Is periodontal treatment useful?
The dentist usually decides whether such treatment is necessary. During the regular annual check-up the dentist uses special probes to check whether a pocket has formed around the tooth, whether the gingiva is bleeding and much more. Based on various measuring points and standardized indices, periodontal treatment is indicated or not.
The threshold values, up to which point oral hygiene is okay and from which point it is not, are scientifically investigated. One should therefore listen to the advice of the dentist. Of course, you do not have to trust him blindly, but can get advice on how and which therapy would be the best for you.
The consequence of untreated periodontitis is bone loss and thus tooth loosening. Sooner or later the teeth are lost. Furthermore, the inflammation in the mouth is not to be neglected. It corresponds to the size of a palm of the hand or a 5€ bill. This inflammation represents a great risk for patients with heart disease or pregnant women.
Is periodontal treatment painful?
A periodontosis treatment (actually called periodontitis treatment) does not have to be painful anymore.If there is a suspicion of periodontal disease, a so-called periodontal status is determined and the diagnosis is made. The dentist measures the pocket depths with a millimeter probe. The patient only feels a feeling of pressure.
This is followed by the pre-treatment phase, beginning with professional tooth cleaning by a dental specialist, which is usually carried out before the status is determined. The tooth cleaning is very rarely perceived as unpleasant or even painful. This pre-treatment is necessary to remove superficial plaque and tartar, to optimize oral hygiene and to assess the motivation of the patient.
The costs for this are usually not covered by the statutory health insurance, but tooth cleaning is a prerequisite for the subsequent “closed treatment”. In a further session of this “closed periodontal treatment” the tooth or root surface is cleaned by curettage and ultrasound with cooling. Since the instrument is moved along the gum and tooth depending on the depth of the pocket, the patient feels pressure.
In addition, depending on the degree of inflammation, it may bleed moderately strongly. A previous injection takes away the pain completely, the numbness usually lasts for 2 hours. If one fears a puncture, surface anaesthetics (usually ointments) are used, but these must be paid for privately by patients with statutory health insurance.
If possible and therapeutically reasonable, treatment can also be performed on two consecutive days. It is often felt to be more gentle if the right side is treated first and the left side in a separate session. To promote subsequent wound healing, almost exclusively Chlorhexamed (CHX) products are recommended, which are used at home in the form of a flush or gel.
For a better effect an SLS-free toothpaste should be used in combination with CHX (no foaming agents). If necessary, the dentist can also prescribe painkillers such as ibuprofen and issue a sick note. In some cases the patient feels sensitive tooth necks after such a therapy, especially when eating cold food.
The reason for this is that the gums have subsided, the inflammation has subsided and areas of the tooth that were previously masked by the swollen tissue can now be seen and felt. In such a case Elmex® gelèe from the pharmacy, Sensitive toothpaste or special varnishes applied by the dentist can help. These close the access to the nerve endings.
If the “closed therapy” also requires surgical treatment (“open periodontal therapy”), depending on the surgical technique, gums are detached from the bone, inflamed gums are resectively removed, cleaned under “sight” and/or possibly regenerative work is performed. Bone replacement materials, membranes to cover the defect, etc. are used.
These techniques are microsurgical operations. The wound area is larger than in “closed therapy” and wound healing is more protracted. Certain behavioural patterns must be observed.
The surgery as such is painless due to the injections. Should there still be any sensation, a follow-up injection can be given at any time. Afterwards stitches are applied.
If the ends of the sutures are left too long, they may chafe and cause irritation of the tongue or cheek. In this case the dentist can quickly remedy the situation. In severe cases, after periodontal treatment, it is necessary to take antibiotics.
In order to increase the chances of success, the use of antibiotics is often used, because since the causative plaque consists of waste products of bacteria, it makes sense to reduce the bacterial colonization within the oral cavity. In addition, the patient is encouraged to use an antibacterial mouth rinse after brushing his teeth in the evening (Full-Mouth-Desinfectin). Meridol mouthrinse and Listerine mouthrinse are well-known products.
Aggressive periodontal disease often causes the development of exposed tooth necks, which not only look unattractive, but also cause many patients an enormous pain reaction to warm, cold or sweet food and drinks. These exposed necks of teeth have long since become a thing of the past, as gum transplants are becoming increasingly common. The dentist usually removes a tissue flap in the area of the palate and fixes it to the exposed neck of the tooth.To prevent the graft from coming off again, extreme caution is required when brushing your teeth and eating.
