Periodontitis is a process of inflammation that occurs in periodontal tissues. In this case, bone destruction, inflammation of the gums occurs. The periodontium is the tissue that surrounds the tooth. When the disease occurs, one or more components of the periodontium are affected.
Causes contributing to the development of the disease
The causes that influence the appearance of the disease can be divided into local and general. They have an equal effect on the appearance of periodontal disease. Local include:
- Plaque. The oral cavity contains bacteria that produce waste products. Daily brushing of teeth prevents the appearance of plaque and plaques. But the balance between tooth tissues and bacteria is disturbed, which leads to the appearance of soft plaque, which later turns into stone. Mineralization is promoted by saliva. As tartar builds up, there is pressure on the gums. Inflammation of the gum pocket leads to periodontitis.
- Saliva. The composition of saliva occupies a special place in the appearance of periodontal disease. It contains enzymes responsible for the breakdown of food and promotes stone formation.
- Iatrogenic factors. Surgery and dental prosthetics increase the risk of developing periodontitis. The disease develops rapidly. The pain is pronounced.
- Significant stress on the teeth. Excessive load on the periodontium occurs when 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 liquid feeding, the dentary bone atrophies, which leads to the appearance of pockets between the tooth and gum.
Common factors in the development of periodontitis
To the general factors provoking the development of periodontal disease include the general condition of the body:
- Vitamin deficiency is the main cause of the disease. The lack of vitamin A, B1, C, E negatively affects the production of collagen. Leads to a change in the structure of the gums. To restore tooth tissues, vitamin A is required. B1 and E improve metabolism and the speed of regenerative processes.
- The state of the vessels affects the appearance of gum pockets. Atherosclerosis provokes the risk of developing periodontal disease. In the pockets formed, food remains are collected, the tissue around the bone is destroyed. There may be pus.
- Reduced immunity allows you to accelerate the process of disease development. When pathogenic bacteria multiply in the oral cavity, the body cannot cope with them on its own, which increases the duration of the disease.
- Disruption of the thyroid gland increases the risk of periodontal disease. Associated disease is diabetes mellitus. In this case, generalized periodontitis occurs with a long course.
- Diseases of the gastrointestinal tract increase the amount of histamine in the blood of the sick person, which increases the risk of periodontal inflammation.
- Changes in blood composition provokes the appearance of periodontitis. A decrease in hemoglobin, platelets, leukemia leads to changes in the gums, osteoporosis of bone tissue.
- Sedatives, antipsychotics, prolonged stress increases the likelihood of developing the disease.
Disease classification
Classification of periodontitis varies according to the nature of the course of the disease:
- spicy;
- chronic;
- abscess;
- regression.
The disease proceeds locally, affecting only one area of the gums, or diffusely. In this case, the treatment is long and requires compliance with the doctor's recommendation to complete the course of the disease.
Classification of periodontitis according to ICD 10 determines the severity of the disease:
- Mild degree affects no more than 1/3 of the bone. Inflammation of the gingival pocket - no more than 3.5 mm in depth. At the same time, the teeth do not wobble. Treatment is completed quickly and has a good prognosis.
- Moderate severity is characterized by the presence of a gingival pocket up to 5 mm. The teeth become mobile. The process of chewing food is disturbed. There is pain. The bone is damaged up to half of the root of the tooth.
- A severe form of the disease is determined when the gingival pocket is more than 5 mm and destructionbone tissue by more than half. Tooth mobility reaches grade 3 or 4.
The degree of tooth mobility is a key way to determine the degree of periodontitis by visual examination:
- 1 degree of tooth mobility is characterized by a tooth displacement of no 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 the axis.
X-ray examination - a type of radiograph suitable for the diagnosis of local periodontitis - allows you to identify foci of varying degrees.
Periodontal disease in children
Periodontosis in children is different from that in adults. The child grows, the tissues undergo a restructuring. The 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 the bone tissue.
In the twentieth century, it was believed that all types of periodontal disease do not occur in childhood. Recent studies prove otherwise. The mobility of teeth in children is attributed to the change of milk teeth to permanent ones, 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 is similar to that of an adult. due to delayed diagnosisa severe degree of the disease is detected.
Types of periodontitis
Periodontitis often occurs after untreated gingivitis. The infection reaches deep tissues, captures the adjacent tooth. It can spread further, affecting the bone and most of the oral cavity. There are the following types of periodontitis:
- focal;
- generalized;
- spicy;
- chronic;
- purulent;
- chronic generalized;
- abscessing;
- aggressive form.
Focal
In the classification of periodontitis, focal or local disease is distinguished. The main difference is the acute course of the disease. The symptoms of this type of periodontitis are:
- pain while eating;
- mucosal edema;
- reddening of the gums;
- blood;
- bad breath;
- tooth mobility;
- appearance of gum pockets;
- reaction to cold and hot.
With an increase in the focus of inflammation, pain increases when chewing. Children are susceptible to this type of disease during the change of teeth. In adolescence, this type of periodontitis develops into a chronic form. Timely treatment helps to avoid the progression of the disease.
Acute Periodontitis
Acute type of periodontitis is divided into 3 stages:
- Gum bleeding, itching, irritation. There may be some pain from the cold. There are no visible changes at this stage.
- Bleeding occurs while brushing teethand eating solid food. A gingival pocket appears. The teeth become mobile. There is pain when biting. The person experiences discomfort. At this stage, most patients seek help from dentists.
- The bone tissue is partially destroyed. The gum becomes loose. Teeth loose when chewing. Left untreated, the disease at this stage leads to tooth loss.
Acute periodontitis is caused by inflammation. Occurs due to mechanical, less often thermal damage. The active interaction of pathogenic flora and a decrease in immunity leads to inflammation. Vascular permeability increases, blood supply decreases, tissue structure is destroyed.
Provoking factors for the development of an acute illness are:
- diseases of the nasopharynx;
- chronic cholecystitis;
- diseases of the genitourinary system;
- cysts and granulomas.
Chronic form
According to the ICD classification of periodontitis, the chronic form is determined (KO5.3). This is a long-term form of the disease that gradually destroys periodontal tissues. With such a course, a person may not notice the disease until the last stage.
The chronic form is dangerous by 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 chronic periodontitis are:
- bleeding duringdental care time;
- pain when biting;
- inflammation;
- discomfort in the gum area.
The fewer symptoms appear, the longer the disease is not noticed. The pain disappears, bleeding decreases, and the person stops worrying, 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. In treatment, this is the most severe case. The most common 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 are long lasting;
- bone tissue is destroyed;
- the gum stops holding the tooth;
- purulent discharge appears and bad breath intensifies;
- severe pain when brushing teeth;
- increased tartar.
The severity of the disease is determined after examination and X-ray.
Purulent and abscessing form of the disease
With a purulent condition of the periodontium, pus appears constantly. If the disease is not treated, then it goes into the stage of an abscess. The focus of inflammation and the amount of pus increase. The tissues are destroyed. The tooth cannot be saved. It is necessary to carry out therapy to avoid further infection. On thesestages, 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 into the deeper layers of the tooth faster. The disease is developing rapidly.
In an aggressive form, the following types of periodontitis are distinguished:
- disease of systemic diseases;
- ulcerative necrotic;
- chronic adult disease;
- rapidly 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 the eruption 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. Teeth lose their shape. The arc changes. In this case, plaque on the teeth does not play a big role. Type A is typical for young people up to 26 years old, type B - up to 35 years old.
Ulcer-necrotic periodontitis occurs in untreated forms of the disease and often recurring. Left untreated, it leads to tooth loss. Timely access to the dentist will help maintain he althy teeth.
The type of stabilization in periodontitis is determined by the doctor. The tire is selected taking into account the clinical picture and analyzes.
