Periodontal disease-Tri-Service General Hospital

What are the symptoms of periodontal diseases? Gingiva bleeding is one of the most common symptoms of gum inflammation. Gingivitis may induce little discomfort, ... GoToMaincontent Makeanappointment Internationalmedicalservices Download TheE-GovemmentEntryPointofTaiwan ::: DentistryDepartment Introduction MedicalTeamMembers HealthServices&Info MedicalService AdvancedImplantCenter MakeanAppointment TransportationGuide ::: Home / DentistryDepartment / HealthServices&Info Whatisperiodontaldisease?  Therearemanydifferenttypesofperiodontaldiseasebutgingivitisandperiodontitisarethemostcommon.Gingivitisisusuallyduetotheaccumulationofbacteriaonthesurfacelayerofgumtissue,whichcausesinflammationdepictedthroughgingivaredness,swelling,andbleedingonbrushing.Untreatedgingivitisprogressestobecomeperiodontitis,whichisthechronicinflammationanddestructionoftheperiodontalligamentandsupportingbones.Whenthegingivalfiberandperiodontalligamentaredamaged,thegummarginseparatefromtheteethformingaperiodontalpocket.Pusformationcanoftenbefoundintheseareas.Asbonedestructionprogresses,theperiodontalprobingbecomesdeeperandteethbecomeincreasinglyunstable.Whatarethesymptomsofperiodontaldiseases?   Gingivableedingisoneofthemostcommonsymptomsofguminflammation.Gingivitismayinducelittlediscomfort,butitprogressesslowlyandconstantly.Manyperiodontaldiseasesareaccompaniedwithgingivableeding,whichisusuallyignoredatfirstplace.Bythetimetheperiodontaldiseasegetattention,theconditionmayhaveworsenedandbecomemoredifficulttotreat.Therearealsoothersymptomsthatcanindicatethepresenceofperiodontaldisease,suchasloosened,flaredoutorspacingofteeth.Thegumsmaybegintoshrinkawayfromthecrownandteethmayappeartobecomelonger.Whenpusformsintheperiodontalpocketandcannotbedrainedout,itbecomesaperiodontalabscess.Theabovesymptomsmayonlyappearwhentheperiodontaldiseasebecomemoresevere.Thisiswhyeverypatientshouldroutinelyhavedentalappointmentstoexamineandmaintainhisorherperiodontalcondition.  Howperiodontaldiseasesarediagnosed Dentistsobservethecolorandcontourofthegums,checkthedegreeofteethlooseness,andplacetheperiodontalprobedowntotheguminordertomeasurethedepthoftheperiodontalpocket.Thistestiscalledperiodontalprobing.Thisisanecessarypartofathoroughdentalexaminationforadults.Ifbonelossisnoted,afullmouthX-rayexaminationissuggestedforfurtherassessment.Whatcausesperiodontaldisease?       Plaqueiseasilyaccumulatedovertothegummarginandbetweenteeth.Whenpatientshavepoorbrushinghabits,abacterialfilmwillcovermostofthetoothsurface.Almosteveryadultandchildwillhaveplaqueandcalculusdepositionintheirmouth.Theplaqueismainlycomposedofbacteria,minerals,andwater.Ifthebiofilmlayerisnotremovedovertime,itbecomescalculus,andthesurfacelayerwillcontinuallybecoveredbynewlayersofplaqueandbacteria.Inflammationofthegumsisusuallycausedbytoxinsexcretedfrombacteria,orcellsreactingtothehumanimmunesystem.Inadditiontoincompleteremovalofdentalplaque,residualfoodparticles,poordentalfillings,orthodonticbraces,orpoorlydesignedfixedpartialrestorationscanallinduceguminflammation.Personalfactorsincludinggeneticpredispositionandhormonalimbalances,suchasdiabetes,pregnancy,andthyroidinsufficiency,canallcontributetoone’speriodontalcondition,mainlybecausetheyaffectapatient’simmunesystem.Howtopreventperiodontaldisease?       Themostimportantstepistolearntocleanyourteetheffectively.Throughmirrorsandgoodlighting,fooddebriscanberecognizedandteethcanbecleanedthoroughly.Buttherealcrisisisthatthegrowthofbacteriaaroundthetoothsurface,whichthenturntodentalplaque,iseasilyignoredwhenbrushing.Aplaquedisclosingagentcanbeusedtorevealplaquedepositionandhelpinoralhygienemaintenance.       Thedentistshouldcreateanoralhygieneplanforeachpatient.Oralhygieneinstructionsuchashowtobrushtheteetheffectivelywithoutharmingtheteethorgumsshouldbeinformedtothepatient.Useofdentalflossorinterdentalbrushesisaneffectivewaytoremoveplaquebetweentheteethandlearningtousetherighttoolseffectivelyisfirststeptotreatperiodontaldisease.       Dailytoothcleaningcanreduceplaqueandcalculusformationtoaminimumlevel,butitcannotcompletelypreventthemfromforming.Moreover,thecalculusthathasalreadybecomefirmlyattachedtotheteethbelowthegingivalmargincannotberemovedthroughbrushing.Theremovalofcalculuscanonlybecompletedbyscaling,usuallyperformedusingaprofessionaltool.Manydentistsuseultrasonicdevicestoremovethecalculusfromthetoothsurface,oruseprofessionaltoolsforfurtherrootplaning.Whatisthetreatmentofperiodontaldisease       Inearlystages,mosttreatmentsincludesubgingivalscalingandrootplanningatthegingivalmargin.Dentistuseadevicecalledacurettetoremoveplaque,calculus,andinflamedsofttissueintheperiodontalpocketaroundtheteethandsmooththerootsurface.Thepurposeofthetreatmentistoremovethebacteriathatcauseinflammation.       Thisusuallyallowsthegingivatoreattachtothetoothsurfaceorshrinktoreducethedepthoftheperiodontalpocket.Satisfactoryresultscanbeobtainedbysuchscaling,rootplanning,andcleaningoftheteethinmostearlycases.       Forseverecases,treatmentcanbecomplicated.Ifdeepperiodontalpocketsstillremainafterremovingthedeposits,advancedsurgicaltreatmentunderlocalanesthesiaisneeded.Thissurgicalprocedureismainlytoprovidepatientswithasuitablegingivacontourforcleaning,andanenvironmentconducivetoperiodontaltissuerepairandreattachment.       Patientswithperiodontaldiseaseshouldacceptpreventivetreatmentregularly,suchastheremovalofnewlyformedcalculus,polishingtheteeth,checkingtheocclusion,andre-examiningtheperiodontalcondition.Theseallowpatientstokeeptheiroralhygieneandtomaintaintheresultsafterperiodontaltreatment.Whoshouldyougotoforperiodontaldiseasetreatment?       Generalpractitionerscandetectortreatperiodontaldiseaseearly.Instageofpreventionofperiodontaldisease,generalpractitionersplayanimportantroleineducationandoralhygieneinstruction.Afterexamination,patientsdiagnosedwithperiodontitiscanbereferredtoperiodontalspecialistswithextensiveprofessionaltrainingforfurthertreatment.       Afteraseriesofperiodontaltreatments,periodontalspecialistswillreferthepatientbacktotheirfamilydentistforcontinuedfollow-upinordertomaintainperiodontalhealth.About90%ofpatientscanmaintaintheirteethandperiodontalhealthafterrapidandcorrecttreatmentandcare.Maintenanceofperiodontalhealth       Ifyouhavejustcompletedfullmouththerapyofperiodontaldisease,nowit’sthetimetoenterthemaintenancephasetomaintainyourperiodontalhealth.Regardingthismaintenancetreatment,youmayhavesomequestions.Thefollowinglistmaybeabletoansweryourquestions.Ifyouhavefurtherquestionsafterreadingthislist,youcanaskyourperiodontistformoreinformation.I.Whatisthemaintenancephase?Themaintenancephaseisaplantokeepyourperiodontalhealthincludingperiodontaltissuesandalveolarbone.Onceperiodontaltreatmentiscompleted,thestatusofperiodontalhealthmaybeinastateofinactivity,butmustbecontinuouslyfolloweduptopreventrecurrence.II.Whyisitimportanttohavethemaintenancephase?       Ifyouareapatientsusceptibletoperiodontaldisease,thebacteriacausedperiodontaldiseasemayoftenappearinyourmouthandconstantlyinvadeyourteethandperiodontaltissue.It’simportantthatyouneedtodosomethingtopreventrecurrenceofyourperiodontaldisease.       However,youshouldmaketheefforttoupholdyourdailyoralhygieneroutinesuchasbrushingandflossing.Periodontalpathogensusuallyappearintwotofourmonthsafterthelastsessionofprofessionaltoothcleaning.Ifyouwanttomaintainyourperiodontalhealth,bookappointmentsforprofessionalcheck-upsregularly.Removalbacteriaandcalcifieddepositsregularlyisimportant.Duringthecheck-upsinthemaintenancephase,dentistscanalsodetectforpossibledentalcaries(cavities)andprovideanopportunitytoupdateyourdentalhealth.3.Whowillperformthecareduringthemaintenanceperiod?       Thisanswerdependsontheseverityofthepatientandthediseasecomplexitydiagnosedduringthefirstphase.Ingeneral,themoreserioustheinitialsituation,themoreyouneedaperiodontisttosuperviseyouroralhygienecare.Ifyoureceivedsurgicaltreatmentduringthetreatmentofyourperiodontaldisease,aperiodontalspecialistissuggestedtocontinuethefollowupappointments.4.Whatisexaminationsortreatmentsareperformedduringthemaintenancephase?1.Checkforchangesinyourgeneralhealth2.Checkforabnormalchangesyouroralcavity3.Checktheperiodontalconditionandremeasurementofclinicalattachedtissue;probingofgumsmayberequired4.Checktheplaquecontrollevel;furtheroralhygieneinstructionsmayberequired5.Checkforpresenceofdentalcavities;X-rayexaminationmayberequired6.Calculusdeposits,plaque,stains,androughsurfaceofteethorundergum7.Useorprescriptionofmedicine8.Checkandadjustocclusion9.Informyouandyourgeneraldentistaboutyourperiodontalanddentalhealth5.HowoftendoIneedtoseeadoctorduringthemaintenancephase?Thisdependsontheresultsofyourperiodontalcondition.Themaintenanceintervalcanbefromeveryfewweeksoreverysixmonthsorevenonceayear.Eachone’ssituationisdifferent,andthetimesofconsultationsduringthemaintenancephasewillbeaffectedbythefollowingfactors:DifferenttypesofperiodontaldiseasePatientresponsestoperiodontaldiseaseandtreatmentDifferenttypesofperiodontaltreatmentDifferentgrowthratesofdentalplaqueOralhygienecondition6.Willperiodontistinformmygeneraldentistafterroutinecheckwithinmaintenancephase?It’snecessaryforperiodontiststocommunicatewithgeneraldentistforprognosisduringthemaintenancephase.Additionaldentitioncaremaybediscussedforteethrehabilitation.7.Willtheperiodontistnoticemycaries?Iffound,whatwillhedo?Periodontalmaintenancewillnotreplacegeneraldentalcheck,andonlyfocusonclinicalattachmentandalveolarbonesituation.Therefore,ageneraldentalcheck,suchasnewcaries,replacementoffiller,prosthesisproblemandotherdentalproblemstillneedtobecheckedregularly.Oncenewcariesarefound,periodontistwillreferyoutoyourgeneraldentistforfurtherevaluation.8.Iamafraidofintakeofradiographicdose.AsIaminmaintenancephase,howoftenshouldItakeradiographicfilm?Radiographicfilmisonlytakenifnecessary.Ingeneral,thepatientshouldbetakenfullmouthradiographicfilmevery2-4years.Additionalradiographicfilmwillbetakenifnecessary. Afterperiodontaltreatment,it’sdangerousandharmfulforyoutoassumethatperiodontaldiseasewillnotrecur.About70-90%populationhaveahistoryofperiodontaldisease.Nowthatyouhavetheknowledgeofperiodontaldiseaseandtreatmentprocess,pleasereferyourfriendsorfamilytotheperiodontaldepartmentforfurtherevaluation.Thankyou. 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