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SISDENTE - Sistema Integrado de Saude Bucal

O que é Periodontite?

Quando a gengivite não é tratada ou quando o tratamento é prorrogado a infecção e a inflamação migram das gengivas para os tecidos q suportam os dentes, ou seja, os ligamentos e o osso. A perda de suporte faz com que os dentes apresentem mobilidade e, em muitos casos, acabem simplesmente caindo, fenômeno esse conhecido como periodontite. A periodontite é a doença da boca q mais causa perda de dentes.

Ocorre o acúmulo da placa e do tártaro nas raízes dos dentes. Como esse acúmulo desencadeia o processo de destruição dos tecidos de suporte, a infecção causa o aparecimento de um espaço entre as gengivas e os dentes, que está acumulando tártaro e placa. A inflamação desse tecido infectado causa inchaço o que contribui ainda mais para a retenção da placa bacteriana e formação de tártaro. Em casos mais graves pode ocorrer o desenvolvimento de abscessos periodontais.

No exame da boca é possível ver gengivas inchadas, moles, bastante avermelhadas e sangrantes ao toque ou expontaneamente. O paciente pode apresentar mal hálito e cálculos e placas podem estar presentes na junção dentes-gengivas, com espaços aumentados nas gengivas. Geralmente as gengivas não apresentam dor ou estão levemente sensíveis, exceto nos casos que haja abscesso dentário. As gengivas podem apresentar retrações e os dentes mobilidade.

O tratamento da periodontite tem como objetivo reduzir a inflamação, através da eliminação dos agentes infecciosos e eliminar os espaços entre gengiva e dente (se existir). É importante a avaliação da saúde geral do paciente pois algumas doenças ou distúrbios podem estar relacionados com a presença da periodontite.

A profilaxia dos dentes é bastante meticulosa exigindo o uso de inúmeros instrumentos ou aparelhos para eliminar o acúmulo de placa e tártaro nos espaços entre raízes e gengivas. Por conta dessa abordagem detalhada e profunda, normalmente é necessário a anestesia do local que será tratado. A partir desse momento o paciente necessita de intensa conscientização de sua higiene oral para impedir mais perda de tecidos de suporte. Através de técnicas de escovação e do uso do fio dental, o dentista explicará de que forma e em que frequência o paciente fará sua higiene caseira. É imprescindível que os pacientes com histórico de periodontite, mesmo os tratados, façam reavaliações com o dentista mais de duas vezes por ano.

Em casos mais avançados ou de difícil acesso pode ser necessária uma abordagem cirúrgica. Espaços profundos nas gengivas podem precisar ser limpos através de um acesso cirúrgico. Dentes com mobilidade podem precisar de fixação.