Direct aggravating factors of the periodontal disease

Direct aggravating factors on the progression of the periodontal disease

• Bad oral hygiene
  

When teeth cleaning is not often enough and is not done with the right tools, this is what contributes the most to the development os the periodontal disease. It’s particularly important to do interdental cleaning for a patient who suffers from a periodontal disease. In order to do so, special equipment is needed - the most important thing is to use interdental brush since the ideal hygiene cannot be maintained with the toothbrush only.

• Factors that complicate cleaning
  

Unfortunately it might happen that the patient’s restorations are unsuitable for a thorough cleaning. Thus, adequate oral hygiene can’t be achieved even with the utmost care. Bad quality restorations are those with protruding tooth filling edge or if the edge of the crown goes too deep under the gums.

• Smoking
  

Substances inside the tobacco smoke damage the blood circulation inside the gums. Thus, it’s even more difficult to notice gingivitis since the bleeding of gums is reduced. Persistent low blood flow prevents immune system cells from accessing the site of the infection - furthermore, it directly inhibit the defensive capabilities of immune cells. All these together aggravate the periodontal disease when it comes to smoker patients. 

• Hereditary factors
  

The defensive capability towards bacteria is adversely influenced by the reduced operation of immune system cells / proteins which are affected by hereditary factors.

• Hormonal factors
  

Changes in the hormone system also have an effect on the inflammatory reactions. Hormonal actions during pregnancy and puberty might aggravate periodontal disease due to the increased inflammatory reactions.

• Diabetes and immunodeficiency
  

When it comes to immune deficiency and diabetes, unfortunately there’s a high chance that periodontal disease develops despite the best oral hygiene. This is due to the decreased immune response against pathogens.

• Taking medicines
  

If the patient takes medicines for osteoporosis or cancer (where the nature of the disease requires drugs containing bisphosphonate) he/she might have severe symptoms following surgeries where the bones were also affected. It’s important that patients who take this type of medication learn adequate oral hygiene even before they start taking the given medicine. We help them in that and make perfectly cleanable restorations for them.

Taking certain drugs may lead to inflammatory gingival hyperplasia. Such medicines are Cyclosporin immunosuppressive drugs, Calcium channel blockers used for hypertension or Hydantoin derivatives used in epilepsy.

Treatment

When treating periodontal disease, it’s important to find out what’s behind it, since certain aggravating features might modify the treatment plan. In the first phase, we always perform an ultrasonic plaque removal and help the patient to develop the perfect oral hygiene. No matter what type of hygienic treatment we do at the clinic, the key to success is the patient’s cooperation at home (oral care and teeth cleaning with the appropriate devices). However, ultrasonic plaque removal can’t fully clean dental pockets which goes deeply under the gums. In such cases, root planing (closed curettage) is necessary. During this intervention, the plaque under the gum is removed with specially designed instruments, under local anaesthesia. If the pockets are so large that closed curettage is not enough for a perfect cleaning, we’ll perform an open curettage. The dentist gently peels off the gum in the affected area so that the deeper pockets become more accessible, since complete cleaning is only possible that way. The surgery is done under local anaesthesia. We often supplement this surgical cleaning with regenerative materials for the purpose of complete healing. Once these materials are installed, the gums are stitched together.

Periodontal (calcified) pockets can be treated with regenerative surgeries, using protein extracts and bone graft materials. We tell the patient to visit us again following the surgery, in order to check his/her appropriate oral hygiene. Stitch removal is done 10 days after the intervention.

Make an appointment and visit our specialists!

Our doctors who have this branch of science:

Dr. Krisztián Kövér Parodontology, periodontal treatment

Dr. Lilla G. KOVACS Periodontist