Periodontal Therapy - Medical Experts

Periodontal therapy aims to slow the progression of periodontitis. Periodontitis causes gum recession.

If left untreated, tooth loss may result. Periodontal therapy (also known as UPT) focuses on treating inflammation of the periodontal tissues.

As such, it is not unlike a professional teeth cleaning, but goes far beyond the scope of that procedure. The treatment is based on the Bern Concept from the 1980s, which was developed by the University of Bern.

Comparison of a healthy tooth, a tooth with gum inflammation, and periodontitis @ bilderzwerg /AdobeStock

The main goal of periodontal therapy is to treat periodontitis. This chronic dental disease has demonstrably increased in recent years: nearly 90 percent of people over the age of 65 are affected by periodontitis.

Nevertheless, UPT is not yet widely used: According to estimates, just 10 percent of periodontitis patients undergo this treatment.

While periodontal therapy cannot completely prevent tooth loss, it has been shown to reduce the risk by about half.

Depending on how advanced the periodontitis is, UPT sessions take place every three to six months. But that’s not all: To preserve the tooth for as long as possible, the therapy should be continued for life.

Before the actual treatment begins, a comprehensive medical history is taken. This means that the dentist carefully analyzes the current condition of the teeth. Using a periodontal screening and an X-ray examination, the dentist evaluates each individual tooth.

The UPT procedure itself involves the following treatment steps:

1. PZR: professional teeth cleaning
2. Photodynamic antimicrobial therapy using a laser
3. Assessment of inflammation parameters and pocket depth measurements once a year
4. Cleaning of inflamed gum pockets
5. Treatment of exposed root surfaces
6. Removal of hard and soft plaque

If the patient wishes, a local anesthetic is administered to ensure the treatment is completely pain-free. Depending on the overall condition of the patient’s teeth, additional treatment options may be considered.

These include:

• Treatment of inflamed pockets using antibacterial rinses
• Treatment of sensitive tooth necks
• Cavity diagnosis
• Assessment of individual oral hygiene

An UPT goes beyond professional teeth cleaning @ Tommaso Lizzul /AdobeStock

About three months after the initial treatment, bacterial colonization typically occurs again. Depending on the patient’s risk of periodontitis, treatment should therefore be repeated every three months for the rest of their life.

A person’s risk of periodontitis depends on both genetic factors and their oral hygiene index. Factors such as stress or smoking can also significantly increase the risk of periodontitis.

The treatment known as Pact is particularly important. This photodynamic antimicrobial laser therapy kills all bacteria present in the gum pocket.

This procedure is completely free of side effects and painless. The goal is to prevent bacteria from recolonizing the area. These bacteria cause inflammation of the periodontal tissues, which can lead to periodontitis and tooth loss over time.

Equally important is the regular measurement of pocket depths. The dentist uses this measurement to assess the stability of the periodontal ligament. It also provides insight into whether periodontal therapy has achieved the desired results.

If the gum pockets are deeper than five millimeters, special treatment is necessary. In such cases, home oral hygiene and professional teeth cleaning are insufficient to clean the teeth adequately. UPT can be of great help in this situation and prevent the progression of periodontitis.

Another measure as part of periodontal therapy is the assessment of the bleeding on probing (BOP) index for each tooth. If bleeding occurs during a pocket probing, this is a sign of inflammation. In that case, further treatment is necessary.

Since periodontitis is a chronic dental disease, comprehensive follow-up care must be provided after periodontal therapy. The success of the treatment depends largely on the extent to which the patient attends all follow-up appointments.

In dentistry, this follow-up care is also known as maintenance therapy. Important: Periodontal therapy is not a preventive measure, but rather a complementary treatment.

In addition to regular follow-up care, thorough oral hygiene is essential. Your dentist can provide you with valuable tips on proper oral hygiene.

Periodontal therapy consists of three treatment phases:

1. Prevention
2. The actual therapy, and
3. Follow-up care

Statutory health insurance plans generally cover only the costs of the main treatment itself. This refers to the comprehensive cleaning of the gum pockets. Professional teeth cleaning, however, as well as oral hygiene instruction, must be paid for by the patient.

As mentioned earlier, periodontal therapy cannot completely prevent tooth loss. However, statistics show that the likelihood of tooth loss is reduced by half when patients undergo UPT regularly.

In this case, the prognosis is quite good, and the affected tooth can be preserved well into old age. The sooner a patient recognizes and treats periodontitis, the more likely it is that the tooth will be preserved well into old age.

Therefore, be on the lookout for possible warning signs such as bleeding gums, bad breath, or exposed tooth necks.