Periodontitis is one of the most common diseases of a dental nature. The launch of the pathological process occurs under the influence of various adverse factors. The disease is characterized by the presence of an inflammatory process in the gums surrounding the tooth, against the background of which tissue destruction occurs. Most patients ignore the first alarming symptoms and seek medical help when the existing symptoms significantly worsen the quality of life. Meanwhile, advanced periodontitis can lead to complete tooth loss.
Development mechanism
Pathology manifests itself gradually, starting with the inflammatory process in the gums, which bleed with any mechanical effect on them. Over time, exposure of the neck of the teeth occurs. At the same time, their angle of inclination changes, and therefore they become extremely mobile. As a result of the pathological process, a pocket is formed between the gum and the tooth, which serves as a favorable environment for the propagation of pathogens.
There are 3 types of periodontitis:
- Acute.
- Chronic.
- Necrotizing.
The first type is characterized by a rapid course, that is, the rapid destruction of teeth and gums. In chronic periodontitis, the pathological process develops very slowly, while patients experience exacerbation episodes, which are replaced by long periods of remission. The necrotizing form is considered the most severe, it is characterized by the death of soft and dental tissues. It occurs, as a rule, in people with severe immunodeficiency.
Pathogenesis
Periodontitis is a disease whose main cause is plaque, which hardens and forms stone over time.
The development of the pathological process can occur under the influence of the following provoking factors:
- Smoking. Tobacco helps to slow down the reaction rate of the body’s defenses, which increases the risk of bacterial flora joining the periodontium (tissues surrounding and securely fixing the tooth). Also, in smokers, the regeneration processes take longer, which worsens the course of the disease. In addition, the substances contained in tobacco, reacting with saliva, contribute to the creation of a favorable environment for the functioning of pathogens.
- Non-observance of hygiene rules. An insufficiently high degree of purification of the oral cavity most often causes periodontitis. Plaque hardens over time and turns into stone.
- Hereditary predisposition. It is extremely rare, but still becomes the cause of the development of the disease. The risk group includes people whose close relatives suffer from periodontitis.
- Violation of the production of saliva. Against the background of a decrease in secretion production, the process of cleaning the oral cavity worsens naturally. As a result, plaque and tartar begin to form. In most cases, saliva production is impaired while taking anti-inflammatory drugs and antidepressants.
- Diabetes. In patients with a similar diagnosis, the disease is detected much more often. The difficulty lies in the fact that with diabetes mellitus, treatment of periodontitis rarely leads to a positive result.
- Hormonal imbalance. Most often, such a violation occurs during pregnancy, lactation, menopause, as well as against the background of some diseases. Hormonal imbalance helps to weaken the body's defenses, which increases the risk of pathology. For example, if a woman suffered from an inflammatory process in the gums before pregnancy, then periodontitis may develop during the period of gestation.
- An unbalanced diet leading to a deficiency of vitamins B and C, as well as calcium. The latter is important for bones, without it, not only the teeth are destroyed, but the entire musculoskeletal system suffers. With a lack of vitamins B and C, the strength of the connective tissue decreases, which increases the risk of periodontitis.
- Regular consumption of soft foods. Teeth constantly need to provide a load, otherwise the process of self-cleaning is disrupted. In addition, the provoking factor is the habit of chewing food on one side. In this case, the load is distributed irrationally.
The risk group also includes persons with an incorrect bite and / or shape of the teeth.
Causes of the development of the disease in children
The disease can be diagnosed for the first time with teething. In this case, it is customary to talk about prepubertal periodontitis. In children, the main cause of the disease is poor oral hygiene.
In addition, the state of the body's defenses is of no small importance. Against the background of their weakening, the likelihood of developing an inflammatory process that gradually turns into a disease increases.
Symptoms
Periodontitis is a pathology, the course of which is extremely rarely accompanied by the appearance of painful sensations.
At the initial stage of the development of the disease, signs of gingivitis appear:
- gum redness;
- swelling;
- bleeding
- local increase in body temperature.
If you do not consult a doctor at this stage, both soft and bone tissues are involved in the pathological process. As a result, the separation of the gums from the teeth begins, due to which the latter look longer, and pronounced gaps are formed between them. The progression of the disease leads to accumulation of pus and bad breath. Patients at this stage complain of a constant metallic taste, in addition, the process of tooth loss starts.
Since periodontitis is not accompanied by pain, the first alarming sign is bleeding gums. If it appears, you must immediately consult a dentist. The urgency is due to the fact that at this stage the process is reversible, since the periodontal ligament is not yet involved in the inflammatory process.
Developmental stages
Pathology can be either localized or generalized. In the first case, the inflammatory process proceeds in the area of one or several teeth, in the second - in almost all.
In addition, there are several degrees of severity of periodontitis:
- Easy. It is characterized by slight exposure of the tooth. The depth of the periodontal pocket can be up to 3.5 mm, it is easily visualized during the examination by a doctor. At the same time, the teeth remain motionless.
- Medium. The periodontal pocket has a depth of 3.5-5 mm. The roots of the teeth at this stage are bare half. In addition, their slight mobility is noted.
- Heavy. The depth of the periodontal pocket is more than 5 mm. In this case, the roots are bare more than half. Marked tooth mobility is noted .
Ignoring the disease can lead to an abscess.
Conservative treatments
Pathology requires an integrated approach. At an early stage of development, it is possible to get rid of the disease using non-surgical methods. The appropriateness of their appointment is assessed by the doctor based on the results of the diagnosis, which consists in examining the patient and analyzing the x-ray of the teeth.
The conservative treatment of periodontitis consists of the following items:
- Local treatments.
- Physiotherapy.
As a rule, patients seek qualified medical help at the stage of a pronounced pathological process. In such cases, the treatment of periodontitis is aimed at preventing the deepening of existing gingival pockets and stopping the destruction of soft and bone tissues. The duration of therapy is delayed when pathogens are attached.
Local treatments for periodontitis include the following:
- Oral hygiene. This procedure is one of the most important. The process of removing plaque can only be carried out by a dentist using special tools. The result of professional oral hygiene is to cleanse the teeth of pathogens accumulated on them. In addition, the progression of the disease is significantly slowed down.
- Laser treatment of periodontitis. Its purpose is to disinfect the oral cavity, remove tartar and eliminate the pathological contents of periodontal pockets. During the treatment of periodontitis with a laser, the patient does not experience severe discomfort. The procedure is carried out without anesthesia, immediately after its completion, the patient can begin his daily activities.
- Selection of a suitable toothbrush and toothpaste. The dentist, based on the individual characteristics of the patient’s health, talks about the rules for cleaning the oral cavity. After that, the doctor helps with the choice of toothpaste and brush of optimal hardness. It is important to understand that properly selected personal care products have only a symptomatic effect. With the help of medical pastes, it is possible to eliminate swelling of the gums and their bleeding, but the disease itself does not disappear.
- Treatment with anti-inflammatory drugs. After thoroughly cleaning the periodontal pockets, it is necessary to stop the progression of the disease and the increase in the number of pathogenic microorganisms. Currently, there are several dosage forms that differ in the mechanism of exposure and degree of effectiveness. These include: ointments, creams and gels. The latter are the most modern dosage form. The advantage of using gels is that they are perfectly fixed on the mucous membrane, and their active substances easily penetrate through it into the focus of the pathology. A lot of drugs are being sold on the pharmaceutical market, the following are recognized as the most effective: Kamistad, Holisal, Asepta, Metrogil Denta. Treatment of periodontitis with ointments and creams is allowed, but the duration of therapy in this case increases. This is due to the fact that these dosage forms have a fat base, through which it is more difficult for active substances to penetrate the gums.
- The use of periodontal dressings. Their task is to provide a longer exposure to drugs introduced into the foci of inflammation. Without the use of gingival dressings, the effect of applying gels, ointments and creams is minimized, since they are very quickly washed out with saliva.
- Taking antibiotics. With periodontitis, this group of medicines is prescribed very often. Before recommending this or that remedy to the patient, the doctor must accurately establish the pathogen and direct the patient for analysis, as a result of which his body's sensitivity to various active substances of the drugs will be established. Antibiotics for periodontitis help stop the progression of the disease and eliminate the inflammatory process.
- Injection To reduce swelling in the gums, the doctor may prescribe injections. With periodontitis, glucose or hydrogen peroxide is used. To relieve inflammation, hormone-containing drugs are injected. In most cases, this measure is resorted to with exacerbation of periodontitis.
- The intake of vitamins. It is necessary to strengthen the body's defenses.
- The intake of enzymes. As a rule, they are prescribed if the patient suffers from a severe form of pathology. Enzymes contribute to the splitting of necrosis, due to which the healing process is accelerated.
In addition, the specialist prescribes drugs that help eliminate the root cause that caused the disease.
After the main treatment, a set of rehabilitation treatment procedures is indicated. Their task is to improve the blood circulation in the affected soft tissues.
The most effective methods are as follows:
- Hydrotherapy. The essence of the method: the doctor irrigates the oral cavity with water containing carbon dioxide and drugs.
- Electrotherapy. Special pads are moistened with a healing solution and applied to the gums. Then, through the electrodes, current flows to them.
- Vacuum massage. It is carried out using special equipment. Massage helps to normalize blood circulation and cleanse teeth from plaque.
- Mud therapy. Applications in combination with hydro and electrotherapy are especially effective.
- Phonophoresis. In the pathological focus through ultrasonic waves, the flow of ascorbic acid is provided, which positively affects the state of the gums.
If taking medications for periodontitis does not lead to a positive result, the doctor decides on the advisability of using invasive techniques.
Surgical intervention
Indications for surgical manipulation are the following conditions:
- inefficiency of conservative methods;
- large depth of periodontal pockets;
- tooth mobility;
- malocclusion;
- severe gum damage;
- involvement in the pathological process of the alveolar processes.
There are several methods of surgical treatment of periodontitis:
- Curettage. After preliminary anesthesia, the doctor eliminates the plaque that has formed under the gum, also clears the root of the tooth from it and scrapes out the pathologically overgrown soft tissue. The final step is suturing.
- Gingivectomy is simple. The surgeon dissects the gum and removes the overgrown tissue and tartar, and then applies a sterile dressing to the wound. After 2 days, it is removed.
- Gingivectomy is radical. After dissection of the gums, the doctor removes pathologically altered tissues (both dental and soft). Then the specialist treats the wound with drugs and applies a periodontal dressing.
- Patchwork operation. It is indicated for a large number of affected teeth. The doctor makes deep cuts in the gums (down to the bone), after which he separates and processes the mucoperiosteal flap. The bare part of the gum is scraped. After that, the separated tissue returns and is fixed with sutures.
- Hemisection of the tooth. Using a separation disk, the doctor divides it into 2 parts and removes part of the affected root. By the same principle, his amputation occurs.
- Plastic gums. It is carried out in various ways.
- Orthopedic treatment.
In the presence of complications (for example, an abscess), the patient is prescribed an emergency operation. In the process of surgical intervention, the focus of inflammation is opened and its drainage.
Folk methods
Information on how to treat periodontitis at home should only be provided by a doctor. The use of alternative methods does not exclude the need to seek qualified medical help.
The most effective recipes for improving the course of the disease:
- Prepare fir and sea buckthorn oils. Mix the components in equal proportions. Wrap the bandage on the index finger, moisten in the mixture. Massage the affected areas for 10 minutes twice a day.
- Grind calendula and linden flowers. Mix the components in equal proportions, pour boiling water. Insist 20 minutes. Strain and rinse the mouth with the resulting product at least 4 times a day.
- Grind the root of the oak. Take 1 tsp. funds and pour 250 ml of cold water. Put the container on fire. Boil for 20 minutes. After cooling, strain and rinse the mouth with the resulting broth as often as possible.
Before using this or that prescription, consult your dentist. This is due to the fact that some plants reduce the effectiveness of drugs.
Prevention
After effective treatment of periodontitis, it is necessary to regularly follow certain recommendations, as a result of which the risk of re-development of the disease is significantly reduced.
The complex of preventive measures consists of the following items:
- Rinse the mouth with decoctions prepared from medicinal plants.
- Periodically apply anti-inflammatory applications with dental gel on the gums.
- Regularly undergo a course of physiotherapy procedures.
- Use only toothbrushes, toothpaste and floss that are suitable for the person.
- Visit the dentist every six months for the purpose of a routine examination.
To prevent the occurrence of periodontitis, due attention must be paid to the rules of hygiene. Toothbrushing should not take less than 2 minutes.
Finally
Periodontitis is the most common dental disease. It is characterized by the development of the inflammatory process in the soft tissues, which over time are separated from the tooth, which can also be destroyed. In the formed periodontal pockets, the accumulation and reproduction of pathogens takes place.
Currently, the disease can be eliminated by both conservative and surgical methods. The first are used at an early stage in the development of pathology. Surgery is inevitable with a large depth of periodontal pockets and the presence of complications. , . , .