Periodontology

Gum disease affects the tooth-supporting structures (the periodontium) and is collectively known as periodontitis (formerly "periodontosis"). This inflammation is caused by bacterial deposits (plaque) colonizing the root surface. Over the long term, this leads to ever-deeper gum pockets and a breakdown of the structures supporting the tooth around the root. Teeth first become loose, and tooth loss follows later. Early signs can include swollen gums, bleeding gums (e.g. while brushing), deep red discoloration of the gums, and bad breath. Occasional pain and teeth that appear to be "getting longer" are also possible symptoms. The insidious part is that periodontitis can develop without you noticing clear signs. This is why this gum disease is often only discovered at an advanced stage at age 40 or 50, even though early warning signs were already present. How can periodontitis be prevented? The cause of periodontitis is the accumulation of bacterial deposits in hard-to-reach niches. The most important prevention, therefore, is effective oral hygiene: this includes daily brushing with toothpaste, cleaning between the teeth (floss or interdental brushes) and the tongue, and using mouth rinses — combined with regular professional care (prevention/hygiene appointments). These are the pillars of modern oral hygiene and the most important prerequisite for oral health. Regular dental check-ups should take place, for example, every six months. What are the risk factors? The best prevention is adequate oral hygiene. However, there are factors that increase the likelihood of periodontitis developing and progressing: stress, certain systemic conditions (e.g. diabetes), and smoking in particular all damage the tooth-supporting structures. How is periodontitis treated? Step 1: Hygiene phase First, we address the cause: the deposits in the niches above the gumline usually need to be professionally removed. This is done by our prevention team, who will also give you tips for improving your oral hygiene — because your own cooperation is essential for lasting treatment success. Step 2: Systematic gum treatment In the second treatment step, under local anesthesia, the bacterial deposits (calculus) adhering to the root surfaces are removed from the gum pockets. This is usually done over several appointments using special hand instruments, ultrasonic devices, or the laser, with constant rinsing using a disinfecting solution. The laser is a modern method that removes bacteria from the gum pockets very gently: it has a kind of "scan function" that detects the calculus (a fluorescence-guided feedback system) and then vaporizes it with targeted laser pulses (thermomechanical ablation) until the gum pocket is sterile. It therefore only becomes active in areas where calculus is present. This prevents unnecessary damage to healthy gum and root areas and reflects our commitment to minimally invasive, modern dentistry. Because of its strong antimicrobial effect, it is also used for inflamed implants (peri-implantitis). In some cases we supplement periodontal therapy with photodynamic therapy — another highly effective method of light-activated disinfection, in which oxygen destroys the bacteria's cell walls, entirely without pain. We also successfully use this method in other areas (e.g. peri-implantitis or root canal treatments). Step 3: Regeneration In some cases it's possible to rebuild lost portions of the tooth-supporting structures through microsurgical procedures. This depends on individual factors, not least the extent of the prior periodontitis. Special bone substitute materials are used, placed into the gum or bone pockets, which are then remodeled into the body's own bone during the healing process. Step 4: Aftercare Alongside steps 1–3, the most important part of periodontal treatment is your own commitment: only the patient's cooperation guarantees long-term success! Efficient at-home oral hygiene combined with a regular "recall" (regular professional teeth cleanings) is the key to success and can maintain healthy gums long-term. Our experienced team is happy to support you every step of the way.