Gum diseases and periodontology

bleeding gums

Bleeding gums are one of the most basic health problems in societies. In addition, bleeding gums are one of the first signs of disease.

Why do our gums bleed? If there is an infection, our body tries to defend itself by mounting an immune response, leading to swelling of the blood vessels. This causes veins to bleed at the slightest trauma due to the swelling and thinning of the vessel walls.

When capillaries located in the gums encounter dental calculus, they enlarge to form a defense against bacteria located within the calculus. Similarly, after actions that cause mechanical pressure on the gums, such as biting an apple or brushing teeth, the enlarged capillaries are traumatized and begin to bleed.

The gingival bleeding problem can only be solved by removing the causative calculus. After the calculus is removed, the capillaries narrow, the swelling and reddened appearance reduces, and the gingiva returns to its natural healthy pink appearance. Although different techniques should be used according to the severity of the gum disease, dental ultrasonic scaling is always a priority.

Gum diseases

Gum disease is an inflammatory disease caused by bacterial plaque and tartar accumulation on the teeth.

Symptoms of gum disease include redness of the gums, swelling, bad breath, bleeding in the gums, displacement of the teeth and gingival recession. The most common symptom among these is bleeding gums. In the initial stages of gingival diseases, only the gingiva is affected, while in the middle and advanced stages, the surrounding bone may also be affected.

Treatment

The treatment of gum diseases is carried out by removing the main problem, the tartar and plaque around the tooth and root surface. The gingiva, which is initially red, bleeding and swollen, returns to its healthy old pink color in a very short time after the inflammatory source is removed.

Scraping and hygiene

For all gingival diseases, ultrasonic scaling and optimum oral hygiene are the first treatment steps. According to the degree of progression of the disease, one solution may to be use a dental laser over a series of visits. Advanced mobility in the teeth and some other symptoms may require extraction.

If the disease has only affected the gums, it may be sufficient to remove the calculus and maintain good oral hygiene. Tartar cleaning is the process of removing the calculus, plaque and discoloration accumulated on the tooth surface, with the help of special tools. This should be done regularly even in healthy individuals.

Curettage

In cases where the disease is more advanced, curettage may be required, which requires deep cleaning underneath the gingiva.

During scaling, the root surface is cleaned by entering the pocket, while the gingival tissue of the same pocket is cleaned during the curettage process. This process can be done with conventional methods using hand tools, or it can be done with Er:YAG lasers.

Use of the laser

Lasers are used in clinics with advanced in terms of technology and knowledge. With laser, gingival tissue cleaning can be performed more comfortably and effectively. In the advanced stages of gum disease, if there is an advanced loss of bone, different laser treatment techniques can be used depending on the type and severity of bone loss, without the need for surgical procedures.

Mobile teeth

If a tooth decays, we can say that only that tooth carries a risk. But since gum disease is a problem that usually 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 loose or mobile teeth are found, it is may be due to factors such as tooth grinding or clenching, but more likely due to gum disease. This situation is very common yet has a high success rate when treated in the early stages.

If tooth mobility is limited to a few teeth, this is sometimes due to locally advanced gum disease. It may also be due to factors that cause advanced bone loss around a single tooth, such as inflammation around the root tip caused by dental caries and subsequent nerve infection.

laser treatments

Inflamed tissues that cause tooth mobility due to gum disease are removed and treated with laser-assisted periodontal treatments. In cases of mobility caused by inflammation at the root tip, the inflamed tissues around the root are removed and treated with SWEEPS laser technology applied during root canal treatment. It should be determined whether the loosening of the teeth is caused by gum disease, root tip infection, or clenching and grinding.

Gum retractions

Gums are protective barriers on teeth.

Gum recession is more common especially in people with a thin gingiva type. In addition, gingival recession, which is most commonly caused by calculus accumulation, can also develop because of an excessive teeth clenching habit, hard and incorrect tooth brushing, gingival activation by lip-cheek musculature and excessive forces during orthodontic treatment. Individuals with gingival recession may experience hot-cold sensitivity, decay on exposed root surfaces, and aesthetic problems.

Treatment stages

Today, the treatment of gingival recessions has a very high success rate in the hands of experienced physicians. The first step in the treatment of gingival recession is to determine the cause of the recession and then to eliminate the cause. In the second stage, the root surface is closed with the appropriate surgical technique and the third stage is the motivation of the patient in terms of oral care in the post-operative period.

Functional and aesthetic surgery

Lost gingival tissue is often replaced by a gingival transplant from the upper palate, integrating it into the extracted area. At this stage, the connective tissue graft and free gingival grafts taken from the upper palate are integrated into the exposed root surface by a specialist physician, using specialist microsurgical techniques and suturing techniques. It is possible to provide an aesthetically pleasing appearance by repairing the gingival recession, to protect the opened tooth root surfaces, and to prevent the recession of the gums in that area by improving the thickness of the thin gingiva.

Dental cleaning

Regular dental scaling is a must for a healthy and sustainable oral and dental health. At the same time, the first step of treatment in gum diseases is tartar cleaning.

Unwanted tartar formation

In cases where the bacterial plaque cannot be removed from the tooth surface, tartar formation can be seen. Initially soft plaque transforms into dental calculus due to a precipitation of minerals in the saliva. Tartar formation is usually a condition related to saliva. Saliva normally has the property of washing and polishing the tooth surface, but when its consistency becomes dense due to factors such as drugs, smoking, age and some diet types, the minerals in it tend to precipitate, triggering the formation of tartar on the soft deposits on the teeth.

Respectful of dental tissue

Teeth cleaning can be done manually with the help of special hand tools or by using an ultrasonic device called scaler/cavitron, and with tools that remove calculus with the effect of water. As the tartar clings to the tooth surface with the acidic materials secreted by the bacteria inside, it disrupts the smooth structure of the tooth surface over time.

Contrary to popular belief, tartar cleaning does not harm the tooth surface. It aims to remove the deposits on the tooth surface and to obtain a smooth surface on the tooth and root surface with tartar cleaning. As tartar cleaning does not cause any harm to the tooth surface, tooth loss may occur over time in cases where tartar cleaning is not performed for a long time.

Periodic control

The accumulation of calculus in individuals occurs at different times. A general check-up is required every six months. These controls are important in terms of both early detection and cleaning of accumulated dental calculus, and determination of general oral health.

Gum treatment with laser

One of the biggest risks for general oral and body health is gum diseases, which can be a source of inflammation in the body. With laser technology, it is possible to perform advanced gum and gingival treatments without the need for incisions and stitches, by eliminating the factors that disrupt tissue biology.

Depending on the severity and stage of gum disease, 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 the bone level, and therefore only scaling may be sufficient for treatment.

Deep laser cleaning

If treatment is not done in the first stage, bone resorption begins. Then just cleaning and removing the calculus deposits is not enough. It is also necessary to deeply clean the teeth and surrounding tissues under the gums. After this cleaning (Subgingival Curettage with Laser), it is possible to get long-lasting treatment results if individuals follow the teeth cleaning recommendations of the dentist who treats the gum disease.

If the necessary treatment is not performed in the second stage, bone resorption continues in the tissues surrounding the tooth, and at an angle to the tooth. At this stage, it is necessary to renew the reducing bone around the tooth. In this case, the aim is to create new bone around the tooth. We do this using artificial bone materials in a surgical procedure called “Flap operation”. Today, modern periodontology gives up surgical methods and recommends non-invasive periodontal treatments.

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Among the non-invasive periodontal treatments used in the non-surgical solution of advanced periodontal diseases, the WPT technique has gained importance with its successful results. In laser gingival treatments performed by applying the double wavelength "WPT technique", all foreign materials and tissues around the teeth are cleaned with Er:YAG laser without any interventional surgical procedures. Thus, the natural state of tissue biology is achieved and the blood that fills the angular bone defect is coagulated by stimulating it with Nd:YAG laser. The body can then form bone and other healthy tissues as by transforming the clot. Thus, there is no need for advanced surgical procedures and foreign materials such as bone graft.

What are the advantages of using laser in periodontal treatments compared to traditional treatment methods?

The duration of gingival treatments with laser is shorter.
Laser treatment leads to a more comfortable outcome with reduced pain.
After laser treatments, bleeding, swelling and bruising are minimal and therefore recovery time is quicker.
Gingival recessions due to trauma caused by traditional hand tools is not seen in laser treatments.
After gingival treatments with laser, tooth sensitivity decreases.
After the gingival treatments with laser, there is no damage to the gingiva and therefore no detrimental aesthetic change in the patient's smile.

Gum Aesthetics (Pink Aesthetics)

Our smile is one of the most characteristic features of our personality. To be able to talk about the smile design that provides a real oral and dental aesthetics, it is necessary to obtain a symmetrical, healthy gum image that is compatible with the lips and teeth. If the gums are not the correct shape, gingival aesthetics can be improved with Er:YAG laser, which is an easy, healthy and very successful method in terms of post-procedure comfort.

A fast and comfortable biological recovery is very important in aesthetic treatments such as smile design. With Fotana Er:YAG laser systems, shaping of the gums can be done painlessly and without bleeding with minimal anesthesia. Healing is quick and comfortable, as the laser biologically activates tissue healing.

Pink aesthetics (gum aesthetics) treatment process

An excessive or asymmetrical appearance of the gums, for example when talking or laughing, prevents a beautiful smile. In such cases, tooth improvements will not create the aesthetic we want. The procedure performed to improve the appearance of the gums is called gingival leveling (gingivoplasty). We can also call this process pink aesthetic in general.

In our clinic, to perform pink aesthetic applications we use hard tissue (Er:YAG) lasers and to level the gingival and bone tissues without needing to perform more extensive procedures such as open bone surgery. After this laser procedure, patients often do not even need to take painkillers.

Depigmentation | gum pinking

The harmony and symmetry of the gums with the lips and teeth are as important as the color and tissue structure. Healthy gums are pink in color and have the consistency of orange peel texture. It is possible to bring dark and purple discoloration of the gums to the color and consistency of healthy tissue with the Er:YAG laser.

In some people, a dark color may be dominant in the gums, as well as the browning of the skin. The outermost layer of the gingiva, called the subepithelial layer, consists of pigment tissues that give the tissues their color. In people with dense tissues, a dark appearance occurs 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 applying very localized anesthesia (sometimes without the need to do it).

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