Treatment of Teeth and Gums

Usually, a person experiencing pain cannot say with certainty what exactly is bothering them, but that is not necessary. At “Osadchiy Dental Clinic,” first-class highly specialized dentists work to help eliminate various diseases of the oral cavity:

• a general dentist treats caries, periodontitis, pulpitis, periapical disease, and performs tooth restorations;
• a prosthodontist solves aesthetic and functional dental problems;
• an orthodontist corrects issues related to malocclusion and tooth alignment;
• an oral surgeon performs tooth extractions and dental implant placement, as well as other oral and maxillofacial surgery tasks.

The most common dental requests are treatment of gum diseases, caries, and pulpitis. Most clinics in Kyiv and Ukraine offer services for treating these conditions. However, before choosing one specialist over another, patients should familiarize themselves with certain nuances and details. Quite often, such knowledge helps avoid confusion and get quality dental treatment at an optimal price.

All dental diseases can be roughly divided into three groups:

• diseases of the crown portion;
• diseases of the root portion;
• diseases of the soft tissues surrounding the tooth (mucosa).

Each disease has its own treatment protocol that the doctor must follow. In this article, we will examine in detail the diseases that mainly fall within the competence of general dentists.

• Diagnosis of oral cavity diseases;
• Treatment plan development;
• Caries treatment;
• Pulpitis treatment;
• Periodontitis treatment;
• Periodontal disease treatment;
• Treatment of stomatitis and gingivitis;
• Endodontic treatment of chronic periapical tissue diseases;
• Tooth restoration;
• Professional oral hygiene;
• Teeth whitening.

• Pain in the oral cavity;
• Bleeding of soft tissues (gums);
• Halitosis (bad breath);
• Changes in tooth color;
• Increased tooth sensitivity (reaction to sweet, sour, cold, hot);
• Mechanical tooth damage (cracks, chips, injuries);
• Recession (exposed tooth root);
• Prevention (routine visits every 3–6 months).

Caries is a complex process that develops slowly in the hard tissues of teeth. As a rule, the disease begins asymptomatically and is difficult to detect except during a dental appointment.

The development of caries leads to damage of the hard tissues of the tooth with the formation of a cavity in the dentin (soft tooth tissue), and without treatment, it leads to inflammation of the pulp and periodontium — that is when painful sensations begin. Complications may also arise. It should be remembered that in an unfavorable course of caries, there is a high probability of tooth loss.

In summary: caries belongs to diseases of the crown portion of the tooth and is associated with the destruction of enamel and dentin tissues under the influence of acid processes.

Possible symptoms of caries:

• pain or tooth sensitivity;
• light, dark, or brown spots on the surface of teeth;
• discomfort while chewing.

Types of caries:

• superficial (initial enamel defects);
• medium (damage to deep enamel layers and partially dentin);
• deep (enamel damage and deep dentin damage).

Depending on the type, the following types of caries treatment are possible:

• filling (removal of damaged tissues and replacement with filling material);
• endodontic treatment (applied when the pulp is affected and involves canal filling).

If deep caries has led to significant destruction of dentin and reached the pulp but has not affected it, the doctor removes the damaged tissues and fills everything with filling material.

Caries treatment becomes more complicated if the destruction is located close to the pulp. Placing a filling can lead to significant sensitivity and discomfort. This is because the pulp produces odontoblasts and forms dentin. Over time, the pulp becomes denser and smaller — it builds tissues around itself, essentially “walling itself in.” That is why, when treating deep caries, it is necessary to ensure that the pulp continues to produce dentin.

To achieve this, the doctor places a calcium-containing liner between the filling material and the pulp, which helps the pulp produce secondary dentin, thus keeping the tooth alive and nourished.

The use of a calcium-containing liner does not significantly increase the cost of caries treatment but greatly improves its quality. The patient does not experience discomfort after filling.

If deep caries has nonetheless affected the pulp and the infection has spread, pulpitis treatment (inflammation of the pulp) becomes necessary.

Pulpitis belongs to diseases of the root portion of the tooth, and its treatment involves:

• devitalization of the tooth (nerve removal);
• treatment of canals with a special antibacterial solution (and/or laser treatment);
• canal filling (using an apex locator to ensure that the filling material does not extend beyond the root tip).

Many patients fear depulpation, believing that by “killing” the nerve, the entire tooth is “killed” as well. Outdated methods, which are practically no longer used in Kyiv clinics, involved the use of aggressive materials. Indeed, under the influence of these materials, the tooth became more fragile. However, modern materials have become gentler, and a depulpated tooth covered with a crown can last quite a long time.

Typically, the cost of pulpitis treatment is influenced by the complexity of the case, the number of root canals in the given tooth, the amount of material used, and additional equipment.

At “Osadchiy Dental Clinic,” we use state-of-the-art endodontic equipment from leading manufacturers such as MicroMega and Parkell for root canal treatment. This allows us to perform a complete root canal treatment in just one visit without pain and prepare them for the next stage of filling with endodontic pastes.

A microscope in dentistry is auxiliary equipment for the doctor that greatly facilitates their work. At the same time, the use or non-use of a microscope during treatment is not a factor that affects the outcome.

The use of an apex locator, which prevents going beyond the root tip, X-rays, and caries markers are important factors that significantly affect treatment outcomes, but the same cannot be said about the use of a microscope. It is necessary to reduce the strain on the doctor’s eyesight, but not to improve patient treatment results.

Most often, when it comes to dental treatment under a microscope, it means that the doctor will use a microscope for, say, faster detection of the canal entrance during pulpitis treatment. Finding the entrance to obliterated (narrowed) canals can be quite difficult, and significant magnification needs to be applied. At this stage, one can speak of dental treatment under a microscope with a slight stretch.

The fact that many dental clinics in Kyiv emphasize the use of a microscope speaks more about marketing than medicine. Catchy headlines like “Dental treatment under a microscope” allow raising service prices, but the quality of services will depend not on auxiliary tools, but on the experience and skills of the doctor. At “Osadchiy Dental Clinic,” we also use a microscope, but only when necessary, as the use of additional equipment increases the cost of dental treatment.

The commonly used word “gums” in dentistry is technically incorrect — the oral cavity contains mucous membrane. However, phrases like “gum diseases” and “gum inflammation” have become so firmly established that we are compelled to use this imprecise term.

Gum disease on its own is very rare; it is associated with an increase in conditionally pathogenic microflora. Sometimes it is provoked by physical, chemical, or microbial factors.

Types of mucosal diseases

Treatment of gum diseases depends on the type of disease. Local medication treatment, systemic treatment, surgical treatment, and combined treatment are used.

It should be noted that in 95% of cases, gum disease occurs as a result of a tooth disease. It is the reaction of surrounding tissues to an infection located in the tooth. In these cases, treatment of gum inflammation involves eliminating the source of infection in the tooth. Once the tooth is treated, the mucosa will also recover, most often without additional treatment of gum inflammation.

Supportive therapy is also possible. It involves biorevitalization of the oral mucosa, when medications that promote improved blood supply to tissues are administered. This can help suppress the inflammatory process.