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Curettage is a procedure performed in the course of periodontitis. The purpose of curettage is to shallow the gingival pockets that promote plaque build-up. In order to minimize the patient's unpleasant sensations, the procedure is performed under local anesthesia.
Curettage of gingival pocketsis performed in patients with gingivitis when the removal of plaque (tartar) alone does not bring the expected results. Do you want to learn what curettage is and what should be done in the postoperative period? When is open curettage and when is closed curettage?
The doctor with the help of special devices, the so-called curette removes inflamed tissue and bacterial biofilm residing in the gingival pocket. Curettage is preceded by cleaning the root surface from calculus and plaque (SRP treatment). Both procedures are aimed at cleaning the pocket and the root surface from bacteria (as much as possible) and removing the inflamed tissues of the gingival pocket. As a result, the places of residual plaque are leveled. Thanks to both of these procedures, the contamination-free gingival pocket heals and is covered with new, unchanged epithelium. It is worth noting here that the gum lost in the disease process will not rebuild and the visible recessions will still remain.
What are the types of curettage?
There are two types of curettage:
- closed curettageis a procedure performed on patients with a pocket depth not exceeding 5 mm. The gingival pocket is cleaned under local anesthesia. The procedure is performed without incising the gum and detaching the mucosa.
- open curettageis a surgical procedure performed on pockets larger than 5 mm. The doctor cuts the gum and prepares the gingival flap to reveal the root surface and deeper tissues. The inflamed tissues and the root surface are thoroughly cleaned under visual control. In the final stage, the doctor moves the formed flap to its place and sutures the wound.
Curettage: postoperative period
Patients in the post-treatment period may notice slight bleeding from the cleaned areas. The gum may be slightly tender andpainful (it is worth getting painkillers). Gingiva may appear swollen and discolored. As in the case of removing supragingival deposits, also in this case the teeth may become temporarily hypersensitive, e.g. to cold or warm food.
Patients who have undergone closed or open curettage are obliged to follow the doctor's instructions. If an antibiotic is prescribed, it should be taken as indicated. Patients are required to maintain proper oral hygiene. A soft brush should be used in the first days after the treatment. In pharmacies, you can buy special brushes for patients after surgery. At first, brushing should be limited to the crowns of the teeth, with special care not to damage the gums. Rinses containing chlorhexidine may be useful in maintaining oral hygiene. Chlorhexidine is a chemical compound that has a bactericidal and bacteriostatic effect on many strains of microorganisms (it should not be used for more than 14 days).
In the first days after the treatment, a semi-fluid, soft diet is recommended, and you should not eat hot food. The patient should not consume alcohol and should not smoke cigarettes for at least 48 hours after the procedure. If open curettage was performed, a visit to remove the sutures will be necessary (after about 7-10 days). Periodontal disease is a chronic disease. Patients must remember that in addition to taking care of oral hygiene, they will have to attend regular check-ups, combined with professional removal of dental plaque. Otherwise, the disease will come back and the results of treatment will be lost.Worth knowing
The subject of interest of a periodontist is periodontium, i.e. a set of tissues surrounding a tooth and holding it in place. The periodontium consists of the gum, the alveolar bone with the periosteum, periodontium and root cementum. There are many factors that adversely affect the condition of the periodontium. The basic and most common cause of gingivitis and periodontitis is residual plaque. Plaque deposition is associated with poor oral hygiene. The main component of the said plaque are bacteria that make up a complex ecosystem. Toxins and metabolic products of microorganisms cause the body to respond in the form of developing inflammation. Initially, deposits are located on the surface of tooth crowns and the inflammation is limited to the gums only. This process is called gingivitis. Gingivitis-related changes are reversible anddisappear with appropriate treatment. If the pathological process is not limited, gingivitis turns into periodontitis and affects deeper tissues. This condition is commonly called periodontitis and is irreversible. Tartar gradually builds up under the gingiva, causing the formation of gingival pockets and loss of bone tissue. The deep pockets favor the further deposition of subgingival bacterial biofilm, and this is the vicious circle. The main symptoms of gingivitis and periodontitis are swelling and redness. The gums bleed even with minor injuries (e.g. tooth brushing). The teeth may be loose or change their position. One of the methods of treating deep gingival pockets is curettage.