Periodontitis is one of the most common dental diseases. 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 which tissue destruction occurs. Most patients ignore the first alarming symptoms and seek medical help when the existing signs significantly impair the quality of life. Meanwhile, advanced periodontitis can lead to complete loss of teeth.
Development mechanism
Pathology manifests itself gradually, starting with an inflammatory process in the gums, which bleed with any mechanical impact on them. Over time, the neck of the teeth becomes exposed. At the same time, their angle of inclination changes, in connection with which 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 reproduction.pathogens.
There are 3 types of periodontitis:
- Spicy.
- Chronic.
- Nekrotizing.
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 episodes of exacerbation, 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 persons with severe immunodeficiency.
Pathogenesis
Periodontitis is a disease whose main cause is plaque, which hardens and forms calculus 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, and therefore increases the risk of attachment to the periodontium (tissues surrounding and securely fixing the tooth) of the bacterial flora. Also, in smokers, 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 an environment favorable for the life of pathogens.
- Failure to follow the rules of hygiene. Insufficiently high degree of cleansing the oral cavity most often causes periodontitis. Plaque over timehardens and turns to stone.
- Hereditary predisposition. It is extremely rare, but still becomes the cause of the development of the disease. The risk group includes persons whose close relatives suffer from periodontitis.
- Impaired saliva production. Against the background of a decrease in secretion production, the process of cleansing the oral cavity in a natural way worsens. As a result, plaque and tartar begin to form. In most cases, saliva production is disrupted by 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, 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 the course of certain diseases. Hormonal imbalance contributes to the weakening of the body's defenses, which increases the risk of pathology. For example, if before pregnancy a woman suffered from an inflammatory process in the gums, then during the period of bearing a child, periodontitis may develop.
- Unbalanced diet leading to deficiency of vitamins B and C, as well as calcium. The latter is important for bones; without it, not only 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 developing periodontitis.
- Regular consumption of soft foods. Teeth constantly needensure the load, otherwise the process of their self-cleaning is violated. 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 people with malocclusion and/or teeth shape.
Causes of the development of the disease in children
The disease can be diagnosed for the first time during the eruption of milk teeth. In this case, it is customary to speak of 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, gradually turning into a disease, increases.
Symptoms
Periodontitis is a pathology, the course of which is extremely rarely accompanied by the occurrence of painful sensations.
At the initial stage of the development of the disease, signs of gingivitis appear:
- reddening of the gums;
- puffiness;
- 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 gums begin to separate from the teeth, due to which the latter look longer, and pronounced gaps form between them. The progression of the disease leads to the accumulation of pus and bad breath. Patients at this stage complain of a persistent metallic taste,in addition, the process of tooth loss starts.
Because periodontitis is not painful, the first warning sign is bleeding gums. When it appears, you should immediately contact your 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.
Development stages
Pathology can be both localized and generalized. In the first case, the inflammatory process occurs in the area of one or more teeth, in the second - in almost all.
In addition, there are several degrees of severity of periodontitis:
- Easy. It is characterized by a 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. Teeth remain still.
- Average. The periodontal pocket has a depth of 3.5-5 mm. The roots of the teeth at this stage are half exposed. 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 exposed by 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 withusing non-surgical methods. The expediency of their appointment is assessed by the doctor based on the results of the diagnosis, which consists in examining the patient and analyzing the radiograph of the teeth.
The scheme of conservative treatment of periodontitis consists of the following items:
- Local procedures.
- Physiotherapy.
As a rule, patients seek qualified medical care at the stage of a pronounced pathological process. In such cases, the treatment of periodontitis is aimed at preventing the process of deepening existing gum pockets and stopping the destruction of soft and bone tissues. The duration of therapy is delayed when pathogens are attached.
Topical 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 the cleaning of teeth from pathogens accumulated on them. In addition, the progression of the disease is significantly slowed down.
- Treatment of periodontitis with a laser. 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 performed without anesthesia, and immediately after its completion, the patient can begin their daily activities.
- Selection of the right toothbrush and toothpaste. Dentist basedon the individual characteristics of the patient's he alth, talks about the rules for cleansing the oral cavity. After that, the doctor helps with the choice of toothpaste and brushes of optimal hardness. It is important to understand that properly selected personal hygiene products have only a symptomatic effect. With the help of medicinal 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 thorough cleaning of periodontal pockets, it is necessary to stop the progression of the disease and the growth of the number of pathogenic microorganisms. Currently, there are several dosage forms that differ in the mechanism of action 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 pathology. Many drugs are sold on the pharmaceutical market, the following are recognized as the most effective: Kamistad, Cholisal, 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 fatty base, through which it is more difficult for active substances to penetrate into the gums.
- Using periodontal dressings. Their task is to ensure a longer effect of drugs introduced into the foci of inflammation. Without the use of gum dressings, the effect of applying gels,ointments and creams are kept to a minimum as they are washed out very quickly by 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 identify the pathogen and send the patient for analysis, as a result of which the sensitivity of his body 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.
- Injections. To reduce swelling in the gums, the doctor may prescribe injections. For periodontitis, glucose or hydrogen peroxide is used. To relieve inflammation, injections of hormone-containing drugs are carried out. In most cases, this measure is resorted to during exacerbation of periodontitis.
- Taking vitamins. Needed to strengthen the body's defenses.
- Intake of enzymes. As a rule, they are prescribed if the patient suffers from a severe form of pathology. Enzymes promote splitting of necrosis sites, due to which the healing process is accelerated.
In addition, the specialist prescribes drugs that help eliminate the root cause of the disease.
After the main treatment, a set of restorative therapy procedures is indicated. Their task is to improve the blood circulation process in the affected soft tissues.
The most effective methods are:
- Hydrotherapy. The essence of the method: the doctor irrigates the oral cavity with water containing carbon dioxide and medicinalfunds.
- 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 clean teeth from plaque.
- Mud treatment. Applications are especially effective in combination with hydro- and electrotherapy.
- Phonophoresis. Ascorbic acid is supplied to the pathological focus by means of ultrasonic waves, which has a positive effect on the condition of the gums.
If taking medications for periodontitis has not led to a positive result, the doctor decides on the appropriateness of using invasive techniques.
Surgery
Indications for operational manipulations are the following conditions:
- inefficiency of conservative methods;
- great depth of periodontal pockets;
- tooth mobility;
- malocclusion;
- pronounced 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 removes the plaque that has formed under the gum, also cleans 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 cuts the gum and removes the overgrown tissueand tartar, after which he applies a sterile dressing to the wound. After 2 days, it is removed.
- Radical gingivectomy. After dissection of the gums, the doctor removes pathologically altered tissues (both dental and soft). Then the specialist treats the wound with medicines and applies a periodontal bandage.
- Patchwork operation. Indicated with a large number of affected teeth. The doctor makes deep incisions in the gums (up to the bone), after which he separates and processes the mucoperiosteal flap. The exposed part of the gum is scraped off. After that, the separated tissue is returned and fixed with sutures.
- Hemisection of the tooth. Using a separation disc, the doctor divides it into 2 parts and removes part of the affected root. By the same principle, it is amputated.
- Gingival plastic surgery. It is carried out in various ways.
- Orthopedic treatment.
If there are complications (for example, an abscess), the patient is scheduled for emergency surgery. During the surgical intervention, the focus of inflammation is opened and drained.
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 onindex finger, moisten in the resulting mixture. Massage the affected areas for 10 minutes twice a day.
- Chop 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.
- Chop the oak root. Take 1 tsp. means 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, you should consult a dentist. This is due to the fact that some plants reduce the effectiveness of medicines.
Prevention
After effective treatment of periodontitis, it is necessary to regularly follow certain recommendations, as a result of which the risk of recurrence of the disease is significantly reduced.
The set of preventive measures consists of the following items:
- Rinse your mouth with herbal decoctions.
- Apply periodically to the gums with an anti-inflammatory dental gel.
- Get regular physical therapy.
- Use only the right toothbrush, toothpaste and floss for the person.
- Visit the dentist every six months for a routine checkup.
To prevent the occurrence of periodontitis, due attention must be paid to the rules of hygiene. cleansingteeth should not take less than 2 minutes.
In conclusion
Periodontitis is the most common dental disease. It is characterized by the development of an inflammatory process in the soft tissues, which eventually separate from the tooth, which can also be destroyed. Pathogenic microorganisms accumulate and multiply in the formed periodontal pockets.
Currently, the disease can be eliminated by both conservative and surgical methods. The former are used at an early stage in the development of pathology. Surgical intervention is inevitable with a large depth of periodontal pockets and the presence of complications. In addition, to improve the course of the disease, it is possible to use alternative methods. How to treat periodontitis at home, it is better to check with your doctor.
