The branch of dentistry that deals with the supporting structures and tissues of the tooth is called periodontics.
The supporting structure includes the gingiva, the periodontal ligament and the alveolar bone. Periodontics mainly treats gum and periodontal disease.
Bacteria are the main cause of periodontal disease. Other factors which may influence the occurrence of periodontal disease include bad oral hygiene, smoking, diabetes and hormonal disorders.
Gum disease is the inflammation of the gingiva (gum). A healthy gum is pink, firm, fits snugly around the tooth and does not bleed. An inflamed gingiva is darker in color, swollen, soft and bleeds. Gum inflammation is usually limited to gum tissues and is also characterised by the presence of plaque. Gum inflammation is reversible and with the proper treatment and care in terms of dental hygiene, gums can heal and stay healthy.
Periodontitis is the inflammation of the supporting structure of the teeth. Chronic periodontitis is triggered by a gum inflammation caused by the presence of plaque and bacteria. Periodontitis is considered a slow-progressing disease. Even if in most cases this disease concerns adults, it can be found in children and young adults whose teeth accumulated plaque for very long periods. In case other influencing factors are met such as diabetes, a habit of smoking, or the consumption of certain medication, the disease can turn aggressive. Unlike gum inflammation, periodontitis is characterised by the presence of plaque not only on the teeth surface and around the gum but also under the gum along the root of the tooth. As a direct consequence, the disease causes bone loss as well as the increase of the width and length of the periodontal pockets (pockets formed between the tooth and surrounding tissue because of bone loss and tissue destruction). In most patients, the changes caused to the supporting structures of teeth (by plaque and bacteria) is not visible at first. However, it can be detected by examining more deeply the gums, underneath the gums and by doing a dental radiography.
Periodontal disease therapy consists in re-establishing the conditions that would allow for a good oral hygiene routine to have effect. The initial phase of the therapy requires the removal of plaque and tartar and the polishing of roots in order to prevent bacteria from accumulating further. To treat gum and periodontal disease we use 2 different dental lasers: a diode laser with a wavelength of 940 nm and an er:yag laser with a 2780 nm wavelength. Depending on how much the disease has progressed, lasers can be used for open gum flap treatments or closed gum flap treatments. Open flap treatment is a minimally invasive surgery during which the gum flap is raised to allow for the laser to treat and clean the root surface of a tooth. Closed flap treatment does not require surgical intervention since the laser emission reaches the diseased tissues by passing through the gum pockets. Severe cases of periodontitis may require an antibiotic therapy too. Moreover, periodontitis is a chronic disease that takes long treatment and regular check-ups.