We only worry about them when they bleed or swell, so when inflammation is underway that needs to be extinguished before it does more damage. Gingival inflammation affects 30 million Italian adults, or half of the population, but just 17% receives the diagnosis and only 3% declare that they have been treated to cure the disease.
The result is an increase in cases of severe periodontitis and with it the risk of losing teeth: this is underlined by the experts of the Italian Society of Periodontology and Implantology (SIdP) on the occasion of the European Day of healthy gums on 12 May.
How we brush our teeth
According to research by Top Doctor, 33% do not know that you have to brush your teeth vertically and not horizontally, 68% clean them for less than two minutes almost always thinking about something else, without focusing on what they are doing. The result is an increase in gum inflammation. “One in 3 Italians – he explains Nicola Marco SforzaSIdP president – wrong technique for brushing teeth that should never be cleaned horizontally, as many do, but with a vertical rotational movement “.
But what are the most common mistakes to avoid? “There are several”, replies Sforza, who lists: “Brushing too hard, not brushing your teeth long enough, not using dental floss and brush, use whitening toothpastes containing abrasive pastes, do not rinse your mouth with water, use toothbrushes that are hard or too soft “.
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How to use the toothbrush well
So what is the right way to clean your teeth? “If you use the manual toothbrush, but also the electric one, today often suggested by dentists and hygienists – replies Sforza – the movement must start from the gums and pass vertically over the tooth in order to best eliminate food residues and remove plaque. bacterial that adheres tenaciously to the areas of the teeth near the gums: never the other way around, even internally, avoiding brushing too hard to avoid damaging both the teeth and the gums “.
How long
Woe to brush your teeth quickly and without awareness. “To perform oral hygiene maneuvers correctly – Sforza points out – it is necessary to spend at least two minutes brushing your teeth. Unfortunately, most people take much less time and do it without looking at what they are doing and thinking about something else. If you do not focus on the maneuvers – warns the expert – it is easy to skip points and not brush the entire dental arch well, causing the appearance of bacterial plaque, tartar and therefore gingival inflammation as well as increased risk of dental caries “.
To the dentist for aesthetic reasons
There is also another phenomenon to worry experts: from a survey conducted at the beginning of 2022 by Key-Stone in collaboration with SIdP on about 1800 people, it emerges that Italians are finally returning to the dentist, but mainly for aesthetic reasons. “We have seen a boom in aesthetic interventions, from whitening (+ 24%) to clear aligners (+ 130%)”, he says Rodolfo GianserraSIdP vice president who adds: “But we also had a 7% increase in dental extractions, compared to the pre-Covid period, often a consequence of severe and untreated gingival inflammation: only 17% of patients receive the diagnosis, as soon as the 3% are treated with adequate therapies. Periodontal treatments – Gianserra observes – are just 4-5% of the total therapies provided by dental offices, but the gap between the number of patients and diagnosis must encourage everyone to pay more attention to in order to avoid the initial forms of periodontitis, these pathologies worsen with a greater risk of tooth loss, greater need for therapy and higher costs also determined by the need to replace the lost teeth, restoring function and aesthetics “.
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Pyorrhea alarm: beware of hasty solutions
Another consequence of periodontitis is pyorrhea, that is, the total loss of teeth from which almost 800 million people worldwide suffer, according to data from the Global Burden of Disease. Also in this case the cause must be sought in a late diagnosis: “The clinical signs of the disease – he explains Stefano Scavia, professor in Oral Surgery and Implantology at the Bicocca University of Milan – are characteristic, yet it is difficult to identify them because, to date, there are very few professionals who have completed a specialization path suitable for the correct and complete practice of periodontology. It thus happens that, often and willingly, it is the patient himself who reports the problem to his doctor, most of the time when the situation is now serious and chronic and just as often it is the doctor himself who provides vague and not at all conclusive solutions “.
How to treat pyorrhea
What to do then? The treatment of periodontitis must always begin with non-surgical therapy, set up and developed on the basis of the data collected: “It is mandatory – argues Scavia – to start with a superficial cleaning followed by different forms of analysis and measurement of the severity of periodontal disease, this is often followed by the decontamination of sub-gingival tissues “.
Regenerative treatment usually focuses on the most severely affected areas of the oral cavity. Around the natural teeth it allows to reconstruct bone, periodontal ligament, gingival tissue, albeit still with limits. “95% of implant cases – concludes Scavia – require the association of one or more regenerative techniques, but few clinicians are able to truly regenerate the tissues of the mouth. Most professionals, who use implant therapy, unfortunately they limit themselves to inserting the implants where and when it is still possible, without taking into account the correct morphology, the bio-mechanical function and the anatomy of the supporting tissues. Anatomically, structurally and functionally reproducing the tissues of the oral cavity, as they are were created in nature, it is the correct procedure. ”
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The role of the dentist
The slogan of the European Day of Healthy Gums this year is ‘Take care of your gums’, a warning addressed to all, including dentists: “We need greater awareness on the part of citizens, but also of dentists themselves, of the need for early diagnosis and therapy. periodontal, today more simply, thanks to the European Guidelines adapted by SIdP and adopted in Italy with publication on the website of the Ministry of Health “, concludes Sforza. “Dentists can do a lot, always using the periodontal probe during check-ups, just as the probe is always used for detecting caries”.