Periodontology

What is Periodontology?

Periodontology is a branch of dentistry that deals with the diagnosis, prevention and treatment of gingival diseases. Teeth are surrounded by a complex tissue called Periodontium. This tissue includes the gingiva, the membrane surrounding the root canals, and the alveolar bone, which is responsible for protecting and supporting the tooth. Healthy gingiva has a rose-pink appearance, orange peel texture, does not bleed when teeth are brushed, and covers the neck area of the tooth.

What is a Periodontal Disease?
Periodontal diseases are inflammatory diseases that affect the bone tissues that support the gums and teeth. According to statistics, the problem that causes the most teeth loss after dental caries is gingival diseases. Moreover, a gingival disease is 2-3 times more likely to cause tooth loss than a regular caries. Diseases involving the gums and jawbone are responsible for 70% of tooth loss in adults.

Periodontal diseases respond easily and successfully to treatment when diagnosed early. For this reason, it is important that you visit your dentist at certain intervals. Bleeding that occurs when you bite a hard food or brush your teeth is an indication that you should go for a check-up immediately.

Symptoms of Gingival Disease:
The first and most important symptom of gingival diseases is gingival bleeding. “Healthy gums do not bleed.”

• If there is swelling and redness on gums,
• If there are recessions in the gums and sensitivity on the exposed root surfaces,
• If there are black areas on the edges of the gums or between the teeth due to tartar,
• If there is inflammation between the tooth and the gum,
• If there are swaying, lengthening and gaps between the teeth,
• If there is a constant bad smell and bad taste in the mouth.

In the Formation of Gingival Diseases;

• Insufficient and incorrect brushing,
• Not using auxiliary hygiene materials such as dental floss or mouthwash,
• Plaques: Soft form or hard form called tartar,
• Structural disorders: Abnormalities in the face and jawbone, crooked teeth, localization disorders,
• One-sided chewing habit,
• Wrong filling or other treatments,
• Smoking: The rate is 4 times higher in smokers,
• Failure to regularly have tartar examination plays a major role.

Why Should Tartars Be Cleaned?
When teeth are not cleaned properly, food residues accumulated on and between them produce bacteria. These structures, called bacterial plaque, are responsible for dental caries and gingivitis, and they form tartar with the effect of saliva over time. If the plaque is not effectively removed from the teeth, it becomes a hard structure called tartar. As long as it remains on the tooth, it damages the surrounding support tissues of the tooth, causes damage to the gums and causes gum discomfort. If the disease is left untreated, the teeth will eventually sway and may even require extraction.

Main Gingival Diseases are:
Gingivitis: The first stage of gingival disorders is inflammation called Gingivitis. There are symptoms such as bleeding and odor with some redness in the gums. It may have negative consequences such as tartar, plaque, crooked teeth and caries. It is seen by weakening the connection between the teeth and gums of the bacterial plaque consisting of microbes. Healthy gums are pink and should be firmly attached to the tooth.

Disease and inflammation of the gums are called gingivitis. In gingivitis, the gums easily bleed, red, painful and swelled. If gingivitis is not treated, the disease progresses further, spreads to the jawbone and causes the teeth to fall out in the future.

Periodontitis: The most common cause of tooth loss in adults is not caries, but gingival diseases. It is the next stage of the gingival disease which was not treated during gingivitis stage. It includes the onset and progression of losses in periodontal tissue and alveolar bone. The circular fibers connecting the tooth to the jaw bone melt, and pathological spaces called pockets form between the gum and the tooth. The microbes accumulating in these cavities cause the infection to progress, damage and melting in the tooth root and alveoli bone.

During periodontitis, a blueish redness may be observed on the gums. As the gums are recessed, the root parts of the teeth begin to appear and are seen to grow longer. This is a very important warning to consult the dentist urgently. If periodontitis is not treated, the bone holding the tooth melts, the teeth start to sway and tooth loss becomes inevitable.

Gingival Recessions are Divided into Two:
General Gingival Recessions: If the person has gingival diseases, it is generally the case that the gum follows the bone and recesses with the melting of the bone due to the bacteria that cause bone melting in the whole mouth. In such a case, the person should definitely undergo gingival treatment. At the beginning stage, you can understand whether you have gingival problems or not, as it will manifest itself in the form of bleeding odor.

Local Gingival Extractions: These are the extractions seen in individual teeth, sometimes in corner teeth, sometimes in dog teeth. What is the Treatment for Gingival Diseases?


Even if you take the ideal care of your teeth, sometimes you may have gingival diseases due to genetic reasons. The first step in the treatment can provide complete recovery by a good dental cleaning by the dentist and taking care of the patient’s oral hygiene. In slightly more advanced cases, it involves removing the attachments (plaque and tartar) on the teeth called curettage and ensuring a smooth root surface. Curettage removes bacteria and irritants that cause inflammation in the gums. Generally, this treatment is sufficient for the gingiva to be adapted back to the tooth or for the gingiva to shrink and destroy the bacteria-containing pocket. In the majority of cases in the early period of gingival disease, daily effective oral care following tartar cleaning, plate removal and a smooth root surface is sufficient for a successful treatment.

Surgical treatment includes flap operations for more advanced cases. Bone grafts can also be placed if the molten bone needs to be supported in the flap operation or if bone will be formed in that area. Thus, new bone formation can be achieved. However, bone formation never reaches its previous level. Flap operations are sutured operations.

After the operation, you will need to visit for checks at the intervals instructed by your dentist. Your physician will follow up the condition of your gums, convey the issues you should pay attention to after treatment, and give you the necessary care instructions.

What is Gingivoplasty?
Gingivoplasty is one of the minor surgeries performed when the shape of the gum is not uniform. In this procedure performed under anesthesia, the physician shapes the gingival contour by using a scalpel, laser, gingival shaping porcelain mill or cautery device. This procedure is generally used to correct fibrous structures that develop after inflammatory conditions in the gums, tissues around the coating or implant, or gingival folds that occur during orthodontic treatment. This procedure is a very easy and we can use our teeth on the same day. We can continue our activities such as eating, talking and brushing after the procedure.

How to Prevent Gingival Diseases?


The primary task in the prevention of gingival diseases should be performed by the person. The person should perform daily oral care correctly and regularly to preserve their teeth in a healthy condition. In other words, teeth should be brushed and flossed regularly. The bacterial plaque on the teeth should be removed. The dentist should be visited at regular intervals, and check and treatment warnings should be taken into consideration.

It should not be forgotten that the mouth is a whole while brushing teeth. Therefore, the gums should be brushed along with the teeth. It is necessary to place our toothbrush in the area where the tooth and gum meet, and brush with circular movements. Movements from right to left/up to down are incorrect and cause wear on the tooth as well as damage to the gum. This circular movement continues by changing locations as the number of teeth that the brush can clean. Both the anterior and the posterior surfaces of the teeth should be brushed this way.

The point to remember is that the tooth has 5 surfaces and only three of these surfaces can be cleaned with a brush, that is, the interfaces of the teeth facing each other should be cleaned with dental floss. When using dental floss, it is important to always insert clean floss between the teeth and apply it to the tooth to be cleaned by pulling it from the gum to the tooth (red to white). The floss should not be placed on the interface with lateral movements.