Why do our teeth fall out?

Periodontal disease is the main cause of tooth loss in adults. According to the latest research, 3 out of 4 patients, i.e. 75% globally, and unfortunately a much higher figure in our country, suffer from it. Prevention and early treatment of periodontal disease are the only ways to keep our teeth healthy.

What is periodontal disease?

It is a disease that affects the tissues that support the teeth (gums, bone). The first stage is gingivitis, which is manifested by gum bleeding when we brush our teeth and is accompanied by bad breath. If it is not diagnosed and treated in time, then it most often results in periodontitis.

Periodontitis is a subsequent stage of gingivitis, where, in addition to gum inflammation, there is also inflammation of the bone that supports the teeth. Thus, as the disease progresses, teeth loosen, gain significant mobility and eventually fall out.

What are the symptoms of the disease?

Periodontal disease has various symptoms, such as gum bleeding, gum redness and swelling, gum detachment from the teeth, receding gums, teeth shifting, teeth mobility, bad breath, pus, etc.

If you present any of these symptoms, you should seek periodontal treatment.

Can someone have periodontal disease without noticeable symptoms?

Of course, it is possible. Most patients do not experience any pain and, therefore, periodontal disease can easily go unnoticed. Therefore, it is very important to visit your dentist at least every six months for a periodontal tissue examination.

What causes periodontal disease?

The main cause of periodontal disease is dental plaque. There is a crevice between the teeth and the gums, called the gingival sulcus, which always “hosts” a number of bacteria. If these bacteria are not effectively removed with proper oral hygiene, then they multiply and facilitate the growth of other bacteria, which aggravate the problem.

What other factors contribute to the onset of periodontal disease?

Although dental plaque is its primary cause, other factors, such as pregnancy, an unhealthy diet, smoking, stress and certain medications, can contribute to the development of periodontal disease.


How can periodontal disease be diagnosed?

Periodontal disease can be diagnosed by the dentist through x-rays and clinical examination during the patient’s visit to the doctor’s office.

Can periodontal disease be prevented?

Of course, it can. Proper oral hygiene is the most effective method of preventing the disease. It is necessary to use the appropriate oral hygiene products (toothbrush, dental floss, interdental brush) after each meal, as instructed by your dentist.

If you do not suffer from periodontal disease, you should start this preventive routine right now. However, if you suffer from the disease, you should first seek treatment and then continue to follow the oral hygiene routine recommended by your dentist. After the treatment is completed, you should visit your dentist regularly, in order to monitor the condition of the periodontal tissues.

Is periodontal disease treatable and how?

There are two main methods for treating periodontal disease: the non-surgical (conservative) method and the surgical one.

The non-surgical method involves training the patient in a new oral hygiene routine and removing the inflammation by dental scaling and root planing, that is by a deep and effective dental cleaning.

This method aims at removing tartar from the teeth and smoothing the dental root, in order for the detached gums to reattach to the teeth. Nowadays, laser technique is used in many cases, in combination with non-surgical treatment.

However, due to the severity of the disease and the particular characteristics of the teeth, sometimes non-surgical treatment is not enough. In such cases, the problem is fully resolved with the help of minor surgical procedures.

To conclude, both methods are likely to be combined with various medications, depending on the patient.

What is esthetic periodontal surgery?

It is a type of periodontal plastic surgery and it aims to correct the esthetic imperfections of the gums. These imperfections mainly occur in people with a high smile line (that is, when gums are exposed when smiling) and mostly concern denuded roots due to gingival recession, asymmetry in the gingival margin levels, dark pigmentation of the gums and, lastly, small teeth due to the presence of considerable quantity of gums.

What are dental implants?

Dental implants are artificial substitutes for the root of  one or more teeth that support the prosthetic part (tooth) connected with them.

What material are implants made of?

Dental implants are mostly made of titanium or titanium alloy. Titanium is a highly histocompatible material that has been used for several decades in orthopedics. Therefore, it is a tested, perfectly safe material, which does not pose any risk to the patient’s health, nor does it cause allergic reactions.

Within the dental market, there are many reputable companies with well-documented implant systems. The choice of system is at the discretion of the dentist.

Who is the ideal patient for dental implants?

Patients with a healthy medical history, as well as those with general diseases under control, are ideal patients for dental implants after the dentist’s consultation with their treating physician

As for the implant area, it should have sufficient bone tissue, so that the implant is stable and safely placed in relation to important anatomical elements adjacent to the implant area (e.g. sinus, nerves).

Bone adequacy is determined through a radiographic examination, a panoramic X-ray and a CT scan (dental scan). In many cases of bone deficiency, its regeneration can nowadays be achieved with modern bone regeneration techniques (bone grafts, membranes).

How is the implant placed?

The implantation process is extremely simple. After local anesthesia, like the one performed for a filling, a hole is drilled into the bone with the drilling depth being decided on the basis of an X-ray previously studied. The implant is screwed in this hole and the area is sutured. The implant can be completed with the final crown or bridge usually after 2-4 months.

What are the success rates of dental implants?

Internationally, as well as in our clinic, after 28 years of experience, the success rates of dental implants reach 96%. Unsuccessful osseointegration, that is the integration of the implant to the bone, is what causes implant failure. In this case, the implant is removed with a very simple procedure and replaced with a new one.

What is immediate loading (″teeth in a day″)?

It has been proven in recent years that, if during the surgical placement the implant is sufficiently stable in the bone (a fact determined with appropriate tools) it is possible to place the interim prothesis in the implant on the very same day. The final prosthetic work is performed after 2-4 months.

What symptoms should the patient expect after implant placement?

The implantation process is a simple surgery, similar to an easy tooth extraction. Therefore, usually, patients do not experience much pain, but just a slight swelling for the first 3 days. Care should be taken when eating (cold and soft food for the first 2 days) and it is recommended to avoid smoking and aspirin taking, to apply cold compresses and to take antibiotics and analgesics.

Most of the time, patients themselves admit that the symptoms were much milder than expected!

Is special care required for implant maintenance after their placement?

The implantation process is a simple surgical procedure, similar to an easy tooth extraction. Therefore, usually, patients do not experience much pain, but just a slight swelling for the first 3 days. Care should be taken when eating (cold and soft food for the first 2 days) and it is recommended to avoid smoking and aspirin taking, to apply cold compresses and to take antibiotics and analgesics.

Most of the time, patients themselves admit that the symptoms were much milder than expected!

What are lasers?

It is an acronym derived from the words Light Amplification by Stimulated Emission of Radiation (LASER), which essentially describe how laser energy is produced. Laser radiation has a specific wavelength (it is monochromatic), it is concentrated and powerful, making it a tool with specialized and very specific spatial action. At the appropriate wavelength, laser energy is absorbed by bacteria, thus destroying them (photothermal action).

Lasers, depending on the wavelength generated by each device, are divided in diode, neodymium (Nd – Yag), erbium and carbon dioxide (CO2) ones.

Clinically, they are separated into those that affect the hard oral tissues (e.g. tooth, bone, tartar) and those that affect the soft ones (e.g. gums, mucosa, plaque), depending on how the radiation is absorbed by the tissue and cell components.

How safe is the use of lasers?

Laser causes very little discomfort and, depending on the desired result, may or may not require anesthesia. Since it is not ionizing radiation, that is radiation that damages our cellular DNA, there is no limitation to its use. When the appropriate safety measures are taken and if it is used by properly trained personnel, laser is a completely safe tool.

How are lasers applied in periodontal treatment?

Lasers are a modern tool with a wide variety of applications. In periodontal and peri-implant disease treatment, lasers are used as an additional tool in those cases where traditional techniques do not achieve the desired result.

More specifically, with regard to periodontal treatment, lasers are used to improve the therapeutic effect of conservative treatment, thus reducing the possibility of surgical intervention, as well as saving teeth with poor prognosis. They are, also, a quite useful complementary tool in peri-implant disease treatment, where they are used to clean the affected by bacteria implant surface.

They are applied by repeated irradiation of the affected area in different sessions, each time supplying a small amount of energy, thus helping the body’s mechanisms to start the healing process (LLLT- low level laser therapy).

According to modern scientific data, laser application in selected cases helps achieve the best therapeutic result with the least amount of trouble and at the lowest cost.

What is a root canal treatment?

Endodontic treatment, commonly known as “root canal treatment”, is the treatment method for tooth pulp infections. Deep dental caries, repetitive dental work, problematic crowns and tooth injury (cracks, fractures) are some of the most common causes of pulp infection which may be accompanied by severe pain and eventually lead to abscess formation.

This procedure involves removing the organic pulp residue from the inner side of the teeth, disinfecting them and then sealing them with the appropriate materials depending on the case, in order to prevent re-infection.

Endodontic treatment helps preserve a natural smile, maintain a normal chewing function and reduce the need for more complex dental work. With proper care, most endodontically treated teeth can last for life.

When the endodontic treatment of a tooth is completed, it is followed by its restoration using a prosthesis, whose type is determined by the remaining percentage of intact tooth and the prosthetic requirements of the area.

What are crowns?

Crowns are prosthetic restorations that cover the entire tooth in order to protect it from possible fracture during chewing or in order to improve its functional or aesthetic characteristics.

Bridges consist of two or more crowns joined together to repair the loss of one or more teeth.

What are all-ceramic restorations?

Usually crowns have a metal interior and a porcelain exterior part.

All-ceramic crowns are restorations consisting entirely of metal-free porcelain and are made from zirconium or lithium disilicate. All-ceramic crowns, apart from their flawless aesthetic appearance, also have excellent biocompatibility with the adjacent tissues.

Porcelain veneers are very thin pieces of porcelain permanently cemented on the front of the teeth in order to improve their appearance. Porcelain veneers can be used to close gaps, improve the color of the teeth and change their shape or position. The end result is completely natural, similar to the rest of the teeth.

What are complete and partial dentures?

Complete dentures are removable prostheses that restore total tooth loss in one or both jaw bones. They consist of an acrylic base and acrylic teeth (placed on the base).

Partial dentures are removable prostheses that restore partial tooth loss in one or both jaw bones. They consist of a metal base coated with acrylic, on top of which acrylic teeth are placed, and they are held in place with hooks or precision attachments on the patient’s remaining teeth.

What are overdentures?

Overdentures are essentially complete dentures that are “fastened” onto teeth or implants. Their advantage, apart from increased support, is that, due to their smaller volume in comparison to conventional full dentures, patients gets used to them faster.

What are mouth guards?

Mouth guards are thin, hard acrylic constructions that are worn by people who clench or grind their teeth.

The hard acrylic material helps neutralize the loads created by this dysfunction and protects the teeth from abrasions or fractures, while in many cases it also helps reduce the headaches that many of these patients’ experience.

What are inlays and onlays?

Inlays and onlays are modern, very conservative restorations. If the lost tooth structure is more than half of the tooth and the restoration covers a cusp, it is called an “onlay”.

Crowns cause larger reduction of the tooth structure, amounting up to 65% of the tooth volume, while nowadays, with the use of onlays, the reduction of the remaining tooth structure is no more than 30%. The materials used in this procedure are composite resins or porcelain. With the application of inlays and onlays, the use of crowns is limited only to severely damaged teeth.

What does Esthetic Dentistry include?

Esthetic dentistry represents the clinical application of scientifically proven techniques and knowledge that can give a natural appearance to restorations

Its main applications concern the improvement of the position, shape and color of the teeth, providing our patients with a beautiful smile. The characteristics of the modern dental materials used, resemble the ones of natural teeth to such an extent, that they are hardly noticeable, and they include composite resin fillings, porcelain and resin veneers and all-ceramic restorations (crowns or bridges).

In certain cases, achieving an aesthetically pleasing smile requires the use of plastic surgery techniques in the periodontal tissues.

What is teeth whitening?

The whitening process is a minimally invasive way to improve a person’s smile. In this way, and without compromising the integrity of the dental tissues, the color of the natural, as well as the endodontically treated teeth, which sometimes may become discolored, can be improved.

Teeth whitening should always be performed under the supervision of a dentist, irrespective of whether it is performed in a dentist’s office or at home, and it should always be personalized, choosing the appropriate whitening agents, at the appropriate concentration for each patient.