Periodontics in Spain

Yes, periodontitis can be treated, as long as treatment is applied in its early or moderate stages. In cases where it is detected at a more advanced stage, we can also extend the life of the teeth. However, if the damage is excessive, it will be difficult to preserve the affected tooth, and its extraction may become inevitable.

By conducting a detailed study of the patient’s periodontal situation, gathering their clinical and radiological data, and in certain cases, also their microbiological data, the endodontist specialist can make an appropriate diagnosis based on the degree of gingival involvement present. Each patient will have an independent prognosis, which will allow the planning of the most suitable treatment.

The treatment itself:

Scaling and root planing: This involves removing the tartar that is adhered to the root beneath the gum. It is not painful and does not cause facial inflammation, and it is done under local anesthesia. A reevaluation of the treatment progress: Approximately one month after the scaling and root planing, the response to the treatment is evaluated, and it is determined whether any further treatment is needed. If, during the reevaluation, the persistence of calculus in certain deep areas of the root is detected, a small periodontal surgery may be necessary to completely remove the tartar and slightly reshape the alveolar bone. Periodontal surgery is performed under local anesthesia. Treatment monitoring: The patient must follow a periodontal maintenance visit schedule (whether they have undergone periodontal surgery or only scaling), every 3-6 months, depending on the degree of periodontal involvement. The patient must become aware of their hygiene practices, tobacco consumption, and certain foods, which will increase the likelihood of treatment success. The patient’s cooperation during periodontal maintenance is the most important part.

Gum bleeding: The first symptom of periodontitis that may alarm the patient is gum bleeding due to the inflammatory process caused by the accumulation of bacterial plaque in the gingival area.

Dental hypersensitivity: This is an effect of the overexposure of the root, which occurs when the bone and gum are lost.

Tooth mobility: The dental piece moves easily due to the reduced surface area for its attachment at the base.

Bad taste and bad breath (halitosis): The bacteria caused by gingivitis release certain substances that result in this effect in the patient’s mouth. A well-performed periodontal treatment completely eliminates these symptoms.

The main goal of the treatment is to stop the progression of bone loss, as it is generally not possible to recover the bone mass that has already been lost.

For this reason, we must act as quickly as possible, implementing an effective periodontal treatment to prevent the loss of any teeth. While it is true that in certain situations, we can regenerate the lost bone through the application of products that promote the formation of new bone, this is not the usual outcome.

We don’t say it ourselves. The Spanish Society of Periodontology and Osseointegration has presented several studies that confirm the close relationship between bad breath and periodontal disease: More than 85% of halitosis cases involve anaerobic bacteria that cause periodontal disease.

Tobacco is probably one of the most important factors in the formation and progression of periodontitis. A smoking patient promotes lower-quality defense cells, a fact that bacteria take advantage of to progress.
Patients with a genetic predisposition to periodontitis and gingival diseases in general who smoke exponentially increase the likelihood of developing and complicating the disease.
Smoking patients do not experience as much bleeding in the early stages of the disease due to the vasoconstriction caused by tobacco, which means they may notice this warning sign later. As a result, when they seek treatment from a specialist, it may already be too late.
For all these reasons, it is important for patients undergoing periodontal treatment to reduce their tobacco consumption and, if possible, quit smoking.

Periodontitis can be transmitted from parents to children. An individual’s susceptibility to periodontal problems has a hereditary component. Various studies have identified the genes associated with susceptibility to periodontitis.

The infection caused by periodontal disease can play a contributing role in the development of systemic diseases, such as diabetes and cardiovascular diseases.

Patients with diabetes are more predisposed to developing periodontal diseases and cavities. Therefore, we recommend they visit for periodontal check-ups at least every 3 months.

It is important to understand that both periodontitis and diabetes are chronic and complex diseases, with an established bidirectional relationship. In other words, poor control of diabetes is associated with an increase in the prevalence and severity of periodontitis, and severe periodontitis is associated with poor glucose control.