Our periodontium is consisting of periodontal ligament, cementum, alveolar bone and the overlying gingiva. A healthy periodontium should exhibit pink color with firm texture and also firmly attach to the cervical area of teeth (Figure 1).
When oral hygiene goes bad, there usually would be plaque accumulated around teeth. This plaque is actually a cluster of bacteria. In this situation, the bacteria will secret toxic substance that can provoke severe inflammation and destroy the periodontium, which makes bad smell and bleeding in the oral cavity. In advanced form of periodontal disease, multiple teeth extraction would usually be indicated due to the mobility caused by the severe bone destruction(Figure 2, 3).
Periodontal disease is usually chronic. Full compliance is the key for a successful treatment. Usually periodontal treatment has to go through the following 4 stages. Phase One is that the doctor will make a diagnosis from all the information he gets from the patient and decides whether or not he can be a candidate for the treatment. From Phase Two the doctor will start doing scaling and root planing in order to make sure the root surfaces of the teeth are smooth and clean. Also in this stage the oral hygiene instruction is provided to hopefully decrease the plaque significantly. The Phase Three therapy is also called the corrective phase. The objective is to correct any form of disease that remains even the phase two therapy has been done. Periodontal surgeries are indicated in this period. In addition, all the missing teeth should be restored. Full mouth rehabilitation is the ultimate goal of this phase. After all the necessary treatments are finished, Phase Four treatment will be brought to the patient. It includes one of the most important elements of a successful periodontal treatment, the maintenance program. The patient should come back for regular check-ups and scaling together with selective root planing. The frequency should be decided according to the periodontal status of the patient, usually 3 months.
In most of the cases, root exposure is very common after the periodontal treatment. This could be a problem for some people since the exposed roots might be very sensitive to cold or extremely hot food. This could be overcome by patients' meticulous plaque control and fluoride application onto the root surfaces done by the periodontists. After long-term fluoride treatment, root surfaces will be hardened and become much less sensitive than they used to be(Figure 4, 5).
You can preserve as many teeth as possible if you take care of your periodontal problems early. There is nothing better than having your own teeth in your life!
