Periodontitis is a progressive disease that attacks the periodontium, the tissues investing and supporting the teeth, and it comes in acute and chronic form. More common is the chronic form that has long-term, but progressive flow which results in gradual loss of the tissues that consist the periodontium. Periodontitis has three stages: The first stage is the easiest, but as the disease progresses and takes up all the structures of the periodontium, it reaches it’s culmination when the teeth start to be loose, and finally fall out. The symptoms are numerous, but it usually starts with:

• Gingivitis (inflammation of the gums; the color of healthy gums is light pink, but when they became inflamed their color turns to intense red; they become soft and swollen, and it often covers the cervical part of the tooth; this kind of gingiva (gums) bleeds very easily. The gingiva in other situations It can be atrophic i.e. it withdraws towards the root of the tooth, and than the neck of the tooth is made naked);
• Periodontal pocket is a gingival sulcus deepened into the periodontal ligament apically to the original level of the resorbed alveolar crest. This is one of the most important clinical signs of periodontitis. As the disease advances the periodontal pocket deepens: I phase – it’s 1-3mm deep; II phase – 3-6mm; III phase – over 6mm. Periodontal pockets can be very painful especially when there’s purulent exudates, and as a result of that there’s an unpleasant breath.
• Subgingival calculus is hard deposit that piles up on the teeth, inside of the already formed periodontal pocket. The mineralization and the forming of the subgingival calculus is slow and long-lasting process. That’s why thay have hard consistency, and dark brown to black color.
• Supragingival calculus that covering the coronal surface of the tooth to the crest of the gingival margin.
• Dental tartar it’s a hard, yellowish deposit on the teeth, consisting of organic secretions and food particles deposited in various salts, such as calcium carbonate. Also called dental calculus.
• Tooth loosening it’s a result of destruction of the alveolar bone, and that’s why it’s an important symptom when giving the right diagnosis. This kind of teeth are often painful, they make mastication difficult, and they should be taken out.
• Tooth migration–if more teeth are missing than the rest are moving towards the empty space, and because they are also loose, they rotate and incline, and change their physiological place.

Among the different diseases of the mouth, we gave a special place to periodontitis because of its significant importance. Our services consist of educational courses and introducing the patients with these issues, with prevention and the treatment of this disease. Prevention consists of cleaning of the hard dental deposits on time (subgingival calculus and dental tartar), and also cleaning of soft deposits (that become because of improper teeth brushing and food residues).

Cleaning of dental tartar is done with ultrasound and that’s completely fast, effective and relatively painless treatment, after which the teeth gain their whiteness and shine.

Before                   After

Dental tartar cleaning prevents the periodontal pockets from advancing, because the contents of the subgingival calculus are their main substance that leads to the disease worsening. It’s recommend it to do this cleaning two times a year.Polishing is a complete removal of the soft deposits with abrasive fluoride pastes, after which the teeth became brilliant.

After each of these treatments, remineralization with calcium pastes such as Ricaldent-GC Tooth Moose and it’s mandatory. With cases with more advanced peridontitis we do cleaning of periodontal pockets-treatment during which the pathological substrate is completely removed from the periodontal pocket. And than we put medicament inside of it, so we can prevent further spreading of the inflammation. The treatment of the periodontal pockets because of the seriousness of the disease is done in seances and requires time and patience. At this occasion I would like to mention the huge significance the laser treatment has in treating periodntitis. The modern development of dental technology in the recent years has promoted the laser and it’s application in everyday work practice in the dental office. This is our future project which expands the possibilities of working in every area of dentistry, especially In the treatment of periodontitis.