Periodontitis in the ICD is encrypted with codes K04.4, K04.5. The first code is intended for cases of acute processes, the second - chronic. Periodontitis is usually diagnosed against the background of caries - if you start this condition, then an inflammatory process develops. Several forms of periodontitis are known. Each of them has specific features.
Traumatic periodontitis
This disease develops against a background of trauma. Often the reason is a sharp blow, although it may be insignificant in strength, but a prolonged impact on the tooth. This is observed, for example, if a poor-quality seal is delivered. Sometimes the disease periodontitis due to bad habits of a person or the characteristics of his profession.
The traumatic form is acute or chronic. Diagnosing an acute type of disease is not easy - there are no symptoms specific to this disease alone. The main manifestation is severe toothache, especially active if you touch the affected tooth. Body temperature remains normal, no swelling. One of the symptoms of periodontitis in this form is redness of the mucous membranes.
Case Study and Clarification
Suspecting acute periodontitis of a traumatic nature, the doctor examines the patient's tooth, trying to identify chips or biases. It is necessary to assess the condition of the gums. Hemorrhages or swelling of the mucosa are possible, allowing you to clarify the patient's condition. If a visual examination does not allow a definitive diagnosis, then an x-ray is taken. This approach allows you to clarify whether there is a root fracture, dental dislocation.
Acute periodontitis of a traumatic nature is considered established if the displacement of a diseased tooth is detected, due to which it becomes mobile, pain appears, a fracture of the tooth root is established, tissue damage near the tooth, due to which the object has acquired mobility, the crown shade has changed.
Chronicle
The specificity of this variant of the disease is the almost complete absence of pronounced symptoms of periodontitis. Often the patient does not even suspect about his illness. As a rule, discomfort in a chronic form is accompanied only by moments of accidental pressing on an unhealthy area.
With this form of dental disease, people prefer to simply wait out the attack, take an analgesic to temporarily relieve the condition. The approach is wrong - only timely treatment of periodontitis will avoid complications. Without medical assistance, a fistula or cyst may form in the affected area. The focus of inflammation may expand. All this leads to irretrievable tooth loss.
Having suspected symptoms of periodontitis, it is necessary to consult a dentist to clarify the condition. Having determined the diagnosis, the doctor will select the best treatment option. The main goal of therapy is to eliminate the causes that provoked the disease. The course will include relieving symptoms, physiotherapy. Orthopedic constructions or endodontic measures are sometimes recommended. In some cases, the patient is shown tires, removal of an incorrect or too large seal, correction of crowns.
How to warn?
In order not to have to deal with periodontitis, it is necessary to abandon bad habits. Some have been accustomed to chewing on pen caps and pencil tips since childhood - this can easily cause injury. Such consequences can lead to love cracking teeth with a nutshell, biting the thread.
Hygiene measures will help prevent periodontitis. You can reduce the risk of the disease if you thoroughly brush your teeth after each meal.
If necessary, treatment of periodontitis should use the services of a qualified doctor. Only specialists will be able to cope with the problem. It is impossible to cure periodontitis at home.
Fibrous periodontitis
This term is used to denote periodontitis in dentistry, which is characterized by fibrotic changes. As a rule, tissues located near the upper part of the root of the tooth suffer. An infectious agent can provoke the disease. Microscopic life forms can take root in the root canal. As a rule, this form of fibrotic periodontitis is observed if the tooth was previously ill with pulpitis and has not received adequate treatment.
Treatment of periodontitis of the fibrous type may be necessary due to a prolonged violation of the integrity of the tissues. This may be due to wearing prostheses or a poorly placed seal.
Fibrous periodontitis appears only on a fully formed tooth, in which the root system has already developed. For this reason, periodontitis of this form is detected only in adult patients.
How to notice?
The main symptom of periodontitis of the fibrous type is a visual change in the tooth and tissues near it. There are usually no vivid symptoms that the patient may notice, due to which the disease is considered to be a rather complex dental one. During a visual examination of the oral cavity, the doctor can detect a cavity affected by caries - this is where periodontitis is usually localized.
Due to pathological changes, the shade of the tooth is disturbed. The patient has a bad breath from his mouth. To clarify the diagnosis, it is necessary to take an x-ray. A distinctive feature of the disease is the gradual replacement of periodontal tissue with fibrous tissue. This leads to an expansion of the periodontal gap. Periodontitis of permanent teeth can usually be determined by barely seeing an x-ray.
Treatment features
The medical history of periodontitis is such that only nowadays do doctors have a more or less accurate idea of how to deal with it. But before, the only approach was a radical one - a bad tooth was removed.
If fibrotic periodontitis is established, it is necessary to determine what triggered it. The channels of the root system are examined, when signs of destruction are detected, these areas are treated, the inflamed areas are disinfected. At the end of this stage, you can seal the channel. The etiology of periodontitis in some cases is a poorly placed seal. To cope with the disease, you will have to consult a doctor to remove previously placed fillings, clean the cavity and replace the material with a new one.
If fibrous periodontitis is suspected, the doctor should be checked if possible. When making a diagnosis, treatment should be started immediately. Complications of periodontitis of this form are pain, foci of inflammation, tooth loss.
How not to get sick?
As in the case of many other dental diseases, the most effective method of preventing periodontitis is a thorough and regular cleaning of the oral cavity. Hygienic measures involve twice daily use of toothbrushes and pastes, rinses. An important aspect is the correct choice of brush and suitable paste. It is worthwhile to check with your doctor how to brush your teeth correctly - this will prevent injury to yourself.
Less risk of developing periodontitis, if you regularly visit the clinic in order to remove plaque, stone on the teeth. Once a year, you need to see a doctor for a prophylactic assessment of your oral health. This will determine the violation of the integrity of the teeth at the initial stage, that is, the treatment will be quick and painless.
The doctor knows better than the layman what it is - periodontitis of the tooth, how to deal with it, so only a doctor can be entrusted with the treatment of the disease. Modern clinics use effective equipment for brushing and healing teeth, so it’s wise to use the services of such institutions. To get rid of periodontitis using ultrasound, lasers, diathermocoagulation.
Disease: onset and progress
As mentioned above, periodontitis develops if the tooth is affected by pulpitis. This process is observed as a complication of caries, if you start a tooth condition. Pathological microflora gets access to the channels of the root dental system. From the classification of periodontitis it follows that the disease is non-infectious, infectious. The first is due to trauma, an unsuccessful tooth treatment, the second is infection with staphylococcus, streptococci, fungi, actinomycetes. Such bacteria in the process of life produce toxic substances that can lead to necrosis of organic tissues. Sooner or later it becomes a cause of complications.
Acute form: some types
In the classification of periodontitis, the development of the serous form is mentioned. Such a dental disease manifests itself as a pain syndrome, which intensifies if you try to bite or chew food with a sick tooth. The peculiarity of the form is the presence of a purulent substance, which is stored inside the tooth cavity, without any way out. Soreness becomes stronger if you take a horizontal pose. An increase in sensation accompanies cooling or heating of the affected area.
Serous periodontitis in acute form can provoke facial swelling. In some cases, there is no pain at all. Some patients note that alleviation of the condition during exacerbation can be achieved by pressing on a bad tooth. Sensing the disturbing area does not give effect, since organic tissues are already affected by necrotic processes. Additional problems are associated with the inefficiency of an x-ray as a method for diagnosing a condition.
Purulent acute form
What is it - periodontitis of a tooth in acute purulent form? The term is used to denote a disease that is usually manifested by pulsating soreness. Weakenings are short-term, small. Periodontium - the area of spreading of pus, the tooth is mobile. Often, the disease is accompanied by swelling of the face.
The complexity of the diagnosis is associated with the lack of useful information on an x-ray, although the patient complains of pain. Infection can provoke an increase in the volume of the lymph nodes. Sometimes periodontitis provokes fever, the general poor condition of the patient. If the abscess bursts, complications may develop.
Subtypes of Forms
Acute purulent periodontitis is a collective concept. Several varieties stand out. A periodontal type is possible, in which microscopic abscesses are observed, explained by the influence of purulent secretions. The enodosal type of periodontitis is a condition where pus gains access to bone tissue. The disease is accompanied by infiltration. Subperiosteal periodontitis manifests itself as a swelling of the face, swelling of the gums. Pus accumulates in the periosteum. A complication of periodontitis is a flux that provokes severe pain.
If the periosteum is destroyed, pus from this area enters the soft tissues. Such periodontitis is called submucous. It is characterized by severe facial edema, but the pain is slightly less than with the option of localizing purulent discharge in the periosteum.
The nuances of patient research
If acute periodontitis is suspected, electroodontometry is necessary. As a rule, the pulp does not respond to temperature changes. X-ray does not show changes. If we take blood samples for examination, the content of leukocytes is only slightly higher than normal, but the deviations are insignificant.
Differential diagnosis of cases involves the analysis of all information received on the occasion of the information, as well as an assessment of the condition of the person as a whole. Acute periodontitis is similar to acute pulpitis. An insufficiently careful assessment leads to confusion with osteomyelitis. As a rule, the patient's complaints about pain are analyzed. If the sensations are acute, percussion is observed, and if a focus of inflammation is found in the gum, periodontitis can be diagnosed.
Treat - Do Not Cripple
At home, acute periodontitis can not be cured. If the diagnosis is confirmed, the type of disease is established, the doctor will develop an integrated approach to its elimination. It will require systemic treatment, perhaps it will be a radiological method. Even with the most effective approaches, the risk that the tooth will have to be removed is high enough.
To prevent periodontitis, it is necessary to regularly undergo preventive examinations at the dentist and to avoid any injuries. It should be remembered that the risk of developing the disease is higher against the background of disorders in the respiratory system and digestive system.
Chronicle
In the absence of adequate treatment, an acute disease becomes chronic. It develops quickly enough. The main symptom is severe pain. The syndrome becomes especially pronounced if you eat hotter. Swelling of the gums near the diseased tooth, redness is observed. Perhaps the formation of fistulas.
To alleviate the condition of the patient, the focus of inflammation should be stopped. For this, antibiotics are used. With periodontitis, it is necessary to process the channels of the root system of the itch, organize the drainage of the fluid and restore all the tissues. If endodontic treatment is not possible, an operation will have to be rescheduled.
Popular antibiotics for periodontitis are drugs containing amoxicillin and clavulanic acid. Metronidazole preparations are widely used. Tetracycline was used extensively in periodontitis, but it has now been proven that the combination of metronidazole, amoxicillin, clavulanate shows the best effect. Combination therapy is effective in a wide range of pathological bacteria.
Progress of the disease: how does everything happen?
The first stage of periodontitis is the presence of a local focus that does not have access to neighboring tissues in the periodontium. Gradually, the inflammatory process becomes larger, several areas appear, merging with each other. There is a periodontal lesion, but the space is closed, which leads to an increase in pressure due to the production of fluids by the tissues. Sooner or later, an exudate breaks into the bone jaw subspaces. The pressure decreases, the pain temporarily becomes weaker, the patient's condition improves slightly. The progress of periodontitis continues: the activity of the inflammatory focus is still high, and the periosteum becomes infected over time.
The next stage is explained by the anatomical features of the periosteum. This element is quite dense, therefore, for a long time it withstands the pressure of purulent secretions, the volume of which gradually increases. A tumor appears near the root of the tooth. This area is disturbed by soreness, then the periosteum breaks, the discharge falls on the oral mucosa. This stage is called fistula. Pus gets the opportunity to flow out, the pain becomes weaker, it can completely disappear. Inflammation continues to develop. Lack of treatment can trigger osteomyelitis.
What's next?
The forecasts are relatively good if it was possible to suspect periodontitis on time and seek qualified help. The sooner you start treatment, the more successful the method will be chosen, the better the future of the patient. Over time, periodontitis becomes fibrous.
If there is no possibility to see a doctor or a person is too addictive with going to the clinic, purulent complications form over time. Foci of an abscess appear, the development of phlegmon and periostitis is possible. The condition as a whole is getting worse.
Periodontitis may eventually pass from the acute form to the chronicle. In this case, the condition is generally tolerable, from time to time exacerbations are possible.
To avoid negative consequences, you should visit a doctor. The doctor will first make a diagnosis and determine the features of the case, then provide the ability to clean the diseased area from pus, and clean the canals of the root system of the tooth. Sometimes in the acute stage the only way out is an urgent tooth extraction, dissection of the periosteum. Only in this way can serious complications be avoided.