General characteristics of gingivitis

General characteristics of periodontitis

treatment of gingivitis and periodontitis

Gingivitis treatment

The treatment of gingivitis consists of a dental cleaning along with instructions for proper hygiene and home care

Periodontal treatment

Periodontitis, in contrast with gingivitis, apart from inflammation is also characterized by tissue loss and presence of periodontal pockets. Pockets are empty spaces between the tooth roots and the gums, where bone was previously present. It is impossible to clean them using a toothbrush because of their depth. They form when bacteria of dental plaque infiltrate deep underneath the gums, cause inflammation, bone loss and loss of attachment between gums and bone. For these reasons, periodontal treatment is more complex than gingivitis treatment.

Conservative treatment

The first phase of periodontal treatment is always the conservative treatment also called control of inflammation phase. It consists of a deep cleaning under local anesthesia called scaling and root planing. Scaling removes plaque and calculus along the gumline. Root planning cleans deeper underneath the gums onto the root surface. This process is more sophisticated than a regular cleaning and it also involves the smoothening of the root surface so that bacteria cannot easily adhere to it. The purpose of the conservative treatment is help the tissues heal from the inflammation and to eliminate the periodontal pockets. This way we will create optimal conditions for the maintenance of periodontal health. For many patients that do not have severe periodontitis this phase concludes their active treatment.

Surgical treatment

Three months after the conservative treatment an evaluation of the result is performed. If periodontal pockets are still present in a certain area or even in all the dentition, then surgical treatment will also be needed. This is often the case for patients with severe periodontitis. With surgical treatment we can eliminate the periodontal pockets and in cases that it is possible we regenerate part of the lost tissues. For this process an incision is made on the gums in order to access the roots and debride them thoroughly. If needed, we also remove any irregularities of the surrounding bone. If indicated, we may place special bone grafts in order to regenerate the lost bone.

Crown lengthening – Gummy smile treatment

Crown lengthening is a surgical procedure that alters the gumline position in relation to the tooth crown, which is the visible part of the tooth. The purpose is to increase the length of the visible crown for functional or esthetic reasons. 

The process involves the surgical removal of part of the gums and bone that surround the tooth, to allow for the placement of a prosthetic restoration or to esthetically improve the smile. 

Functional crown lengthening: In some occasions crown lengthening is necessary when there is not enough tooth structure present above the gums to support the placement of a prosthesis (crown or bridge) due to caries of fracture. 

Esthetic crown lengthening: Excess gum tissue display is what causes a “gummy smile”. In certain occasions the gums cover a larger part of the teeth than they normally should causing the teeth to appear short and square. By removing the excess tissue we can fully reveal the teeth and improve the esthetic appearance of the smile.