When there are problems with the oral cavity, it is extremely difficult to ignore such unpleasant changes. It is for this reason that the prevention of periodontal diseases and their subsequent treatment will always be relevant. After all, diseases of this group are quite common, both in adults and in children.
What is the essence of the disease
In order to better understand this issue, there are a few key concepts that need to be addressed. You can start with the periodontium.
This term is used to refer to tissues adjacent to the tooth and securely fixing it in the jaw. In fact, we are talking about the periodontal ligament (connects the bone hole and the root of the tooth), gums, bone tissue, alveolar processes and the cement of the tooth itself. It makes sense to pay attention to the various constituent tissues, for the reason that such a disease can affect each of them individually.
As for the process itself, which has a destructive effect on the elements of the oral cavity, in most cases it is inflammation of the entire structure or tissues of the gingival margin.
By nature, diseases associated with the gumsand teeth, may be tumorous, dystrophic or inflammatory.
It should be understood that periodontal disease is one of the most common problems that patients come to dentists with. Having studied the WHO data, you can find out the following fact: diseases of this kind in children occur in 80% of cases in many countries of the world. Adults also often have to deal with diseases of this group.
Reasons
Of course, problems with the gums and other tissues of the oral cavity do not occur by themselves - certain processes contribute to their appearance.
As for the specific factors relevant to the etiology of diseases in this group, they can be divided into two key categories: local and general. In fact, we are talking about dental plaque, trauma, subgingival and supragingival calculus deposits, prosthetic defects, crowding of teeth, anomalies in the attachment of the frenulum of the tongue and lips, etc.
Any periodontal disease is often the result of an imbalance in the biological system (plaque and oral fluid).
Speaking more specifically about general factors, it is worth highlighting the lack of vitamins of groups B, C, E. Their deficiency has a negative impact on the structure and function of periodontal tissues. The lack of the necessary vitamins can cause such problems as a violation of protein, phosphorus-calcium, carbohydrate and lipid metabolism. Do not exclude the risk of organic and functional changes in the digestive,nervous, vascular, endocrine, as well as the nervous systems of the body.
It makes sense to pay attention to the fact that periodontal disease can be caused by such problems as hereditary predisposition, blood diseases, allergic reactions, changes in the body's reactivity, immunodeficiency and disruption of the hormonal system.
Periodontosis
The basis of this disease is an atrophic-dystrophic process in periodontal tissues. The course of such a disease can be described as slow, without clear symptoms.
In most cases, periodontal disease is manifested by exposing the roots of the teeth or a visual increase in their length due to gum subsidence. Sometimes patients may feel pain in the teeth and itching in the gums.
Treatment and prevention of periodontal disease in this case is reduced to a symptomatic effect through special treatments. It can be "Fluogel", "Ftorlak", etc. As a result, the increased sensitivity of the teeth is removed. The doctor may also prescribe gum auto-massage. This is done in order to correct trophic disorders. In some cases, vestibuloplasty operations are relevant, but the effect of their use cannot be long-term. Wedge-shaped fillings are also possible.
Entiotropic treatment is not used, as the causes of periodontal disease are still not really clear.
Periodontitis and gingivitis
If we talk about such a manifestation of problems associated with the tissues of the oral cavity, like periodontitis, then it is worth noting that thisan inflammatory disease that affects all types of tissues in the jaw area. This condition is characterized by the appearance of progressive destruction of the alveolar processes of the jaw bones, as well as the destruction of the dentogingival junction.
As for gingivitis, it can be described as an inflammatory process that affects only the tissues of the gum margin. This means that only superficial gum tissue is affected.
It is worth knowing about the following fact: these forms of the disease are often interrelated. The bottom line is that the inflammation that has appeared in the tissues of the gums can eventually affect other elements of the periodontal structure. For this reason, a diagnosis such as gingivitis should not be ignored, as it can lead to a much more tangible problem later.
Finding out the causes of periodontal disease, it is necessary to note the influence of a whole range of factors, both external and internal. So, with regard to gingivitis, most often this condition is caused by neglect of oral hygiene, leading to the deposition of tartar and accumulation of plaque.
This means that by taking basic preventive measures, a fairly serious problem can be prevented.
Atrophic gingivitis
Continuing to consider the features of periodontal disease, it is worth paying attention to this form of the disease. It develops against the background of a chronic inflammatory process affecting both the entire dentition and individual teeth.
In this case, the mucous membrane becomes pale pinkcolor, and the gingival papillae are completely absent or smoothed out. In this state, the patient does not feel much discomfort. Complaints are usually associated with mild pain or slight itching in the gum area.
Chronic gingivitis
Classification of periodontal diseases includes such negative changes in the state of oral tissues.
Such a problem is most often recorded in patients with pathology of the digestive or cardiovascular system. The causes of the development of the disease include immunodeficiency states, as well as the impact of environmental factors, including industrial ones. We are talking about chronic poisoning with lead, mercury and other harmful elements. Therefore, it is important to pay attention to working conditions and not to take lightly the possible risks of adverse he alth effects.
The pathogenesis of this type of periodontal disease comes down to the fact that after exposure to an adverse factor on the tissues, bleeding of the gums appears during brushing your teeth and eating solid food, as well as bad breath and a burning sensation.
To eliminate chronic gingivitis, it is necessary first of all to neutralize the factors that cause the development of the disease. Attention should be paid to professional oral hygiene. A full-fledged competent diet, body detoxification and constant water intake will be relevant.
Ulcerative necrotizing gingivitis
This is another form that inflammatory periodontal disease can take. Precededsuch a state of dysbacteriosis, a decrease in the body's resistance, hypoavitaminosis, influenza, hypothermia, immunological problems, various stressful situations and tonsillitis.
It will not be superfluous to know that in case of development of gingivitis against the background of blood diseases, differential diagnosis should be carried out.
Treatment involves the rapid elimination of the focus of inflammation and the implementation of the necessary measures to stop its effect on the rest of the tissues of the oral cavity. It is also worth paying attention to reducing general intoxication. As measures that have a local effect, you can use the removal of necrotic tissue, anesthesia and treatment with broad-spectrum antibacterial drugs of those areas of the gum that have been affected.
Do not forget about prevention: to prevent the recurrence of the disease, you need to avoid the occurrence of infectious diseases and not delay dental treatment in case of obvious problems.
Focal juvenile periodontitis
Those who are interested in the classification of periodontal diseases should definitely pay attention to this form of inflammation.
The essence of this problem is reduced to the selective defeat of the supporting apparatus of the first permanent teeth. Bacteria-actinomycetes provoke such a disease. In the vast majority of cases, such a problem makes itself felt in those children whose parents are carriers of the microorganism mentioned above.
Inflammatory reaction is minimal, but the immune system reactions are suppressed. Over time in the child's bodyspecific antibodies are formed, allowing the next permanent teeth to remain protected.
Treatment of this type of periodontal disease is reduced to the use of antibiotics for 21 days or more, as well as local interventions. Speaking about the long-term use of antibiotics, it is worth noting that this measure is necessary, since harmful microorganisms penetrate not only into the periodontal groove, but also into the periodontal pocket and even deep into bone structures and tissues. Such a negative state is quite persistent, therefore, a long-term effect is required.
Drug-resistant and rapidly progressive periodontitis
This problem is a consequence of the influence of specific microflora of several species. If several types of pathogens act simultaneously, then the action of each of them is enhanced, which leads to tissue destruction and suppression of the immune response.
Given the pathogenesis of this type of periodontal disease, the most effective treatment strategy would be intensive antimicrobial therapy (at least 3 weeks) and thorough mechanical treatment of periodontal pockets.
Surgical intervention is also possible. In this case, flap operations will be relevant, which are done only after the patient has completed a full course of antimicrobial therapy.
In order for the treatment to be as effective as possible, it is necessary to initially conduct a microbiological analysis of the contents of tissue biopsy specimens and periodontalpockets.
Tumor lesions of the periodontium
What makes these diseases special is the fact that they are extremely difficult to predict due to the development of this disease only in people who initially have a predisposition to such manifestations.
Hormonal changes can be identified as a factor provoking the development of tumor and tumor-like lesions. This may be, for example, the accumulation of growth hormone during pregnancy or puberty. The reasons for the appearance of tumor lesions can also include inflammation preceding the disease, or the influence of a traumatic factor that is chronic in nature.
Recently, doctors have fixed another reason for the manifestation of such a pathology as periodontal tumor lesions. We are talking about the active use of anabolics, which young people often use during bodybuilding and other strength sports.
Methods of treatment of periodontal diseases in the case of this pathology are reduced to the elimination of inflammation and trauma (if the latter is present) and, if necessary, the removal of overgrown tissues by surgery. The operation is the most relevant method for such diagnoses as "hypertrophic gingivitis", "gingival fibromatosis" and "interradicular granuloma".
After surgery, it is important to carefully follow the rules of oral hygiene and use antibacterial and special antiseptic rinses.
Diagnosis of periodontal diseases
The diagnosis process takes into account the degreethe nature and prevalence of the process, as well as the clinical picture as a whole.
If we are talking about periodontitis, then differential diagnosis in this case will be focused on identifying three main symptoms, with which you can determine the severity of the disease. We are talking about bone resorption, pathological tooth mobility and the depth of the periodontal pocket.
Acute and chronic forms are identified by the commonality of the following symptoms: swelling and hyperemia of the mucous membrane of the alveolar process, pain in a particular tooth when squeezing or chewing food, infiltrate and worsening of the patient's condition as a whole.
As a distinguishing feature that indicates this type of periodontal disease, abscesses can be identified that appear in different places. First one passes, and after 5-7 days another appears. The place of their localization is close to the gingival margin, but there is no message with the periodontal pocket.
The definition of the various forms of gingivitis has been presented above. But as for the diagnosis of traumatic nodes, in this case, in addition to the degree of periodontal damage, it is necessary to establish the etiological factor. For these purposes, a standard survey and a survey method are suitable. After that, you will need to pay attention to the pathogenesis of the disease.
Treatment
In principle, the diagnosis and treatment of periodontal diseases come down to identifying specific symptoms, determining the form of the disease, its features and then neutralizinginflammation along with painful symptoms.
But, depending on the situation, the methods of overcoming the disease may have certain differences.
It should also be understood that the key goals of treatment are the restoration and preservation of chewing function, the normalization of aesthetics and the neutralization of the negative impact of pathological processes both on the body as a whole and on periodontal tissues in particular.
It is difficult to single out a separate method of influencing the problem as the most relevant, since only complex treatment of periodontal diseases can give the desired result.
It is also important to know that there are a number of basic principles on which the process of overcoming the disease is built. This is individuality, complexity, pathogenetic, as well as etiotropic therapy. A series of restorative measures completes the treatment process.
As for the key tasks that clinical periodontics provides, they look like this:
1. Pathogenetic substantiation.
2. Impact on the microbial (etiological) factor.
3. Measures aimed at preventing the progression of the destructive process.
4. Therapeutic effect on the entire body and periodontal tissues in particular. The essence of entiotropic therapy in this case is to eliminate the underlying cause of the disease.
5. Restoration of the functional and morphological characteristics of the periodontium.
There are now many different antimicrobials available with the right degree ofeffects, which are presented in a variety of forms (threads, gels, elixirs, plates, ointments, etc.). But it is important to understand that the unsystematic use of such funds can aggravate periodontal disease in children and adults, causing the development of oral candidiasis and a violation of the microbiocenosis of the oral cavity.
It is for this reason that after a professional diagnosis, a treatment plan should be drawn up by a qualified doctor who is able to take into account all the individual characteristics of the patient's condition with periodontal pathology. These features include the duration of the disease, the general condition of the patient, the treatment that was carried out before, its results and other factors.
An example is the effect on catarrhal gingivitis. First of all, the patient is taught proper oral hygiene, after which local irritants are eliminated. This can be a filling of teeth affected by caries, with the restoration of contact points, as well as the removal of dental deposits.
The next stage of treatment, which will help eliminate periodontal disease, is local anti-inflammatory therapy, during which the use of phytopreparations is used. Physiotherapy treatment in the case of catarrhal gingivitis will improve microcirculation. For this reason, the patient may be shown electrophoresis, hydromassage of the gums and other procedures.
With appropriate indications, it is possible to eliminate the incorrect position of the teeth, anomalies in the development of soft tissues and bite. In this case, it is noticeabledrugs can help. For example, the gel contains components that have a sufficiently high therapeutic effect. The method of its application is not complicated: after the antiseptic treatment of the gingival margin is completed, the teeth are isolated with cotton rolls, followed by their drying. To apply the gel, a syringe or trowel is used. The gingival sulcus or marginal gingiva is selected as the application site.
It is also recommended to use new generation keratoplasty 3-5 days after the onset of the disease. The result will be stimulation of reparative processes.
Results
Prevention of periodontal disease and treatment of this pathology is an important topic for many, since diseases of the tissues of the oral cavity disturb people of various age categories quite often.
In order not to face gingivitis, periodontitis and other similar ailments, you need to constantly adhere to the rules of oral hygiene and take care of the condition of the body as a whole. If the first signs of the disease were noticed, it is better to immediately go to the doctor, then there are chances for a quick neutralization of the problem.
