How periodontitis and its treatment affect dental aesthetics
Periodontal disease has consequences beyond oral health. Here we show how periodontitis and its treatment affect dental aesthetics.
In many cases, when diagnosing periodontal disease, we find that after conducting the necessary studies, we conclude that gum surgery is needed for its eradication. With gum surgery, our general goal is not to regain lost bone (except for specific cases where grafting is performed), but rather to stabilize the disease at its current stage . In other words, we aim to prevent its progression and maintain the teeth for as long as possible.
The objective of the surgery is to eliminate periodontal pockets, which are spaces that form between the gum surface and the bone surrounding the teeth. At the bottom of these pockets, there is a microbial metabolism that perpetuates the process, as it is impossible to reach the bottom of the deep pockets with conventional oral hygiene methods. The treatment of periodontitis may, as a consequence, be associated with certain aesthetic changes, although these may vary depending on the degree of severity of the periodontal disease, as well as other individual factors.
A) Spaces between teeth or "black triangles":
In some cases, resective surgery may result in the creation of spaces between the teeth. This can occur if the procedure involves the removal of inflamed or damaged tissue that was acting as support between the teeth. These spaces can affect the appearance of the smile.
B) Gum recession after periodontitis treatment
During resective surgery, a portion of the gum tissue may be removed to access the areas affected by periodontal disease. As a result, the gum may be more recessed, and the roots may be more sensitive in the first few days as the tooth roots are exposed. Consequently, the teeth may appear longer, and the gums may show irregularities in their smile line.
C) Changes in gum appearance
After resective surgery, the gums may acquire a different appearance. They may appear thinner, have an irregular contour, or a different color. These changes can affect the aesthetics of the smile and the overall harmony of the soft tissues.
D) Changes in tooth alignment
When periodontal disease affects the tissues surrounding the teeth, it can cause unwanted movements in the position of the teeth. This can result in crowding or irregular spacing, which can be aggravated after periodontitis treatment, affecting the aesthetics of the smile.
E) Periodontal disease can lead to tooth loss
In severe cases of periodontal disease, tooth loss may occur. These missing teeth can have a significant impact on facial aesthetics and the ability to smile with confidence.
F) How to Improve Dental Aesthetics in Patients with Periodontitis
All these changes pose a challenge, especially in the anterior region, particularly if the patient has a gummy smile and shows a lot of gum. In these cases, to prevent this from happening, a more conservative technique can be followed. If that is not possible due to the severity of the disease, a restorative aesthetic treatment of the anterior sector should be performed once the underlying disease has been cured.
