Periodontitis treatment

The mouth is an important part of the face and therefore stands out immediately. A fresh and clean mouth is attractive. It is nice to be able to laugh and talk without worrying about bad breath, a foul taste in the mouth or tarnish on the teeth. Moreover, a healthy mouth is very important for preserving your teeth. Inflamed gums can unknowingly lead to irreparable damage to your teeth and even to the loss of teeth.

Isn’t going to the dentist enough?
Healthy teeth are more than “no cavities.” The dental hygienist(s) has their own specific expertise in oral care and the treatment of inflamed gums. Oral hygienist is a protected title. It is a protected profession with its own training. The dental hygienist(s) treats oral and gum problems as well as helps prevent new problems. And prevention is always better than cure! In any case, it is important to see the dental hygienist(s) when you suffer from:

– bleeding or painful gums
– foul taste in the mouth and/or bad breath
– Loose or moving teeth
– Red and swollen gums
– Gum recession
– Shame regarding the appearance of teeth
– Oral problems: loss of teeth (often resulting in expensive crown and bridge work).

Tartar and inflamed gums.
Inflamed gums are caused by plaque, a sticky white layer containing food particles and chalk. Between teeth and along the edge of the gums, this is difficult to remove. Plaque can become hard; this is called tartar. This can cause the gums to become inflamed. Your gums become red, bleed quickly and you may develop bad breath. Over time, the space between teeth and gums (called the “pocket”) widens and teeth loosen. Eventually, teeth may fall out because the jawbone is affected and retracts. Jaw bone that has disappeared once does not return. Good oral hygiene can prevent these problems.

What does the dental hygienist(s) do?
Exactly what the dental hygienist(s) does and how much time it takes depends, of course, on the nature and severity of the problem. You will first meet the dental hygienist(s) and receive education. We will ask you some brief questions about your teeth, gums, your health in general and other issues important to oral health. For example, your daily activities and your diet. Any pregnancy is also important, as you may be especially susceptible to gum disease. Then the dental hygienist(s) will do an oral examination. Depending on the nature and severity of the problem, we can make a parostat if necessary. This will accurately describe the condition of your gums. Treatment is always based on that parostat: in fact, it shows exactly how much your gums are improving or deteriorating. Then we will make a treatment plan with you. In that treatment plan, the dental hygienist will agree with you what treatments are needed, how and when they will be performed. We will also tell you in advance approximately how much your treatment will cost. Finally, possible follow-up appointments can be made. Should the pockets be less than 4 mm, the element will not be treated and will provide a financial windfall.

What does the dental hygienist(s) expect from you?
Treatment alone is not enough. Regular maintenance is necessary, just as you need to brush your teeth to prevent cavities. You must keep up with care at home. This means brushing twice a day and cleaning the spaces between your teeth once a day. This requires a lot from you, which is why motivation is important. The dental hygienist(s) will give you instructions for brushing and interdental cleaning.
There are many different oral care products for sale; the dental hygienist(s) will tell you which ones are right for you and how to use them. You are expected to keep up with your care at home as well as return for follow-up care after treatment. Only then will you achieve optimal results. In addition, your dietary habits affect the condition of your teeth and gums. The dental hygienist(s) will tell you how to keep your mouth healthy through healthy eating.

Paro – protocol

The description of this pathway is a guideline for treatment of gum disease. Not every practice follows the same steps. The paro- protocol is a treatment protocol for the treatment of periodontitis. The protocol is an elaboration of internationally accepted treatment methods of periodontitis. The Dutch paro-protocol was established in 1998 through consultation between the Dutch Society for the Advancement of Dentistry and the Dutch Association for Periodontology. The protocol consists of a number of stages. These phases are detailed below;

1) Intake/ Pocket status/parodontic status
2) Initial treatment (professional dental cleaning)
3) Medication
4) Reassessment after three months
5) Recall 1 after three months
6) Recall 2 after 12 months

Our treatment method

1) Intake / Pocket Status
At the first appointment, general health is first reviewed through a questionnaire. Next, a pocket periodontium status is made. A treatment plan is also prepared and discussed with you. We will give you an estimate of the total cost. A pocket or periodontium status shows the condition of the gums around all teeth. This status provides information to what degree your gums are inflamed. Each element of your teeth is mapped out, the number of teeth affected, the severity of the inflammation, and the number of treatments needed for you. After the intake, 5 more follow-up treatments follow, spread over a period of one year. The measurement of pockets is done with a pocket probe. Pockets are the unhealthy, sunken spaces between tooth and gums. In general, pockets give rise to inflammation.

2) Initial treatment
Initial treatment involves comprehensive treatment of the pockets. Tartar, plaque and bacteria are removed from the pocket using an ultrasonic tartar remover and hand instruments. Depending on your dental situation, you will be advised to use something in addition to brushing to clean between your teeth. Various aids can be used for this purpose, such as dental floss, toothpicks or brushes. The patient’s commitment and motivation are very important throughout this process for obtaining and maintaining optimal results. To obtain and maintain the best possible results, regularity of maintenance treatments is very important. Thus, it is very important that the patient follow the instructions of the dental hygienist(s)/ dentist to the best of their ability. Please take into account the anesthesia. It is strongly advised against driving vehicles or other machinery after treatment.

3) Medication
This treatment usually follows within a week of the second treatment. In this treatment, an ointment is applied that speeds up the recovery of the gums.

4) Reassessment
When the initial therapy is complete, an appointment is made with the patient for the reassessment, usually 3 months later.During this treatment, the patient and I review the results, whether there has been improvement and whether it meets the expected results. Also, the areas that are still unsettled and out of order are reviewed and noted. These spots will be well maintained in future maintenance treatment. If there is improvement, the patient himself will notice it earlier, the gums will bleed less, the bad breath or foul taste will disappear. During this treatment, some tartar and/or tarnish is also removed.

5 and 6) Recall
To maintain or improve the resulting healthy oral situation, it is necessary to visit the dental hygienist regularly. Depending on the situation, an appointment is made every 5 or 6 months Maintenance treatments depend on each patient and situation. Factors involved include patient age, general health, motivation and input, amount of tartar, severity of inflammation and regularity of follow-up treatment. With maintenance treatment, we ensure that the gums are kept up, and that your mouth remains “inflammation-free” or stability is maintained. All weaknesses, which were discussed in the reassessment, are given additional treatment. Indicative time duration is up to 20 minutes.
Recall 2 is the same treatment as recall 1 except that it is exactly 1 year after the first treatment, the pocket status measurement. The dentist will again measure pockets at recall 2 to record recovery or probability of recurrence and compare with parostatus 1.

Attention!!!

The cost of a paro-status track is not small. For example, measuring pocket status is €179.00. This includes taking pictures of all the elements. The cost of these photos will be added to this amount. Therefore, please check carefully whether your insurance covers these costs. Furthermore, costs are relative, thus indicating that costs are incurred per element. The more elements are treated, the higher the final cost will be.

Please further note that some treatments are performed under anesthesia. This anesthesia can often last as long as three hours. Please keep follow-up appointments and your work in mind.