Gum Diseases & Periodontology
What is Scaling and Root Surface Smoothing?
It is the most common preventive method among the treatments of gum diseases. In scaling, tartar or plaque, also called tartar or plaque, is removed. Plaque is a sticky substance and most of it is made up of bacteria. Dental calculus is formed with the hardening of plaque over time. Plaque and calculus adhere to the tooth surface, especially to the root surfaces below the gingival margin. Since plaque tends to adhere to rough surfaces, the root surfaces must be leveled. In this process, all calculus is removed and irregularities on the root surface are removed.
When is it applied?
Scaling and root surface smoothing procedures are performed to remove plaque and tartar that cause gum disease. In the early stages of the disease, this treatment is sufficient to control the condition in gingivitis, that is, gingivitis. However, in advanced cases, this procedure may be the first step of treatment.
How is it applied?
Ultrasonic tools such as cavitron and hand tools are used for scaling and root surface smoothing. Ultrasonic instruments work with air pressure or electricity. They have two components. It has a blunt metal tip. This tip vibrates at high frequency and removes plaque and tartar from the surface of the tooth. The second component is a water flushing system, which cools the metal tip as it works and helps to remove debris from the tooth. The handpieces have sharp edges that rest against the tooth and remove calculus from the tooth surface. These handpieces are called scalers and curettes. They come in various shapes and sizes for different teeth and different surfaces of the same tooth. Firstly, large plaque and calculus are removed from the crown and root surface of the tooth with ultrasonic instruments. Hand instruments are used to remove all remaining material and to smooth the root surfaces. When the dentist is working under the gingival margin, he/she cannot see plaque or calculus. However, he is guided by the roughness of the root surface. In the early stages of gum disease (gingivitis) or when more advanced gum disease is localized in one part of the mouth (localized periodontitis), scaling and root planing are usually completed in a single appointment. If the patient has periodontitis, one half of one jaw is treated in one appointment. The treatment is therefore completed in four sessions.
What to do after treatment
There may be hot-cold sensitivity and mild pain for 2-3 days after treatment. Painkillers can be used to eliminate pain. After scaling and root planing, antiseptic mouthwashes can be used, especially if there is pain that makes it difficult to maintain oral hygiene. You should also continue to brush and floss your teeth. On the first day after scaling and root planing, there may be slight bleeding.
What are gingivectomy and gingivoplasty?
Gingivectomy is the surgical removal of gum tissue. Gingivoplasty is the shaping of healthy gingival tissues around the tooth. These procedures are performed by periodontists specialized in gingival diseases and gingival tissues.
Where is it used?
Gingivectomy is a treatment developed for the treatment of gum disease. Today, it is also used for aesthetic arrangements. There are two reasons for the removal of gingival tissue. The first reason is the presence of gingival pockets formed between the teeth and gums. The accumulation of food residues and bacterial colonies in these areas causes difficulty in cleaning. If these pockets contain only gingival tissue, they can be removed by gingivectomy. In some cases, there may be too much gingiva around the tooth. This is a condition that prevents the teeth and gums from being kept clean. It is also a cosmetic problem. In severe cases, it may affect chewing and speech. Some medications, such as epilepsy medications, can cause excessive gingival growth. Sometimes there may be no obvious cause. With the help of gingivoplasty, the reshaped gums have a more natural appearance. Gums that are misshapen or asymmetrical due to genetics, disease or trauma can be corrected with this procedure. This procedure can also be performed for aesthetic reasons only. Gingivoplasty is usually performed alone. However, in some cases, it can also be applied after gingivectomy or graft application added to the gingiva at the gingival margin.
Gingival bleeding is one of the most basic health problems in societies.
Bleeding gums is the most obvious indicator of gum disease.
So why do our gums bleed?
If there is an infection somewhere, our body’s defense mechanism dilates the vessels there, causing more defense cells to flood into that area. In addition to the excessive swelling of the vessels, creating an oedematous and reddened appearance in the tissue, it causes bleeding as a result of the slightest trauma by swelling and thinning of the vessel walls.
The capillaries in the part of the gum close to the tartar expand to create a defense against the bacteria in the tartar. After actions that create mechanical pressure on the gums, such as biting an apple or brushing teeth, the dilated capillaries are traumatized and start to bleed. The problem of bleeding gums can only be solved by removing the causative calculus. After the tartar is removed, the capillaries narrow, the oedematous and reddened appearance disappears and the gum returns to its old healthy pink appearance. Although different techniques should be used for the treatment of bleeding gums according to the level of the problems caused by the stones, scaling is always the procedure that should always be prioritized.
GUM DISEASE
For all gum diseases, scaling and ensuring optimum oral hygiene constitute the first stage of treatment. Depending on the degree of progression of the disease, a solution is provided with gradual treatment techniques with laser. Advanced tooth mobility and some other symptoms may require extraction.
If the disease only affects the gums, scaling and good oral hygiene may be sufficient. Scaling is the process of removing tartar, plaque and discoloration accumulated on the tooth surface with the help of special tools and should be performed regularly even in healthy individuals.
In cases where the disease is more advanced, it may be necessary to perform curettage, which requires deep cleaning under the gum. While the root surface is cleaned by entering into the pocket during scaling, the gum tissue of the same pocket is cleaned during the curettage procedure. This procedure can be performed with conventional methods using hand tools or with Er:YAG lasers in clinics that are advanced in terms of technology and knowledge.
Gum tissue cleaning can be performed more comfortably and effectively with a laser.
In the advanced stages of gum disease, if there is severe loss of bone, treatment can be performed without the need for surgical procedures by using different laser treatment techniques according to the type of melting.
LOOSE TEETH
If a tooth decays, we can say that only that tooth is at risk. However, since gum diseases are usually a problem that affects all teeth, it puts all our teeth at risk. For this reason, the detection and treatment of gum diseases is very important for the continuity of oral health.
If the shaking of the teeth is seen in all teeth, this is most likely due to tooth clenching and gingivitis in addition. This condition, which we encounter very frequently in society, is a problem with a high success rate when treated in the early stages.
If the swaying of the tooth is limited to a few teeth, this is sometimes due to regionally advanced gum disease, sometimes due to inflammation around the root tip of the teeth around the root (mostly) due to tooth decay and similar factors that cause advanced bone loss around the tooth.
While the inflamed tissues that cause tooth shaking due to gum disease are treated by laser-assisted periodontal treatments, in shaking caused by inflammation at the root tip, the inflammatory tissues around the root are treated by removing the inflammatory tissues around the root with SWEEPS laser technology applied during root canal treatment.
It should be determined whether the tooth shaking is caused by gum disease or root tip infection, and in case of tooth shaking caused by tooth clenching problems, treatments related to tooth clenching and grinding should also be performed.
GUM RECESSION
Gums are protective barriers on the teeth.
Gum recession is more common especially in people with thin gum type. Apart from this, gingival recession, which is often caused by tartar accumulation, can also develop as a result of excessive clenching habits, hard and incorrect tooth brushing, lip cheek muscle ligaments mobilizing the gums and excessive forces seen during orthodontic treatment. Individuals with gingival recession may experience hot and cold sensitivity, decay on the exposed root surface and aesthetic problems.
Today, the treatment of gingival recession has a very high success rate in the hands of physicians specialized in this field. The first stage in the treatment of gingival recession is to determine the cause of recession and to eliminate the cause. The second stage is to close the root surface with the appropriate surgical technique and the third stage is to motivate the patient in terms of oral care in the postoperative period.
The lost gingival tissue is usually replaced by integrating the gingival transplant taken from the upper palate into the gingival recession area. At this stage, the connective tissue graft and free gingival grafts taken from the upper palate are integrated into the root surface with special microsurgical techniques and special suturing techniques by the specialist physician. By repairing gingival recession, it is possible to provide aesthetically correct appearance, to protect the opened tooth root surfaces again and to prevent gingival recession in that area by thickening the thin gum.
TOOTH STONE CLEANING
Regular scaling is a must for a healthy and sustainable oral and dental health. At the same time, the first stage of treatment in gum diseases is tartar cleaning.
In cases where bacterial plaque cannot be removed from the tooth surface, tartar formation can be seen on the tooth surface. Initially soft plaque turns into tartar as a result of the precipitation of minerals in saliva. Tartar formation is usually related to saliva. Saliva normally has the ability to wash and polish the tooth surface, but when its consistency thickens due to some medications, smoking, age and some types of diet, the minerals in it tend to precipitate and trigger the formation of dental calculus over the soft deposits on the teeth.
Tartar cleaning can be done manually with the help of special hand tools or with devices called scaler / cavitron, which removes tartar by vibration and the effect of water. Since calculus is attached to the tooth surface with acidic materials secreted by the bacteria inside, it disrupts the smooth structure of the tooth surface over time. Contrary to popular belief, scaling does not damage the tooth surface. On the contrary, scaling is aimed to remove the deposits on the tooth surface and to obtain a smooth surface on the tooth and root surface. While scaling does not cause any damage to the tooth surface, in cases where scaling is not performed for a long time, tooth loss can be seen over time.
Tartar Removal Treatment Process
Tartar accumulation occurs at different times in patients. A general check-up is required every six months. In these controls, it is important both for the early detection and cleaning of accumulated calculus and for the determination of general oral health.
GUM TREATMENT WITH LASER
Carrying out your treatments at the right time in gum diseases means saving your teeth.”
One of the biggest risks for general oral and body health is gum diseases that can be a source of inflammation to the body. With laser technology, it is possible to perform advanced gum treatments without the need for incisions and stitches by eliminating the factors that disrupt tissue biology.
Depending on the severity and stage of gum diseases, the type of treatment to be applied also varies.
In the first stage, which manifests itself with gingival bleeding, there has not yet been a decrease in bone level and only tartar cleaning may be sufficient for treatment.
Treatment Process of Porcelain Laminates
If treatment is not performed in the first stage, bone resorption begins. Then only tartar cleaning is not enough. It is also necessary to clean the tooth and peri-dental tissues under the gum deeply. After this cleaning (Subgingival Curettage with Laser), it is possible to get a long-lasting treatment result if individuals follow the tooth cleaning recommendations of the gum treatment physician.
If the necessary treatment is not performed in the second stage, bone resorption continues in the surrounding tissues of the tooth at an angle to the tooth. At this stage, it is necessary to renew the melted bone around the tooth. In classical treatments, in this case, the surgical procedure called “Flap operation” is applied and it is aimed to create bone around the tooth with artificial bone materials. Today, modern periodontology gives up surgical methods and recommends non-invasive periodontal treatments.
Among the non-invasive periodontal treatments (non-invasive periodontal treatments) used in the non-surgical solution of advanced periodontal diseases, the WPT technique has gained importance with successful results.
In laser gum treatments performed by applying double wavelength “WPT technique”, all foreign materials and tissues around the tooth are cleaned with Er:YAG laser without interventional surgical procedures. Thus, the natural state of tissue biology is ensured and the blood filling the cavity of the angularly melting bone around the tooth is stimulated with Nd:YAG laser and coagulated and the body is enabled to transform the clot to form bone and other healthy tissues.
Thus, there is no need for advanced surgical procedures and foreign materials such as bone powder from outside.
What are the Advantages of Using Laser in Periodontal Treatments Compared to Traditional Treatment Methods?
The duration of gum treatments with laser is shorter
After laser treatment, comfort is at a high level and pain is at a minimum level.
After laser treatments, bleeding is minimal, swelling or bruising does not occur, and there is a rapid recovery period for the patient. (Return to social life is fast.)
Gum recession due to trauma caused by traditional hand tools is not seen in laser treatments.
Tooth sensitivity is at a lower level after laser gum treatments.
There is no aesthetic change in the patient’s smile (damage to the gums, burning, etc.) after laser gum treatments.
Pink (Gum) Aesthetics
Our smile is one of the most characteristic features of our personality. In order to be able to talk about a smile design that provides a real mouth and dental aesthetics, it is necessary to obtain the appearance of healthy gums that are harmonious and symmetrical with lips and teeth.
Our smile is one of the most characteristic features of our personality. In order to be able to talk about a smile design that provides a real mouth and dental aesthetics, it is necessary to obtain the appearance of healthy gums that are symmetrical and symmetrical with lips and teeth. If the gums are not where and how they should be, the easy, healthy and successful method in terms of post-procedure comfort is the gingival aesthetic application method performed with Er:YAG laser.
A fast and comfortable biological healing is very important in aesthetic treatments such as smile design. Shaping of the gums with Fotona Er:YAG laser systems can be performed painlessly and without bleeding by applying minimum anesthesia. Since the laser biologically activates the healing of the tissue, healing is fast and comfortable.
Pink Aesthetics (Gum Aesthetics) Treatment Process
When talking or laughing with people in front of us, excessive or asymmetrical appearance of the gums prevents a beautiful smile. In such cases, only interfering with the teeth does not give us exactly the aesthetics we want. The procedure performed to make the gums appear as much as they should be or to make them symmetrical in the area of aesthetic concern is called gingival leveling (gingivoplasty). We can also call this procedure pink aesthetics in general.
Performing pink aesthetic applications using hard tissue (Er:YAG) lasers is a modern technique used to level gum and bone tissues without experiencing an unpleasant process after procedures such as open bone surgery. Patients usually do not even need to take painkillers after this laser procedure.
Laser depigmentation, gum pinking
‘Depigmentation treatment is a long-lasting treatment with a high success rate.’
The color and texture of the gums are as important as their harmony and symmetry with the lips and teeth. Healthy gums are pink in color and have the consistency of orange peel. It is possible to bring the dark and purple discoloration of the gums to a healthy tissue color and consistency with Er:YAG laser.
Color change in the gums can be disturbing for many people. This color change is mostly seen as bruising of the gums. The normal appearance of the gums is like pink coloured and orange peel texture.
In some people, a dark color may be dominant in the gums like skin darkness. This dark coloured appearance occurs in people in whom the outermost layer of the gums, called sub-epithelial epithelium, is dense in pigment tissues that give the tissues their color and may cause aesthetic discomfort. With the Er:YAG laser, it is possible to remove the pigments and achieve the desired healthy pink appearance by performing very small regional anesthesia (sometimes without the need for it).
