can turn into PERIODONTITIS. At the initial stages,periodontitis causes the initial phases of bone destruction.
The so-called PERIODONTAL POCKETS appear, in which plaque
Calculus is hardly attached to the surface of the tooth, and cannot be removed by the patient. The presence of subgingival plaque and calculus is responsible for the progression of the disease which, if left untreated, can cause the loss of an otherwise healthy tooth.
WHAT ARE THE CAUSES OF PERIODONTAL DISEASE?
Periodontal disease is a multi-factor pathology. The main cause is BACTERIAL PLAQUE, without which the periodontal disease cannot develop. Some bacterial species (Porphyromonas gingivalis, Prevotella intermedia and Actinobacillus actynomicetemcomitans) play a fundamental role in the progression of periodontal disease: they are the so-called
WHAT OTHER FACTORS ARE INVOLVED IN THE SETTING OF PERIODONTAL DISEASE?
There is a number of factors which are involved in the setting and in the progression of periodontal disease:
- Smoke
- Stress
- Puberty and pregnancy
- Inadequate restorations (fillings, crowns)
- Some drugs
- Diabetes and other sistemic diseases
- Genetic determination
WHAT ARE THE SYMPTOMS OF PERIODONTAL DISEASE?
Symptoms are often not so evident. The patient may not have any symptom at all, or may understiamte even for a long time the following signs:
- Swollen and red gums
- Bleeding gums
- Alithosis
- Spaces between teeth
- Gingival recessions
- Dental mobility
In some cases the outer appearance of the gingival tissue may look totally normal, in spite of an advanced bone loss. Pain is almost always absent. More often the patient will report only a sense of discomfort. Since symptoms are so vague, if the patient doesn’t go for regular check-up visits, diagnosis may not be made at early stages. The disease may therfore advance until it reache a critical stage.
HOW IS PERIODONTAL DISEASE DIAGNOSED?
Diagnosis is based on CLINICAL EXAM, RADIOGRAPHIC EXAM and, sometiomes, on MICROBIOLOGICAL TESTS.
In order to know the severity of the alteration of the tissues which surround teeth, a measuring around each tooth is carried out, called PROBING; according to probing values a PERIODONTAL CHART is filled in. PERIODONTAL CHARTING is both a prognostic instrument and a baseline datum to control the progression of the disease. A complete set of radiographs (RADIOGRAPHIC STATUS) is necessary to complete the diagnostic phase and for the treatment plan.
A further support in the diagnostic phase is provided by MICROBIOLOGICAL TESTS, a totally painless exam which is performed on plaque samples.
In the past few years, a GENETIC TEST ha s been developed, which allows the clinician to identify patients with a genetically-determined predisposition for periodontal diseases
HOW CAN PERIODONTAL DISEASE BE TREATED? NON SURGICAL TREATEMENT
The kind of treatment is related to the stage periodontal disease has reached: often in the early stages the only tretament, apart from the removal of the fattori aggravanti, consoists of a serie of visits for professional hygiene. It is important not only to remove supragingival calculus , but also subgingival calculus.
SURGICAL TREATMET
If the development of the disease has created deep defects, further treatments may be necessary. Whatever the selected treatment, the objective is regaining oral health and create conditions for home mainteinance.
Once the disease has been treated, non-surgically or surgically, the patient will receive supportive periodontal treatment. These regula visits are absolutely mandatory in order to keep the disease under control.
HOW CAN PERIODONTAL DISEASE BE PREVENTED?
In order to prevent periodontal disease it is necessary to carefully brush and floss daily. Recall visits are important to check the efficacy of home hygiene procedures; moreover they are necessary to remove the calculus which there might be due to an incomplete plaque removal and which cannot be removed without professional instruments.
By following a simple program of home and professional hygiene, a healthy periodontium can be preserved.
As a conclusion, it must be noted that periodontal disease can be prevented. In case it has already set, there are several means to treat it in an effective way: diagnosis is the key to success. In this way long and expensive therapies can be prevented.