Question

I (59, female) have been going to the dental hygienist once a year for over 20 years. Two years ago I was diagnosed with periodontitis. Surgical gum restoration is now required. Is it really necessary or is it possible to treat it with medication? Does it make sense to get a second opinion? How can I find out whether my dentist has experience in these operations and how he is trained? What complications should I expect? C. A. in S. 

Short answer

Prevention and treatment of periodontitis are closely linked. Obtaining a second opinion can be useful. Periodontitis can be prevented by good oral hygiene and optimal cleaning. Treatment consists of meticulously removing all bacteria on the tooth and root surface, including under the gums. This often requires several sessions. Disinfectant rinsing solutions or occasionally antibiotics must also be used to support the treatment.

From the detailed description of your problems, I understand that you suffer from adult periodontitis. Gum and bone loss develops slowly over the years, but only if plaque and bacteria get under the gums and remain there. The visit to your dental hygienist only once a year was therefore insufficient. 

Adult periodontitis is no longer a fate - it can be avoided through good personal oral hygiene and regular, precise professional cleaning. The frequency must be adjusted individually for each patient (usually twice a year for adults without specific problems). 

The treatment of adult periodontitis always begins with a hygiene phase. Patients are instructed in how to carry out their own hygiene and, if necessary, checked several times until they are able to maintain optimal dental hygiene. 

Periodontitis treatment 

The dental hygienist will then meticulously scrape out all bacteria from under the gums. This often requires several sessions and often a local anesthetic. Disinfectant rinsing agents, and in rare cases antibiotics, can be helpful, but are never sufficient on their own. After a healing period of several weeks with continued good oral hygiene, the condition of the gums is examined again. Only then is a decision made as to where surgical treatment is necessary. The most common complications are sensitive tooth necks or teeth that appear longer due to the shrinkage of the inflamed gums.

Training and experience 

Obtaining a second opinion makes sense if you do not trust your dentist personally enough. Your trust and your motivation for optimal hygiene are very important for the success of a treatment. You can find out whether your dentist has sufficient experience for a particular treatment by asking him or her directly or by asking for his or her professional CV. This will list his training, place of training, further and advanced training. Official advanced training titles awarded by the Swiss Dental Association SSO are: "Advanced training certificate SSO for ..." or those awarded by the Swiss Confederation "Specialist dentist for ..." 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on March 18, 2009