iStomatolog > Dental Treatment > Prophylaxis and treatment of gum diseases

Prevention and treatment of gum diseases

What is Periodontium?

The concept of "periodontium" combines a complex of structures (gums, periodontal ligament, alveolar bone, and cementum of the tooth root) that have common sources of innervation and blood supply. They represent a single whole and are connected by common functions and origin.

Most common periodontal diseases


inflammation of the gums, which is caused by the unfavorable influence of local and general factors and proceeds without violating the integrity of the periodontal ligament (ligament of the tooth to the periodontium).


inflammation of the periodontal tissues, which is characterized by progressive destruction (disintegration) of the periodontium and bone.


dystrophic disease of the periodontium, which is accompanied by a uniform decrease in the level of bone tissue without signs of inflammation.

Catarrhal gingivitis

Patients complain of unpleasant sensations in the gums, itching. Bad breath, distortion of taste, bleeding gums during meals or tooth brushing. The general condition worsens little, but periods of exacerbation can be accompanied by malaise and subfebrile temperature up to 37.5 degrees. On examination, swelling, hyperemia (redness), bright cyanosis, their thickening, limited desquamation cells, single erosions, mainly in the area of the peaks of interdental papillae, mechanical irritation of the gums is accompanied by bleeding; there is an increased amount of dental plaque and calculus on the teeth.

Hypertrophic gingivitis

It is a chronic inflammatory process of the gums that is accompanied by proliferative phenomena (tissue overgrowth). It is observed in case of improper positioning of teeth, their crowding, gum trauma caused by overhanging edges of fillings or crowns, endocrine disorders, pregnancy, puberty, the use of diphenyl preparations, vitamin C deficiency, blood diseases, and the like. The nature of complaints is determined by the severity of the disease. Granulating (edematous) form (complaints of gum overgrowth, itching, bleeding, pain during eating, bad breath) and fibrous form (no complaints or the patient notes an unusual appearance and shape of the gums) are distinguished.

Ulcerative gingivitis

This form is characterized by necrosis and ulceration, which develop with a decrease in the reactivity of the body as a hyperergic reaction to sensitization of tissues by the fusospirillary symbiosis. The presence of ulcerative gingivitis indicates serious disturbances in the reactivity of the body as a result of general diseases or a decrease in the resistance of gum tissues. Patients complain of malaise, headache, loss of appetite, fever, decreased performance, bad breath, gum pain, bleeding gums, complications with eating, sometimes pain when swallowing, and trismus.


It is characterized by damage to all periodontal tissues - gums, periodontal ligament, alveolar bone, and tooth. Chronic periodontitis is the most common form in clinical practice. It lasts for years, sometimes decades. With a decrease in the reactivity of the body, accompanying general diseases and the addition of a secondary infection, the inflammatory process in the periodontal tissues exacerbates (periodontitis exacerbation). Among the causes of localized periodontitis, a significant place is occupied by incorrectly and poorly made elements of dental prostheses or dental prostheses in general (bridging prostheses, crowns, clasp prostheses, removable prostheses), partial absence of teeth, which leads to a disturbance in the metabolism of calcium, phosphorus, protein-amino acid composition of bone tissue and the development of inflammatory-dystrophic processes in the periodontium. Also, hormonal disorders, metabolic disorders, and the like should be noted.

A complex of methods for the prevention and treatment of gum diseases includes:

  • Diagnosis
  • Professional cleaning of dental plaque and tartar - ultrasonic cleaning, the use of the PROPHYflex device (or its analog Air flow), pastes of various abrasiveness
  • Open and closed curettage (Grace's curettes)
  • Sanitation of the focus of chronic infection (caries, poor restorations and crowns)
  • Restoration of the integrity of the dentition (bridge prostheses, removable dentures, tooth implantation)
  • Splinting of mobile teeth (with fiberglass or bridge prostheses)
  • Bacteriological examination of the contents of periodontal pockets (to determine the microflora and its sensitivity to drugs)
  • Apparatus treatment - Vector, Heal Ozon (ozone treatment), Lazram (laser treatment)
  • Prescription of drugs to support and correct the immune system
  • Selection of adequate means for individual hygiene (toothpastes, gels, rinses)

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    Main signs of periodontitis

    • Symptomatic gingivitis (inflammation of the gums);
    • Periodontal pockets;
    • Progressive resorption of the alveolar bone (destruction of bone tissue with exposure of tooth roots);
    • Appearance of traumatic occlusion (tooth displacement);
    • Tooth mobility.

    Symptoms of periodontitis

    Patient complaints depend on the severity of the condition - general malaise, unpleasant breath odor, bleeding gums when mechanically irritated, tooth mobility and changes in their position (tilt, protrusion), increased tooth sensitivity, and so on. It is necessary to understand that the development of periodontitis occurs in a geometric progression, it will not pass by itself, tooth mobility will increase (up to tooth loss), inflammation will intensify.

    The earlier the diagnosis is established, the earlier adequate treatment will be carried out, and the more favorable the prognosis will be.

    Stages of periodontitis treatment

    1 Stage

    Removal of dental deposits

    Professional hygiene, which includes ultrasonic removal of dental calculus, air flow cleaning of dense dental plaque from the surfaces of teeth and roots, and final polishing with pastes of varying abrasiveness.
    2 Stage

    Actual periodontitis treatment

    Specific treatment of periodontitis: curettage of gum pockets, laser therapy, ozone therapy, vector therapy, plasma therapy, and medication therapy (if indicated).
    3 Stage

    Tooth treatment

    Sanitation of foci of chronic infection: replacement of poor-quality fillings, crowns, and stabilization of mobile teeth.
    4 Stage

    Restoration of chewing efficiency

    Restoration of the integrity of the dental arch with the help of removable and non-removable prostheses, installation of implants.

    After comprehensive treatment, an oral cavity review and diagnosis is conducted after three months. The necessity and frequency of subsequent supportive procedures are determined only individually.

    Radiological methods of investigation play an important role in the diagnosis and differential diagnosis of periodontitis, periodontosis, and gingivitis.

    What causes periodontitis, periodontosis, and gingivitis?

    Dental plaque and calculus play an important role in the onset of periodontal diseases (gingivitis, periodontitis). The role of microorganisms in dental plaque, such as Str. sanguis, Bac. melonogenicus, and Actinomyces viscosus, is considered to be the greatest.

    In normal conditions, a huge number of microorganisms are present in the oral cavity, and they do not have a pathogenic effect. In addition, there are a number of natural protection mechanisms against this. Saliva plays a key role, effectively preventing excessive accumulation of microorganisms in the interdental spaces and in the area of tooth-gum connections.

    Antimicrobial components of saliva (lysozyme, b-lysin, etc.) suppress the development of microorganisms, thereby preventing their harmful effects on the periodontium. A powerful capillary network is located near the most vulnerable areas (gingival sulci). In case of increased production of toxins, enzymes, and other harmful factors by microorganisms in these areas, protective blood cells (leukocytes) and its components are actively directed to these areas, which deactivate or destroy microbial cells. Thus, the processes of microbial invasion and antimicrobial protection are fairly balanced.

    In what cases can normal microflora cause pathological changes in the periodontium?

    Obviously, this happens when microorganisms accumulate in very large quantities and the usual protective mechanisms are no longer able to neutralize their toxic and enzymatic effects, or when local protective forces are insufficient.

    Like any inflammation caused by an infectious agent, inflammation of the periodontal tissues (periodontitis, gingivitis) depends not only on the presence of microorganisms but also on the overall condition of the body.

    The severity of the process, its clinical and morphological features, and the outcome of inflammation are determined by the reactivity of the organism.

    Smoking and gum disease

    The harmful effects of smoking are well-known. In terms of dentistry, the detrimental effects of tobacco smoke are manifested as follows:

    • First of all, tobacco smoke impairs the ability to resist infection, namely, it reduces the chemotaxis and phagocytosis of neutrophils, limits the formation of antibodies (that is, both the number and activity of protective cells are reduced).
    • The release of anti-inflammatory mediators by monocytes is stimulated.
    • The amount of obligate anaerobic pathogens in the periodontium increases.
    • High doses of nicotine damage fibroblasts (cells that are responsible for the regeneration of the gums and periodontium in case of damage).

    Clinical observations confirm the role of smoking as the main risk factor in the development and progression of marginal periodontitis:

    • The relative risk of periodontitis in smokers is 2.5-5 times higher.
    • The relative risk of periodontitis is significantly higher in children and adolescents.
    • More than 50 cases of periodontitis caused by smoking occur before the age of 45.
    • Quitting smoking can reduce the frequency of periodontitis by 30-60%. In the treatment of periodontitis in smokers, the restoration of gingival attachment is 25-60% less than in non-smokers using the same methods.

    When treating periodontitis ("gum treatment") and regenerative procedures (those that accelerate healing and regeneration) in smokers, the unfavorable prognosis of the postoperative healing process should be taken into account.

    After quitting smoking, the positive effect is immediately evident:

    • The intensity of periodontitis progression decreases
    • The healing of wounds after surgical interventions improves.

    Therefore, motivating the patient to limit or quit smoking is an important part of treating periodontal diseases (periodontitis, periodontosis, gingivitis).

    Advantages of gum treatment at iStomatolog

    • PRF therapy (plasma therapy)
    • Prevention and treatment with HealOzon ozone
    • Prevention and treatment with Lazram laser
    • Vector therapy
    • Exclusive techniques of the iStomatolog clinic
    • Results visible after the first procedure
    • Painless treatment

    Cost of gum treatment at iStomatolog in Kyiv

    The treatment of periodontal diseases is effective only with a comprehensive approach. The cost of treatment depends on the degree of periodontal disease and the general condition of the teeth (the need for additional treatment). Planning the treatment of periodontitis, determining the effectiveness of various procedures, stages, and sequence of treatment can only be done after examination, diagnosis, X-ray, and computer examination. This can be done during a consultation directly at our iStomatolog center.

    Full Price list of dental clinic services is available at the following link 


    No, periodontitis cannot be cured. With appropriate treatment, it is possible to achieve a durable remission of the disease.
    It is impossible to self-diagnose periodontitis. The diagnosis is made based on a clinical examination and analysis of radiographic studies. The reason for consulting a periodontist or a treating dentist is the presence of one or more of the following signs: bleeding gums (or an area around several teeth) during brushing or eating hard food; loose teeth; exposed tooth roots; appearance of defects on teeth at the gum line; unpleasant odor from the mouth, despite thorough and regular hygiene; redness and swelling of the gums; unpleasant sensations of soreness or itching in the jaws; increased wear of teeth; displacement or tilting of teeth, changes in bite.
    Without treatment, tooth mobility will increase, and bone loss in the jaws will progress, leading to complete tooth loss.
    The cost of periodontitis treatment in Kyiv at iStomatolog Center depends on the stage of the disease (tooth mobility and degree of bone loss) and the need for additional therapeutic measures such as tooth treatment, prosthetics, or implantation in the absence of teeth. A detailed step-by-step treatment plan with full financial justification is developed individually for each patient after examination and analysis of radiographic data.
    It is more appropriate to talk about prevention to prevent the progression of the disease. Given that periodontitis cannot be cured, preventive measures should be carried out at least once a year after stabilization of the process has been achieved.
    Prophylaxis and treatment of gum diseases

    Article author:

    Olena Daynetska, chief Doctor of iStomatolog Dental Center

    During a consultation at iStomatolog dental clinic, you have the opportunity to receive digital and video diagnostics, a detailed treatment plan, as well as the overall cost of all stages of treatment.

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    Досвід лікування моїх зубів і приведення у задовільний стан мою посмішку має чималу історію (для інформації, мені за 50). Це пломби у більшості зубів, брекет системи і навіть спроби змінити форму зубів. Щось виходило, але не з першого разу, щось не виходило і намагання повернутись до цієї проблеми не сприймалися схвально. У додаток до всього цього сам процес лікування затягувався на довгі місяці.
    Що мене очікувало в центрі iStomatolog.
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    4. Відсутність бажання затягнути процес лікування на рік (якщо у тебе проблема не одного чи двох зубів). Головне, щоб дозволяли працювати ясна (їх стан).
    5. Матеріали з якими працюють лікарі. Це виключно японський виробник.
    І нарешті результат, який я навіть вже і не очікувала.
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    Что такое профессионализм? Это в высшей степени компетентность, уверенность и любовь к своей работе. «Не боюсь и доверяю» - это, пожалуй, определение собственных ощущений от лечения у Елены Дайнецкой. Мой выбор - iStomatolog и никто другой!!!
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    Тут працюють професіонали вищої кваліфікації.
    Очень рекомендую данную клинику!!!!! Все на высшем уровне!!!! Лечу зубки у Виталия Петровича, врач отличный, мастер своего дела, имеет свой подход к каждому клиенту, всегда с улыбкой и юмором!
    Стоматология супер! Обслуживаемся всей семьёй уже 13 лет. В основном у Ирины и Елены на м. Дарница. Качеством очень довольны! Персонал опытный и приятный) Однозначно рекомендую !!! Спасибо вам за ваш труд!
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    С 2007 года iStomatolog наша семейная стоматология. Почему? Потому что кто лучше делает своё дело, если оно семейное и уже в третьем поколении. Я пришёл по рекомендации моего друга Антона на приём к Ларисе Викторовне. Она сказала мне сразу: «я не вырву не одного зуба если за него можно бороться» Пол года лечения и сейчас у меня только раз в 6 месяцев профилактика. Супруга, дочь, моя мама (83 года) все доверили свои зубки iStomatolog. Правда уже Елена Сергеевна (старшая дочь Ларисы Викторовны) руководит клиникой. Строгая, но наверно так и надо, а то мы всегда пытаемся отсрочить, откладываем на потом профилактику, а потом выкладываем огромные деньги что бы спасти уже гнилой зуб. В этой стоматологии принцип очень простой: делай качественно, относись к людям по человечески, предупреди заранее (ну ведь забываем и «забиваем» на это). Многие подумают заказная статейка. Нет, просто мне повезло, я нашёл тех кому не безразлично мое здоровье и посчитал своим долгом перед Вами, рекомендовать стоматологию iStomatolog.
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    Дуже рекомендую.
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