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Gingivitis Treatment and After
In very early periods of gingivitis, increasing patient’s oral hygiene and informing with microbial dental plaque control may be sufficient for treatment of the disease.
Treatment of a progressed disease is made by cleaning of dental surface (tartar removal). In this treatment which takes at least two sessions, it is aimed to increase oral hygiene of the patient as in all other periodontal disease treatments
Post treatment advices for initial periodontal treatment:
As it is known, uncomplicated simple gingivitis is the widest gingival disease that affects interdental and marginal gingival. It is one of the leading causes of gingival bleeding. Failure in its treatment may cause progress of the disease to deeper tissues and early tooth losses. Elimination of factors which increase dental plaques and plaque accumulation or prevent their removal must be the main target of initial treatment. In treatment of simple gingivitis; a careful examination should be made and dental plaques, tartar, food impaction, improper restorations, irritator removable prostheses and pouch deepness must be evaluated.
Treatment of simple gingivitis should not be completed in one session and should include these processes:
- Importance of plaque control in uncomplicated gingivitis treatment should be told and taught to patients
- Teeth should be removed of all the additions such as plaque, tartar and paints, and a well polishing must be done. Polishing is an important factor in prevention of repeats. Bacterial plaque, which is the most important factor in the beginning of gingivitis and tartar formation, can accumulate faster in rough surfaces that are not applied with polishing.
- Gingiva is observed in control visits and efficiency of plaque elimination is evaluated. In areas şn which inflammation is still present, tartar and plaque elimination may not be entirely successful. Cleaning procedure is reapplied; patient is motivated again about elimination of the plaque. Patients must be called to control visits in order to evaluated causes of failure and success of treatment.
Causes of failure in treatment of gingivitis:
- Especially if tartar particles in the apical site of enamel-cement conjunction are not cleared fully
- If a proper polishing is not made after cleaning
- If the additions to the teeth are cleared but the primary cause of irritation is not eliminated
- If an efficient plaque control is not done
Information and suggestions that should be told to patients during this treatment:
- Periodontal diseases begin with gingival inflammation and the most important factor of gingival inflammation is dental plaque. Tartar is formed by calcification of dental plaques. Tartar has a rough surface and it is always covered with uncalcified plaque. Thus, tartar creates a proper home for plaques and causes the inflammation to last. Therefore, present tartars must be cleared by a dentist. Reformation of a cleared tartar can be prevented with an efficient tooth care.
- Patient must be warned about bleeding and this bleeding sites and bleeding type must be evaluated during examination. IF bleeding is coming from the marginal gingival, newly forming plaque is the cause of this bleeding and elimination of the plaque solves the problem. If the bleeding results from pouch basis, root surface is not cleared well and remaining additions could not be gained proper quality due to the plaque. These additions must be removed for total elimination of the bleeding.
- Tartar removal (detartarage) is not a dangerous procedure that may harm the teeth.
- After doing tartar clearance, teeth may have sensitivity for a while, which is normal. After tartar removal, the areas which was covered with tartar before is exposed and this surface is sensitive to hot and cold. This sensitivity is expected to fade in 3-4 days. What really matters is that patients should not ignore efficient brushing and oral care procedures due to sensitivity. Some doctors may suggest using anti-tartar tooth paste in order to prevent mineralization of new plaque Use of these pastes may increase the possibility and severity of sensitivity in this period.