Symptoms of periodontitis concern most people after the age of 35. This inflammatory disease affects the tissues and ligaments that are around the tooth. Pathology leads to the gradual destruction of dentin. A person suffering from periodontitis can lose his teeth by the age of 50. Therefore, at the first signs of this disease, it is necessary to undergo treatment at the dentist in order to preserve dental tissue and not resort to prosthetics.
What is periodontitis
A periodontal is called connective tissue, which is located between the root of the tooth and the bone process of its hole. It is this part of the dental apparatus that becomes inflamed during periodontitis. In addition, the pathological process affects the ligaments that hold the tooth. Many patients suffer from such inflammation and do not even suspect it. Very often the disease is asymptomatic. Sometimes pathology makes itself felt only when the patient is threatened with tooth loss.
The difference between periodontitis and periodontal disease
Often people confuse two diseases - periodontitis and periodontal disease. However, these are different pathologies. With periodontal disease, there is no inflammation in the periodontium. This is a degenerative disease that is accompanied only by tissue destruction. Periodontitis is an inflammatory process. The signs of these two diseases are also different. Periodontitis is always accompanied by swelling and bleeding from the gums, as well as loosening of the teeth due to damage to the ligaments in the early stages. With periodontal disease, such manifestations are not observed, the dental apparatus becomes mobile only in advanced cases. Periodontitis is very common and is characterized by rapid development. Periodontal disease is observed only in 3% of adult patients, while tooth damage is slow.
Causes of the disease
The exact causes of periodontitis are currently unknown. Dentists suggest that microbes play a large role in the development of inflammation. The accumulation and increased reproduction of bacteria in the gum region is noted. Then microorganisms affect periodontium and cause an inflammatory process. Periodontitis often affects people with tooth decay. Also a provoking factor is poor hygiene of the oral cavity. Periodontitis is often observed in people who rarely brush their teeth.
However, the growth of bacteria is far from the only cause of periodontitis. The following factors can also provoke the development of the disease:
- malocclusion and abnormalities in the anatomical structure of the teeth;
- metabolic disorders in the tooth tissue;
- injuries to the jaw and teeth;
- decrease in calcium and other minerals in the dental tissue;
- deterioration in the adaptation of the dental apparatus due to the consumption of mainly soft foods;
- exposure to radiation;
- stresses.
Most often, not one, but several unfavorable factors affect the condition of the gums. Dentists believe that the etiology of periodontitis is associated with the action of enzymes and toxins secreted by bacteria. They contain substances that not only cause inflammation, but also destroy tissue.
Symptoms and degrees of the disease
Periodontitis is divided into acute and chronic. The symptomatology of these two forms of pathology is different. Acute periodontitis is very rare. It is the result of either a severe tooth injury or a chemical burn. The main symptom of this disease is the occurrence of acute pain in the gums. Unpleasant sensations can be localized in the affected area or may be diffuse. Due to intense pain, patients usually seek immediate medical attention.
Chronic periodontitis is much more common. Pain with this pathology usually occurs only during exacerbation, in the remission stage there are no unpleasant sensations. Because of this, a visit to a doctor is often delayed.
Signs of the disease usually appear after gum disease (gingivitis). They depend on the stage of development of the disease.
A mild periodontitis is characterized by itching in the gums. Periodically bleeding occurs. Small painful sensations appear while chewing food. In the morning, the patient secretes sticky saliva, painted in a rusty color. Already at an early stage, pockets form in the gums, and their size is up to 3 mm.
The initial symptoms of periodontitis resemble manifestations of gingivitis. Therefore, at an early stage, it is sometimes difficult to diagnose a pathology. Periodontitis can only be detected with an X-ray.
The average degree of the disease is characterized by an increase in gingival pockets up to 5 mm. The teeth begin to loosen. The roots are partially exposed. When eating hot and cold food, pain is felt. Deformation of the upper teeth and bad breath are noted.
In a severe stage of the disease, the patient's roots are completely exposed, the teeth begin to fall out. Gum pockets increase to 7 mm. It becomes difficult for a person to chew because of pain. General well-being worsens, headache, malaise, and fever occur. Gums look inflamed and reddened, purulent contents leave their pockets.
Features of the disease in children
The signs of periodontitis in adults have been described above. In children, this disease is diagnosed much less frequently. However, this ailment can occur even in preschool age, when the child does not yet have permanent teeth. The cause of the pathology can be poor oral hygiene, congenital defects of the bite and teeth, trauma and shortening of the frenum of the tongue. Often, periodontitis occurs in those children who have the habit of chewing on a pen or other objects.
If the disease appears at the stage of teething, then the main symptom of periodontitis is acute pain. Itching does not occur in young children. White plaque is noted. The teeth begin to loosen and fall out. This disease can affect the formation of the dental apparatus.
Pathology also occurs at puberty. The cause of the disease can be hormonal changes in the body of a teenager. Symptoms of periodontitis in this case are the same as in adults. This is itching and fullness in the gums, the release of thick saliva, the appearance of bad breath. Pathology is accompanied by the destruction of tooth and bone tissue.
ICD classification
According to ICD-10, periodontitis belongs to the class of diseases under the code K05 ("Gingivitis and periodontal diseases"). It should be noted that the acute and chronic form of pathology are classified in different ways. Acute periodontitis is indicated by the code K05.2. The same group of diseases also includes abscesses, which are complications of periodontal inflammation. Chronic periodontitis is indicated by code K05.3.
Diagnostics
When diagnosing gum periodontitis, it is important to differentiate this disease from gingivitis and stomatitis. Inflammatory diseases of the gums and mouth are not accompanied by tissue destruction and the formation of gingival pockets. However, it must be remembered that under adverse conditions, these diseases can pass into stomatitis.
Diagnosis begins with an examination of the oral cavity. With periodontitis, the following symptoms are noted:
- hyperemia and swelling of the gums;
- friability of the edges of the gums;
- tartar deposits;
- gingival pockets;
- loosening of teeth;
- deformation of incisors;
- exposure of roots.
For these symptoms, the dentist may suspect periodontitis. To clarify the diagnosis, the following examinations are prescribed:
- Roentgenography. With pathology in the picture, you can see the destruction of the partitions between the teeth.
- CT scan of the teeth. This study shows the degree of destruction of bone tissue.
- Doppler ultrasound. This diagnostic method helps to detect a violation of the blood supply to the gums and periodontium.
Usually these methods of research are enough to make a diagnosis. Additional diagnostics are prescribed in severe cases or during a course of treatment to assess the effectiveness of therapy:
- The degree of hypoxia in the gums is determined using a special device. It shows how poorly the nutrition of the tissues around the tooth is.
- Examine bone density. This analysis is usually performed to determine the effectiveness of the treatment.
In some cases, a blood test is prescribed for white blood cells and ESR. It helps to detect the presence of an inflammatory process.
Drug treatment
How to treat periodontitis? Before prescribing medications, deposits, stone and plaque must be removed from the teeth and gums. Perform professional cleaning of the oral cavity by various methods. To do this, use a laser, ultrasound or Air-flow apparatus.
After the oral cavity is completely cleansed, they begin drug treatment. The following drugs are prescribed:
- Antibiotics "Tsifran", "Linkomycin", "Amoxiclav". They are used in tablets or injections. They also make applications for sore spots with medicinal solutions. This helps destroy pathogenic bacteria in the oral cavity.
- Rinses with Maraslavin, Miramistin, Chlorhexidine solutions. These drugs also have bactericidal properties.
- Gels "Holisal", "Metrogil Dent". They are inserted into the gingival pockets or rubbed into the gums.
With periodontitis, antibacterial drugs should not be injected directly into the gums with a syringe. Continuous injections of antibiotics can contribute to tissue destruction.
If the patient has carious teeth, then oral cavity sanitation is carried out simultaneously with the treatment of periodontitis. However, prosthetics should not be used during therapy. Due to the destruction of bone tissue in the later stages of the disease, the crown can be poorly fixed.
Dentists recommend using special toothpastes for periodontitis. Daily toothbrushing with medicinal compounds is also part of the therapy. The following pastes are recommended:
- "Periodontax". This paste contains fluoride, mineral salts and plant components. It relieves inflammation and bleeding well. Its disadvantage can be considered only the bitter taste of the composition.
- Lacalut Asset. The paste contains the antiseptic chlorhexidine, as well as aluminum lactate, which has astringent properties. However, such a composition can be used for no more than 2 weeks.
- "Parodontol Asset". The paste well strengthens loose teeth and improves the condition of enamel. However, it weakly relieves inflammation.
- "Forest Balsam." The drug contains herbal ingredients that effectively relieve inflammation.
- "Elmex Sensitive." The paste has analgesic properties, and also destroys bacteria.
You should also choose the right toothbrush. It should be medium hard. Too coarse bristles can cause bleeding from the gums. The brush should contain both short and long fibers - this will help to thoroughly clean your teeth.
Surgical methods
How to treat periodontitis with surgical methods? Dental surgery is usually done in the absence of the effect of conservative therapy. Most often, curettage is performed. The gingival pockets are expanded, cleaned of plaque and stone, and then the affected areas are removed. Such an operation helps in the early stages of the disease.
In advanced cases, surgery is carried out in a patchwork fashion. Under local anesthesia, gum patches are removed to expose the roots as much as possible. Then the open areas are cleaned, and parts of the tissues are returned back and sewn. This operation is called gingivotomy.
The disadvantage of these operations can be considered trauma to nearby tissues. A more gentle method is splinting. With this surgical procedure, the loose teeth are strengthened with crowns, clasp prostheses or a special crossbar with fiberglass tape. However, such measures only help in the initial stage of the disease.
Hardware therapy
Recently, the Vector apparatus has been used for non-surgical treatment of periodontitis. This device operates with the help of ultrasound waves. It is equipped with various nozzles.
Using the device you can remove dental plaque, plaque and stone. It cleans the gingival pockets to a depth of at least 11 mm. This allows you to get to the most remote sections of the periodontium.
Is it possible to treat periodontitis at home using the "Vector" apparatus? This question often worries patients. The therapy is almost painless, but this device is intended for use in a dental clinic. Using it at home is highly undesirable. Apparatus therapy has contraindications that only a specialist can evaluate. In addition, without special preparation it is very difficult to carry out a full cleaning of the oral cavity.
Folk remedies
The possibility of treating periodontitis at home should be agreed with the doctor. It is impossible to get rid of such a complex disease with the help of folk remedies alone. Rinsing with home-made preparations is not always effective, because medicinal compounds act only on the gums and do not fall into dental pockets. As a result, they do not reach the source of infection.
However, the use of alternative recipes can complement drug therapy. Rinsing the mouth with anti-inflammatory and bactericidal solutions will help alleviate the condition and relieve itching and pain in the gums. The following remedies are recommended:
- Decoctions of calendula, chamomile or pine needles. These plants have bactericidal properties. They relieve inflammation and soothe gums.
- The solution of hydrogen peroxide. Take 10 drops of the drug in 50 ml of water. This remedy is a good antiseptic and eliminates infection on the gums.
- Propolis alcohol tincture. To prepare a rinse, you need 1 teaspoon of the drug per 50 ml of water.
- Green tea. It is brewed with mint in equal proportions. The resulting composition needs to rinse your mouth several times a day.
- Soda with salt. You need to boil 250 ml of water. 5 mg of baking soda and 3 mg of sodium chloride are dissolved in a liquid. The composition is cooled and used to rinse every 2-3 hours during an exacerbation of the disease.
You can also use rinsing agent "Triclosan". This product can be purchased at the pharmacy. It contains an antibacterial component. However, such funds should be used with caution. Triclosan is not recommended for use for more than 1 week. Otherwise, microflora may be disturbed and a fungal infection in the mouth may develop.
Prevention
To prevent the development of the disease, it is necessary to brush your teeth regularly and treat caries on time. It is necessary to visit the dentist at least twice a year in order to prevent periodontitis and other dental pathologies.
Solid foods should be included in the diet. This not only strengthens the teeth, but also contributes to their natural cleansing. Twice a day you need to massage the gums. Fingers make light circular movements near the teeth. It stimulates blood circulation in the gums.
With a tendency to periodontitis, special preventive toothpastes should be used. If a person has signs of tooth mobility, it is urgent to consult a doctor. This will help prevent their loss and further prosthetics.