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Periodontology

The first research

During your first visit to the dental parodontologist, many things will be discussed and done. First of all, the reason for your referral, your own complaints, and your expectations regarding the teeth situation are discussed. In addition, your overall health condition will be checked using a health questionnaire. Then, the state of the periodontal (the tissue around a tooth or choke) is measured and recorded extensively. Here we look at the pocket depths and occurrence of bleeding, and to the motility of teeth and choose. The report is called parade status.
If necessary, the parodontologist makes a number of pictures of the specific jaw bone deviation around a tooth or choir. In some cases a bacterial test is required to determine the composition of the bacterial layer that causes the deviation. This gives a complete picture of the current situation. On the basis of this, a diagnosis is made and explained to you what it means.

Treatment plan

Based on the results of the first research, you will be thoroughly informed about the treatment plan. For each tooth and choice, the extent to which the probability of preservation is maintained and which treatments are necessary.

Budget

In case of a recommended treatment plan, you will always receive a specified budget.

Report

Your own dentist receives a comprehensive consultation report, and a copy of the x-rays and periodontal status.

Initial periodontal treatment

The treatment of paradontitis begins with the specialized cleansing of the root surface of your teeth and your choosing and your mouth. The ultimate goal is to eliminate the inflammation process.
This treatment usually occurs in 2 to 4 sessions, depending on the condition of the teeth. To ensure the treatments are effective, it is important that there is no more than 4 weeks between the first and the last session. Because this is labor-intensive treatment, more agreements will have to be made with our dental hygiënist.

Every week, part of the denture underneath local anesthesia (both above and below your gums) will be thoroughly cleansed, and the root surfaces of teeth and teeth will be smoothed. In addition, much attention and time is spent on cleaning your teeth at home: oral hygiëne. Without proper personal oral hygiene, achieving the ultimate goal of establishing and maintaining healthy gums is not possible.
An antibiotic can also be prescribed for treatment support. Your therapist will discuss this with you.

Interim check

Six weeks after the last treatment at the dental hygienist, an interim check takes place. In this case, it is checked whether the cure has been established, additional instructions may be given, and residues of tartar and plaque will be removed.

Reassessment

Three months after the last initial treatment, an evaluation will take place at our periodontologist, reviewing and measuring the teeth situation, and evaluating the outcome of the series of treatments based on a new period of parodontium compared with the period of periodontal disease during The first visit was made.

The success and direction of follow-up therapy depends on the outcome of our work and the level of your own daily oral hygiene. In most cases, there will be sufficient improvement and you will be included in the so-called aftercare phase. If the situation is not sufficiently improved, a surgical treatment may be advised.
From all evaluation visits to our periodontologist, your own dentist will receive a call report.

Periodontal surgery

When during the initial treatment evaluation, the new periodontal status shows that previous treatment did not lead to sufficient improvement and there are still deeper pockets present with residual inflammation, then flap surgery is necessary.

Local anesthesia removes the teeth of the teeth and jawbone. This gives a good view of the affected area of ​​the bone and the rest of the tartar that may have been left behind. The periodontologist then cleans the root surfaces, removes the inflamed tissue and corrects, if necessary, the jawbone, after which the gums are reattached and attached. Because the inflamed gums are removed, the level of the gums after surgery is often slightly lower. This has the advantage that proper cleaning with ragers is possible. During this procedure, your anesthesia will make your surgery painless.

7 days after the flap operation, the dental parodontologist checks the cure, removes the sutures and gives oral hygiene advice.

Three weeks after the surgery, when the situation has stabilized and healing is complete, the dental hygienist cleans your teeth and gives you additional instructions as needed, and checks if you are able to take care of your gums and teeth properly.

Three months after the last surgical procedure, an evaluation will take place at the periodontologist. In this appointment, the treatment result after periodontal surgery is assessed using a new periodontal status and based on the new outcomes, the duration and frequency of aftercare is determined.
(!) Important to know is that self-care in this is very important. Such surgery only makes sense when the level of oral hygiene and self-care for the teeth is high.

Every 3-4 months you will be returned for periodontal after-care with the dental hygienist. After a year postoperative evaluation takes place. The dental parodontologist assesses the outcome of the procedure and discusses the follow-up process with you.

Aesthetic surgery

Aesthetic surgery includes all surgical procedures aimed at correcting anatomical abnormalities, developmental disorders and traumatic or pathological abnormalities of the gums. Examples of periodontal plastic surgery include: gingivirvation, recession coverage, treatment of peri-implantal soft tissues, crown extension, frenectomy and gingivectomy.

Crown extension

The crown extension is indicated if there is insufficient tooth tissue left over from the crown section of a tooth or choir and there is too little grip on crowns, if there is an inflammation due to deep restoration, a hole is created under the gum and the dentist can No good luck with restoring this, or teeth remain partially covered with gum and jawbone and it may seem like someone has very short teeth.
At the crown extension the gums are loosened from the tooth. Then an edge of the jawbone is removed. Then the gums are corrected and reattached.

Recession cover

Recesses (withdrawal gums) originate mainly from periodontitis but may also have a different cause as a divergent state of a tooth, divergent brush behavior: excessive brushing, which causes gum damage or an orthodontic treatment.
Treatment of a treatable recession will initially focus on addressing the cause of withdrawal (adjusting dental behavior). After that, the surgical treatment can possibly be covered with gum by means of a gum transplant. The gums are loosened from the tooth. A piece of gum is removed from the palate via a hatch. The hatch will be attached again. This piece of gums is placed under the loosened gums at the exposed root surface and attached.

Aftercare

Three months after a surgical procedure, an evaluation will take place at the periodontologist. The result of the surgery is investigated using a new pocket measurement. Based on this research, the frequency of the necessary aftercare is determined.

After completion of initial treatment and / or surgical treatment, it is necessary to visit the oral hygienist regularly. Usually it's 3 to 4 times a year. The treatment consists of additional oral hygiene instructions as well as extensive denture cleansing.

In addition, as the situation stabilizes, the patiënt returns to the parodontologist. This performs an evaluation study that controls the stability and adjusts the treatment.

At the discretion of the periodontologist, dental hygiene can be performed in the practice of Dentist at the IJ, or can be done at a later stage by the dental hygiënist.