How to achieve good periodontal maintenance

What does a periodontal treatment consist of?

A periodontal treatment basically consists of healing the gums. In patients with gum problems we try to heal and, once healed, we try to keep the gums healthy. The gums are the base where the tooth is attached, it is a complex of bone and gums.

There are several phases of treatment:

The initial phase includes the superficial cleaning treatment. This is followed by a deeper cleaning, which can be done in parts of the mouth; in general, it is done in four parts, which are called quadrants.

Prior to treatment, a home dental hygiene assessment and instruction is done, so that the treatment is performed both in the clinic and at home by the patient.

Then, after this phase, a new assessment is made of how the gums are compared to the first visit and it is seen if it is necessary to reinforce the hygiene at home or if new or extra guidelines are needed.

If any area does not improve sufficiently, surgical or laser treatments may be indicated. These treatments can be surgeries in which the gum is opened and the tartar that could not be cleaned in pockets that form between the gum and the tooth and that, in some cases, are very deep, is cleaned with a direct view. The gums can also be reshaped to make them easier to keep clean. On other occasions, a laser treatment can be done, which is a minimally invasive technique, to work on the surface of the tooth with a laser. Tartar and inflammation are removed by this technique, also improving the postoperative period.

Can periodontal treatment be complementary to cosmetic dentistry treatment?

Yes, it can. A cosmetic dental treatment where the gums are inflamed is destined to fail, because the base has to be healthy for the tooth to continue to look good in the long term. In some cases, we do cosmetic gum treatments, such as gum reshaping, so that the integration between tooth and gum is more beautiful and natural.

For example, a person with a smile that shows a lot of gum can have their gums trimmed or reshaped so that there is not so much gum visible when they smile. And with veneers we can then finish beautifying that smile.

In relation to oral checkups, how often is it convenient to do this type of checkups?

It depends a lot on each patient and the habits they have at home. So, there are patients who can have these checkups on an annual basis and do a maintenance and checkup every year, because they are patients who take very good care of themselves and have very little risk of periodontal disease. And on the other hand, there are other patients who need check-ups every 3 months, because they have a higher risk factor. In the latter case, it may be due to a genetic factor or to the need to remind them every three months how to take care of their teeth.

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What diseases can be detected during these check-ups?

During these check-ups, the following can be detected

  • Gum problems
  • Joint problems (the hinge of the mouth).
  • Cavities
  • Cracked teeth and molars in patients who clench their molars too tightly.
  • Oral cancer

Oral hygiene habits to be followed by patients at home

On the one hand, the use of a rotating electric toothbrush is recommended. Brushing should be done twice a day for two minutes; in the clinic, we teach the proper technique for using the electric toothbrush.

And, on the other hand, interdental hygiene guidelines should be followed with interproximal brushes or silicone sticks once a day.

  • Why is an electric toothbrush more advisable than a manual toothbrush?

The electric toothbrush does the job much faster and deeper than the manual one. A person can brush well with a manual toothbrush if they know the correct technique to do it, but they would have to brush for almost 4 minutes to get a good result.

On the other hand, the electric toothbrush has the same effect in two minutes. Even if the patient has little time for brushing, it is much more advisable to use the electric toothbrush, because if the manual toothbrush is used, practically nothing can be cleaned if it is done quickly.

  • Should we avoid flossing and use interproximal or silicone brushes?

From fang to fang, it is advisable to use dental floss, because interproximal brushes have a small problem: they crush the interdental papilla in the long term if used daily in that area.

For molars, whose root shape under the gum is not convex, but rather concave, a dental floss will not clean well under the gums. Thus, in this area an interproximal brush cleans much better and keeps the gums healthier.

  • Toothpastes

It is very fashionable right now to use herbal toothpastes, but they are not recommended. There are some patients who have used this type of aloe vera toothpaste and, although they have good results, in general I do not recommend them. It is better to use a proven toothpaste, because there is more scientific basis on this type of toothpaste.