Periodontitis Treatment: Restore Your Gum Health

Periodontitis often develops slowly and may not cause significant pain at first. That’s why it’s important to pay attention to subtle changes and warning signs. The most common symptoms include:

• Bleeding gums: Spontaneous bleeding or bleeding when brushing your teeth or eating hard foods. Healthy gums do not bleed.
• Red, swollen and sensitive gums: Inflammation is manifested by a change in the color and volume of the gums.
• Bad breath (halitosis): A persistent unpleasant odor that does not disappear even after brushing the teeth.
• Gum recession: Gums recede and expose the tooth necks, the teeth may appear longer.
• Loose teeth: Progressive bone loss leads to loosening of the teeth.
• Change in the position of the teeth: Teeth may begin to „wander“, change their position, gaps may form.
• Purulent discharge from the gums: In more advanced cases In the later stages, pus may appear between the tooth and the gum.
• Pain when chewing: Tenderness or pain when biting may occur.

If you notice any of these symptoms, do not hesitate to make an appointment for an examination. The earlier periodontitis is diagnosed, the easier and more successful its treatment.

The main cause of periodontitis is dental plaque – a sticky, colorless film full of bacteria that constantly forms on the teeth. If plaque is not regularly and thoroughly removed by the correct technique of cleaning the teeth and interdental spaces, the bacteria contained in it produce toxins that irritate the gums and cause inflammation (gingivitis). At this stage, the process is still fully reversible.

However, if gingivitis persists and the plaque mineralizes, dental tartar is formed. This can no longer be removed by regular cleaning and provides an ideal surface for further accumulation of plaque below the gum level. The bacterial infection progresses deeper, attacking the tissues of the tooth’s supporting apparatus (fibrous fibers and bone) and creating so-called periodontal trunks – pockets between the tooth and the gum, where bacteria multiply undisturbed. This leads to gradual destruction of the bone and loss of tooth support.

In addition to poor oral hygiene, there are other risk factors that can contribute to the development or worsening of periodontitis:

• Smoking: Significantly increases the risk of developing and worsens the course of the disease and response to treatment.
• Genetic predisposition: Some people are inherently more susceptible to periodontal disease.
• Diabetes: In particular, poorly controlled diabetes increases the risk of infections, including periodontitis.
• Stress: Long-term stress can weaken the immune system.
• Some medications: For example, medications for high blood pressure, immunosuppressants, or antiepileptic drugs can affect the condition gums.
• Hormonal changes: Pregnancy, puberty, or menopause can increase gum sensitivity.
• Systemic diseases: Some diseases that affect the immune system.
• Poor nutrition: A lack of certain vitamins (such as vitamin C) can affect gum health.

The basis of successful treatment is accurate and timely diagnosis. At Dobrý Dent, we place great emphasis on the diagnostic phase and use modern procedures and technologies. Diagnosis of periodontitis usually includes:

1. Anamnésie: We find out your overall health history, risk factors (smoking, diabetes, etc.), family burden and subjective problems.
2. Clinical examination: We carefully examine your gums, noting redness, swelling, bleeding, receding gums and the presence of plaque and tartar.
3. Measurement of periodontal grooves: Using a special calibrated periodontal probe, we gently measure the depth of the gap (sulcus) between the tooth and the gum for each tooth. A depth of more than 3 mm may indicate the presence of a root canal and loss of attachment.
4. Evaluation of tooth mobility: We determine the degree of mobility of individual teeth.
5. X-ray examination: Standard intraoral X-rays or panoramic radiographs (OPG) help us evaluate the level of bone around the teeth and identify any bone loss.
6. Advanced imaging methods (CBCT): In cases of advanced periodontitis or when planning more complex treatment (e.g. surgical procedures, implantation), we use modern 3D CBCT X-ray at our clinic. This provides a detailed three-dimensional image of the jaws and teeth, which allows us to very accurately assess the extent and nature of bone destruction, plan a surgical solution and minimize risks. Thanks to CBCT, we have a perfect overview of anatomical structures.

Based on all these examinations, we will establish an accurate diagnosis, determine the stage and severity of periodontitis, and propose an individual treatment plan.

Treatment of periodontitis is a complex process that requires active cooperation from the patient and usually takes place in several stages. The goal is to stop the progression of the disease, eliminate inflammation, remove infection and restore the health of periodontal tissues to the maximum extent possible.

1. Initial phase of treatment (Hygiene phase)

This key phase is the basis for the success of any further treatment. It includes:

• Professional dental hygiene: Thorough removal of dental plaque and tartar above and below the gum line (so-called scaling). Our experienced dental hygienists use modern ultrasonic devices and hand tools to achieve a perfect result.
• Instruction of proper oral hygiene: We will teach you effective techniques for cleaning your teeth and interdental spaces (using the right toothbrush, interdental brushes, dental floss) adapted to your situation. Without your active and properly performed home care, long-term success cannot be achieved.
• Removal of retention sites: Possible adjustment or replacement of unsuitable fillings or prosthetic works that can retain plaque.

This phase is necessary to reduce inflammation and create optimal conditions for further treatment. The hygiene phase itself can lead to a significant improvement in the condition in less severe cases.

2. Conservative treatment (Deep Scaling and Root Planing)

If deeper periodontal pockets persist after the hygiene phase, we proceed to the so-called deep cleaning under the gums (deep scaling) and smoothing of the root surface (root planing). The goal is to remove all tartar, plaque, and infected tissue from the root surface in periodontal pockets.

• Precision through a microscope: At Dobrý Dent, we often perform this treatment using an operating microscope. The magnification and perfect illumination of the working field allow us to work with maximum precision, more thoroughly remove all impurities even from hard-to-reach areas, and minimize damage to surrounding tissues.
• Painless treatment: We understand that treatment below the gum line may sound unpleasant. Therefore, to ensure your maximum comfort, we use a modern computer-controlled anesthesia system, the STA (Single Tooth Anesthesia System). This system allows the anesthetic to be applied very slowly and in a controlled manner, which minimizes the discomfort associated with the injection and ensures effective and targeted anesthesia without unnecessary numbness of the lips or tongue. This makes the treatment much more comfortable for you.
• Topical antibiotics: In some cases, we can apply topical antibiotics to deep pockets to promote healing and eliminate bacteria.

This phase is followed by a check of healing and re-measurement of the pocket depth after a few weeks.

3. Surgical treatment (if necessary)

In advanced cases of periodontitis with very deep pockets or significant bone loss, where conservative treatment is not sufficient to completely resolve the problem, surgical treatment may be necessary. The goal of these procedures is to gain access to deeply embedded tartar and infected tissue, reduce the depth of the stumps, and possibly regenerate lost tissue.

The most common surgical procedures include:

• Flap surgery: After the gum is lifted, the surgeon gains a direct view of the root surfaces and bone, allowing for thorough cleaning and possible bone remodeling. The gum is then sewn back into place.
• Regenerative techniques: In some cases, it is possible to support the restoration of lost bone and tissue using bone grafts, growth factors or special membranes (guided tissue regeneration – GTR, guided bone regeneration – GBR).
• Gingivectomy/Gingivoplasty: Surgical adjustment of the shape of the gums.

Even during surgical procedures, we use modern procedures and technologies, including an operating microscope for maximum precision and gentleness. Of course, painlessness is ensured by effective anesthesia, such as the STA system.

4. Maintenance phase (Recall)

Periodontitis is a chronic disease, and even after successful treatment, there is a risk of its return. That is why long-term maintenance care is absolutely essential. This phase includes:

• Regular check-ups: Usually every 3 to 6 months, depending on the patient’s individual risk.
• Professional dental hygiene: Regular plaque and tartar removal is key to preventing relapse.
• Periodontal status control: Regular root canal measurements and monitoring of the condition of the gums and bone.
• Repeated motivation and oral hygiene instruction: Maintaining a high standard of home care is essential.

Only by consistently following the maintenance phase can the long-term stability of the treatment results be ensured and the health of your gums and teeth be preserved.

We believe that investing in modern technology is an investment in the quality of care and comfort of our patients. When treating periodontitis in our Prague practice, we use:

• Operating microscope: It allows us to see even the smallest details, which is crucial for thorough removal of tartar from the surface of the roots during deep scaling and root planing, as well as for precise surgical procedures. The result is more effective treatment and a gentler approach.
• Computer-controlled anesthesia STA: It ensures the most comfortable and painless application of anesthesia, which you will appreciate especially when treating sensitive areas under the gums. Get rid of the fear of pain.
• 3D CBCT X-ray: Provides a detailed three-dimensional image of bone structures, which is invaluable for accurately diagnosing the extent of bone loss, planning surgical procedures, and assessing bone regeneration options.
• Intraoral 3D Scanner: Although primarily used in prosthetics and orthodontics, it can help us digitally record the condition of gums and teeth to monitor the development of the disease or plan complex reconstructions after periodontitis treatment.

These technologies help us not only treat more effectively, but also make the entire process more understandable and comfortable for you.

Treatment of periodontitis requires expertise, experience and a comprehensive approach. At Dobrý Dent we offer you:

• Experienced team: Our doctors and hygienists have extensive experience in diagnosing and treating periodontal disease and are constantly educating themselves in the field. We have been operating in Prague 5 since 2010.
• Comprehensive care under one roof: We provide all care from dental hygiene, through conservative and surgical periodontal treatment, to subsequent prosthetic rehabilitation or implantology, if it is necessary to replace lost teeth.
• Modern equipment: We use cutting-edge technologies (microscope, STA, CBCT, 3D scanner) for accurate diagnostics, effective and gentle treatment.
• Individual approach: We devote enough time to each patient, explain their condition and propose a treatment plan tailored to their needs and possibilities.
• Emphasis on prevention and maintenance care: We know that the key to long-term success is prevention and regular care, which is why we place great emphasis on dental hygiene and recall system.
• Comfort and painlessness: We strive to make your visit with us as pleasant as possible. Modern anesthetic methods and an empathetic approach are a matter of course.
• Pleasant environment: Our clinic in Prague 5 – Anděl (Smíchov) is modernly furnished and designed so that you feel good and relaxed with us.
• Transparency: Before starting treatment, we will always discuss the proposed procedure and financial plan with you.

Periodontitis is not just an oral problem. Chronic inflammation in the body can also have a negative impact on overall health and is associated with a higher risk of cardiovascular disease, complications of diabetes, and respiratory diseases. Investing in the health of your gums is an investment in your overall health and quality of life.

Do not postpone a visit to the dentist if you suspect gum problems. At Dobrý Dent, we are ready to help you. We offer professional care at the highest level in the pleasant environment of a modern clinic in the center of Prague.