Periodontitis is the process of inflammation that occurs in periodontal tissues. In this case, bone destruction, inflammation of the gums. Periodontium - the tissue surrounding the tooth. With the disease, one or more periodontal components are affected.
Reasons for the development of the disease
The causes that affect the onset of the disease can be divided into local and general. They have an equal effect on the occurrence of periodontal disease. To local include:
- Plaque. The oral cavity contains bacteria that produce waste products. Daily brushing prevents plaque and plaque. But the balance between tooth tissues and bacteria is disturbed, which leads to the appearance of soft plaque, which later turns into stone. Mineralization contributes to saliva. With an increase in tartar, pressure appears on the gum. Inflammation of the gum pocket leads to periodontitis.
- Saliva. The composition of saliva occupies a special place with the appearance of periodontal. It contains enzymes responsible for the breakdown of food and promotes the formation of stone.
- Iatrogenic factors. Surgery and dental prosthetics increase the risk of periodontitis. The disease develops acutely. Pain is pronounced.
- Significant load on the teeth. Excessive load on the periodontium occurs in case of malocclusion, tooth loss and surgical interventions. If the load is significant, then the nutrition of the tissues changes, which leads to deformation of the teeth.
- No load on the periodontium. With prolonged feeding with liquid food, the tooth bone atrophies, which leads to the appearance of pockets between the tooth and gum.
Common factors for the development of periodontitis
Common factors that provoke the development of periodontal disease include the general condition of the body:
- Vitamin deficiency is the main cause of the development of the disease. A lack of vitamin A, B1, C, E negatively affects the production of collagen. It leads to a change in the structure of the gums. To restore tooth tissue, vitamin A is required. B1 and E improve metabolism and the speed of regenerative processes.
- The state of the vessels affects the appearance of gingival pockets. Atherosclerosis provokes the risk of periodontal disease. In the resulting pockets, the remains of food are collected, the tissue near the bone is destroyed. Perhaps the appearance of pus.
- Decreased immunity allows you to accelerate the process of development of the disease. With the multiplication of pathogenic bacteria in the oral cavity, the body cannot cope with them, which increases the duration of the disease.
- Violation of the thyroid gland increases the risk of periodontal disease. A concomitant disease is diabetes. In this case, generalized periodontitis with a long course occurs.
- Diseases of the gastrointestinal tract increase the histamine content in the blood of the patient, which increases the risk of periodontal inflammation.
- Changes in the composition of the blood provokes the appearance of periodontitis. Decreased hemoglobin, platelets, leukemia leads to a change in the gums, osteoporosis of bone tissue.
- Taking sedatives, antipsychotics, prolonged stress increases the likelihood of developing the disease.
Disease classification
Classification of periodontitis varies in the nature of the course of the disease:
- sharp;
- chronic
- abscess;
- regression.
The disease proceeds locally, affecting only one area of the gum, or diffusely. In this case, the treatment is long and requires the recommendation of a doctor to complete the course of the disease.
The classification of periodontitis according to ICD 10 determines the severity of the disease:
- A mild degree affects no more than 1/3 of the bone. Inflammation of the gingival pocket - not more than 3.5 mm in depth. In this case, the teeth do not stagger. Treatment ends quickly and has a good prognosis.
- Medium severity is characterized by the presence of a gingival pocket up to 5 mm. The teeth become mobile. The process of chewing food is disrupted. There is pain. The bone is damaged to half the root of the tooth.
- The severe form of the disease is determined with a gingival pocket of more than 5 mm and destruction of bone tissue by more than half. Tooth mobility reaches 3 or 4 degrees.
The degree of tooth mobility is a key way to determine the degree of periodontitis during a visual examination:
- 1 degree of tooth mobility is characterized by tooth displacement of not more than 1 mm;
- 2 degree - tooth mobility more than 1 mm;
- 3 degree - the tooth moves in any direction, including vertical;
- 4 degree - the tooth rotates around an axis.
X-ray examination - a type of x-ray suitable for the diagnosis of local periodontitis - allows you to identify foci of varying degrees.
Periodontal disease in children
Periodontal disease in children is different from a similar problem in adults. The child grows, tissue is rebuilt. Immaturity of the body provokes a negative reaction to irritating factors. Soft plaque in a child can quickly lead to the development of periodontitis. The disease goes deeper, affects bone tissue.
In the twentieth century, it was believed that all types of periodontitis are not found in childhood. Recent studies prove the opposite. The tooth mobility in children is attributed to the replacement of milk for permanent, but this is not always justified. In childhood, the disease has a sluggish character. Therefore, parents and doctors pay attention only to serious forms of periodontitis.
Classification of periodontitis in childhood occurs similarly to an adult. Due to untimely diagnosis, a severe degree of the disease is detected.
Types of Periodontitis
Periodontitis often occurs after untreated gingivitis. The infection reaches deep tissues, captures an adjacent tooth. May spread further, affecting the bone and most of the oral cavity. The following types of periodontitis are distinguished:
- focal;
- generalized;
- acute;
- chronic;
- purulent;
- chronic generalized;
- abscessed;
- aggressive form.
Focal
In the classification of periodontitis, focal or local ailment is distinguished. The main difference is the acute course of the disease. Symptoms of this type of periodontitis are:
- pain while eating;
- swelling of the mucosa;
- redness of the gums;
- blood;
- bad breath;
- tooth mobility;
- the appearance of gingival pockets;
- reaction to cold and hot.
With an increase in the focus of inflammation, pain when chewing increases. This type of disease affects children during tooth changes. In adolescence, this type of periodontitis develops into a chronic form. Timely treatment avoids the progression of the disease.
Acute Periodontitis
The acute type of periodontitis is divided into 3 stages:
- Gum bleeding, itching, irritation appear. Possible slight pain from cold. There are no visible changes at this stage.
- Bleeding occurs when brushing your teeth and eating solid foods. A gum pocket appears. The teeth become mobile. There is pain when biting. The person is uncomfortable. At this stage, most often patients turn to dentists for help.
- Bone tissue is partially destroyed. The gums become loose. Teeth loose when chewing. If untreated, the disease at this stage leads to tooth loss.
The cause of acute periodontitis is inflammation. It occurs due to mechanical, less often thermal damage. The active interaction of pathogenic flora and a decrease in immunity leads to inflammation. The permeability of blood vessels increases, blood supply decreases, the structure of tissues is destroyed.
Provoking factors for the development of acute illness are:
- diseases of the nasopharynx;
- chronic cholecystitis;
- diseases of the genitourinary system;
- cysts and granulomas.
Chronic form
According to the classification of ICD periodontitis, determine the chronic form (KO5.3). This is a long-term form of the disease that gradually destroys periodontal tissues. With this course, a person may not notice the disease to the last stage.
The chronic form is dangerous tooth loss. Long-term use of medications, diabetes mellitus, inflammation of the gastrointestinal tract increase the risk of developing this form of pathology.
The main symptoms of the development of chronic periodontitis are:
- bleeding during dental care;
- bite pain;
- inflammation;
- discomfort in the gum area.
The fewer symptoms appear, the longer the illness is not noticed. The pain disappears, bleeding decreases, and the person ceases to worry, but periodontitis progresses. An exacerbation of the disease or a transition to an acute form is possible. At the same time, there is an increase in temperature, increased pain, inflammation increases in size.
Generalized Periodontitis
The disease affects all periodontal tissues. In the classification of the etiology and pathogenesis of periodontitis, this form occupies a special position. With treatment, this is the most severe case. Most often, the cause is pathogenic bacteria. The main risk group is people 30-40 years old. The disease can develop rapidly.
The main symptoms are:
- bleeding gums has a prolonged nature;
- bone tissue is destroyed;
- the gum stops holding the tooth;
- purulent discharge appears, and bad breath increases;
- severe pain when brushing your teeth;
- an increase in tartar.
The severity of the disease is determined after examination and x-rays.
Purulent and abscessed form of the disease
With a purulent periodontal condition, pus appears constantly. If the disease is not treated, then it passes into the stage of abscess. The focus of inflammation and the amount of pus increases. Tissues are destroyed. The tooth cannot be saved. It is necessary to conduct therapy to avoid further infection. At these stages, the pain becomes unbearable.
Aggressive forms
Periodontitis can occur in an aggressive form, in which the disease has an atypical course. In this case, bacteria penetrate the deeper layers of the tooth faster. The disease develops rapidly.
With an aggressive form, the following types of periodontitis are distinguished:
- disease of systemic diseases;
- ulcerative necrotic;
- chronic adult disease;
- fast progressing;
- Type A and B;
- prepubertal.
Chronic periodontitis in adults occurs after 35 years. Pathological changes are not noticed. The disease appears in the entire oral cavity, affecting almost all teeth. It is almost impossible to notice at the initial stage.
Prepubertal periodontitis occurs during teething of permanent teeth. This form is rare and difficult to diagnose.
Rapidly progressive periodontitis occurs at the age of 14-35 years. It is characterized by rapid destruction of bone tissue. The teeth lose their shape. The arc is changing. In this case, plaque on the teeth does not play a big role. Type A is characteristic of young people under 26 years old, type B - up to 35 years.
Ulcerative necrotic periodontitis occurs with untreated forms of the disease and often recurring. If untreated, leads to tooth loss. A timely visit to the dentist will help maintain healthy teeth.
The type of stabilization in periodontitis is determined by the doctor. The tire is selected taking into account the clinical picture and analyzes.