Subgingival Curettage: Your Ally in the Fight Against Tooth Loss
The periodontium or the supporting structure of the tooth consists of the tissues that hold the tooth firmly anchored in the bone, enabling all of its functions. Although the role of a healthy periodontium in an individual’s overall health is invaluable, these dental tissues are often neglected by patients when the first signs of a disease appear. Due to the gradual, long-term development of periodontal diseases, and the subtle symptoms of these insidious conditions, patients typically visit a dentist only when they notice bleeding or gum recession, or when their teeth start to become loose, which, in most cases, is already too late.
Therefore, in today’s blog, we bring you essential information about the treatment of periodontal diseases and the timely steps we take in order to ensure that your teeth serve you for a lifetime.
“The dentist told me I have ‘deep pockets.’ What should I do?”
Periodontal diseases manifest as the presence of periodontal pockets around the teeth. Given that these diseases have a subtle and chronic course, they are usually detected when a patient visits the dentist for a routine check-up or another treatment.
When your dentist informs you during a clinical exam that you have deep pockets, it means that deep spaces have formed around one or more of your teeth where bone once existed. Since these pockets are often not noticeable at first, it gives the patient the illusion that everything in their mouth is fine. However, the presence of deep, hidden spaces around the tooth roots can cause a number of problems.
The success of treating pathological conditions in periodontology largely depends on the patient’s behavior after the therapy. In order to understand the importance of following the dentist’s instructions, it is necessary to know what caused your disease in the first place.
The developmental path of a periodontal pocket begins with what appears to be a harmless gum inflammation, which is often neglected by patients. Gingivitis, or gum inflammation, is often described as a disease where the collective action of various causes and conditions leads to the onset and progression of this disease.
Poor oral hygiene, genetic predisposition to the disease, the presence of systemic diseases, bad habits such as smoking, pregnancy, and the use of certain medications are the most common causes of periodontal diseases.
Long-term neglect of oral hygiene leads to the first signs of gum inflammation—redness, swelling, and bleeding. Due to the fear of bleeding and further injury to the gums, patients usually avoid brushing their teeth in the affected areas, leading to the increased plaque accumulation in the spaces between the teeth and gums. Prolonged gum inflammation accelerates the inflammatory process within the bone, resulting in bone loss around the teeth and the formation of periodontal pockets, i.e., the onset of periodontitis.
The presence of periodontal pockets is accompanied by the accumulation of food inside them, which cannot be removed by regular tooth brushing. The deep and dark spaces of the pockets are a fertile ground for further bacterial growth and the development of infection in the tissues. The inability to remove the pathological contents from these areas on one’s own leads the patient into a vicious cycle of the periodontal disease, from which they cannot escape alone. In this case, it is essential to perform a professional removal of soft and hard dental plaque from below the gum line and from the tooth roots, i.e., the procedure of subgingival curettage.
What is subgingival curettage?
Subgingival curettage is a therapeutic procedure in which soft and hard dental plaque are removed from the periodontal pocket, the walls of which consist of the tooth root and the surrounding gum tissue. By scraping and polishing the surface of the tooth root and surrounding soft tissue, more favorable conditions are created for reducing the depth of the periodontal pockets.
Since periodontal pockets are often deep, the surface of the tooth root is scraped and polished with special dental instruments that reach the bottom of the pocket. Although the description of the procedure may sound intimidating and painful to patients, it is important to emphasize that subgingival curettage is performed under standard local anesthesia, making it completely painless.
If the dentist measures a pocket depth bigger than 4 millimeters, the procedure of subgingival curettage precedes surgical removal of the periodontal pockets. During this procedure, under visual control, the surfaces of the tooth roots and the surrounding bone are scraped, and the infectious contents are removed from the affected tissue. This treatment is the only way to physically reduce deep periodontal pockets. The surgical procedure is also performed under local anesthesia, making it completely painless.
What are the benefits of subgingival curettage?
The primary goal of subgingival curettage is to eliminate inflammation and infection from the affected area, which the patient cannot heal on their own. Although lost bone cannot be replaced in most cases, it is important to stop the progression of the disease, achieve a healthy condition of the gum tissue, and stabilize the teeth in their sockets.
How should I behave after subgingival curettage?
After the procedure, you can expect temporary sensitivity of the teeth to hot and cold, mild gum bleeding, and gum sensitivity that may last a day or two after curettage. As instructed by your dentist, it is recommended to use mouthwashes and gels with antiseptic properties and active ingredients that support tissue healing.
Maintaining the health of the periodontium is a team effort between the dentist and the patient. To preserve the results achieved through curettage, it is essential to maintain excellent oral hygiene, including regular brushing with a soft toothbrush and toothpaste. Additionally, it is crucial to keep the interdental spaces clean! The gold standard in cleaning interdental spaces for patients with periodontal disease is the water flosser, which uses water pressure to remove food debris from these areas.
When should I visit the dentist?
In addition to six-month check-ups, during which the dentist assesses the condition of your oral health and the level of oral hygiene maintenance, it is useful to recognize the symptoms indicating the presence of the periodontal disease. If you notice bleeding gums during brushing, changes in color or gum recession, bad breath without a known source, or loose teeth, you should visit a dentist.
We advise you…
Schedule your regular check-up and professional teeth cleaning on time, so that we can, with our joint efforts, preserve the health of your periodontium, and enable the preservation of your teeth until old age.
