Periodontitis

Periodontitis is a fairly common oral condition, an inflammation of the tissues that support the teeth, gums and bone beneath them. Initially it appears in a milder form, but later it evolves into one of the most dangerous dental diseases, which, untreated, can have the effect of losing all teeth. This disease (incorrectly called "paradontitis") is in fact the periodontitis, a complication of gingivitis. At statistical level, three quarters of the world's population suffers from periodontitis.

The appearance of periodontitis is conditioned by the level of bacterial plaque in the oral cavity, which turns, over time, into tartar that affects the gums and they begin to withdraw. Subsequently, the exposed bone tissue necrosis and can no longer provide the help needed to support the teeth. Periodontal disease thus destroys soft tissue and the evolution is alarming and progressive. An irreversible lesion, periodontitis has as main causes microbial flora and poor oral hygiene and affects the structures that maintain the tooth, gum, periodontal ligament and alveolar bone.

There are several actions that can reduce the chances of developing periodontitis (which can also have genetic causes, at the root). These include brushing at least 2 times / day, regular dental check-ups and flossing. If initially the gums are inflamed and bleed slightly, due to the tartar and toxins in the bacterial plaque, once periodontitis is installed, the gums separate from the tooth by forming spaces between the tooth and the bone. The inflammatory response in the mouth is reversible with appropriate treatment from a dental point of view, but also by imposing proper oral hygiene.

Periodontitis symptoms

Although without painful clinical signs, periodontitis has several manifestations that may indicate its presence. The first signs, in the early stages, consist in the formation of a dental film, which inflames the gums. They are swollen and bleed when brushing. In the second phase, when the symptoms have evolved into periodontitis, it is noticeable.

• bad breath (breath);
• deposition of tartar at the base of the teeth;
• the existence of a feeling of discomfort on contact with very cold or very hot foods;
• discovery of the root of the tooth, as a result of the withdrawal of the gum;
• changing the position of the teeth, which may seem longer;
• gingival itching;
• teeth become mobile;
• the appearance of abscesses;
• an unpleasant taste felt in the mouth;
• the appearance of pain when chewing food;
• in the advanced stages, the gums become swollen and “fluffy”, acquire a strange color (bright red, dark red, purple) and feel softer to the touch.

Types of periodontitis

Periodontitis is classified into several types or classes, depending on the severity, as follows:

• gingivitis is the mildest form, being also the reversible form, following the scaling, brushing and professional treatment;
• chronic periodontitis is characterized by the accumulation of plaque and the deterioration is slow, the teeth having advanced mobility;
• aggressive periodontitis usually begins in childhood or early adulthood;
• periodontitis manifested as a result of systemic diseases or lesions;
• necrotizing periodontitis includes death of gum tissue, dental ligaments and supporting bone; is installed in people with impaired immunity (diagnosis of HIV, cancer, malnutrition and others).

Risk factors

Among the risk factors for the predisposition to periodontitis are:

• smoking (cigarettes have toxic substances, in addition to the nicotine content; when they gather on the teeth and soft oral tissues, an adequate environment for the development of bacteria is created);
• following treatments (antihypertensives, immunosuppressants, antiepileptics, contraceptives, antidepressants, steroids) that produce secondary compounds that dry the mouth;
• diseases that lower immunity (diabetes, rheumatic diseases, arthritis, osteoporosis, HIV infection, heart disease, anemia, respiratory problems, leukemia, Down syndrome, Vitamin C deficiency etc.;
• genetic predisposition;
• gnashing of teeth / bruxism, which damages the supporting tissue of the teeth;
• hormonal disorders as a result of pregnancy or menopause;
• drug abuse;
• the collagen in the bone is of poor quality;
• old age;
• obesity;
• incorrect brushing;
• old dental work.

Triggers

This dental condition can be favored by various triggers, including:

• smoking and excessive alcohol consumption;
• poorly done oral hygiene, which facilitates the stagnation of bacterial plaques and tartar (with a high microbial load) on dental surfaces;
• certain medical conditions that weaken the immune system and determine the loss of gingival elasticity;
• tetracycline treatments or chemotherapy;
• emotional or psychological stress, which interferes with the immune system;
• old dental crowns, which accentuate the retraction of the gums;
• environmental factors;
• dento-maxillary anomalies.

Complications

Periodontitis has been associated with several complications. Although more studies are needed for a confirmed link, some research has associated it with various health problems. It is suggested that the bacteria responsible for periodontitis may enter the bloodstream and thus lead to.

• inflammation in the body;
• increased risk of stroke;
• myocardial infarction;
• arteriosclerosis;
• respiratory diseases;
• coronary heart disease.

What is certain is that periodontitis leads to tooth loss. If proper treatment is not received, a number of future difficulties may develop, which may include:

• recurrent abscesses, with pus, of the gums;
• increased damage to the periodontal ligament and alveolar bones;
• acute necrotizing ulcerative gingivitis (ANUG);
• permanent holes in the gums;
• persistent bad breath;
• gangrene or pulpal necrosis (death of the dental pulp);
• migration of teeth, which affects food consumption.

When do I have to go to a doctor?

A visit to the the dentist is required frequently, especially for a regular professional hygiene and a consultation. But the periodontist can intervene only in the last stages, when only complex solutions can be applied. Therefore, it is good to know that, in principle, you should go to the doctor (who can detect any manifestations of an oral condition) when:

• notice changes at the gums;
• you brush your teeth and the bleeding is more intense;
• you feel a strange taste in your mouth;
• you have bad breath;
• you have already received a diagnosis that may aggravate oral problems;
• you have a family history of dental conditions.

The diagnosis begins with examinations and continues with the periodontal survey (measuring the depth of the groove pocket between the gums and teeth), so that - depending on it - a suitable treatment plan can be developed.

Treatments for periodontitis

Treatments for this dental condition are available depending on the stage of the disease, as follows:

• stage I: the disease can be reversible in approximately 95% of cases and gingival bleeding occurs; as a treatment, insist on proper brushing, scaling and professional brushing, the disease is monitored and the removal of bacterial plaque is sought;
• stage II: the disease can be reversible in about 85% of cases, the gums are swollen; as treatment, local medicines are indicated and the disease is monitored;
• stage III: the disease can be reversible in about 60% of cases, breathing is foul-smelling; as a treatment, subgingival curettage is performed, local treatment with anti-inflammatory, antimicrobial or antibiotic, but also microbiological analysis;
• stage IV: the chances for the disease to stagnate are 70%, and the teeth are already mobile; as a treatment, surgical operations are made for regenerative purposes and long-term observations;
• stage V: the chances of the disease to stagnate are 50% and the teeth have started to fall out; for treatment, bone additions are made;
• stage VI: it is the most advanced stage, the teeth are completely missing; there is no treatment here and surgery is used to restore the teeth, through implants and dental prostheses.

For a simpler classification, the following can be indicated as anti-periodontitis treatments:

1. Non-surgical treatment

• professional scaling and brushing is performed;
• a subgingival curettage with local anesthesia is performed, in combination with antibiotics or antiseptics, to remove the infection and tartar;
• protein treatments are done.

2. Surgical treatment

Surgical treatment aims to clean hard-to-reach areas (through interventions under local anesthesia) and may consist of:

• flap surgery to lift a portion of gingival tissue through small incisions in the gums;
• a soft tissue graft, for when the gum retracts and the damaged tissue must be replaced, taking portions of the roof of the mouth and then applying it to the affected area;
• a bone graft, if the bone around the root of the tooth has been destroyed;
• inserting a piece of biocompatible material between the existing bone and the tooth;
• diode laser interventions, a technology that can decontaminate periodontal pockets, stimulate gum recovery and reshape the gingival margin.

3. Natural treatments

• horseradish increases blood flow to the gums; you can chew the root or use it diluted as a tincture, 20 drops in a glass of water drunk once;
• olive oil soothes pains and helps heal affected gums;
• propolis tincture is used in the form of local rubbing (3 times / day, 40 drops diluted in 50 ml of water);
• local massage with honey (bee product that has antibacterial properties);
• a solution of equal proportions of lukewarm water and iodized sea salt will act as a disinfectant for the gums and will prevent the appearance of bacterial plaque; it will be applied, preferably, after each toothbrush, in order to reduce the inflammation of the gums and / or to prevent the appearance of bacterial plaque;
• rinses with green tea, thanks to the content of tannic acid (which acts as an astringent and will treat gingival infections);
• mouthwash with chamomile tea (which has anti-inflammatory and antiseptic benefits);
• a gargle with sesame oil, every morning, can prevent the occurrence of dental infections and gingivitis, with amazing therapeutic effects;
• decoction with henbane leaves for rinsing the mouth every morning for a week (do not swallow!);
• aloe vera massage can be effective in oral hygiene, improving periodontal conditions;
• eucalyptus oil is an anti-inflammatory germicide that can treat shrinking gums and stimulate the growth of new gingival tissue;
• according to some studies, lemongrass oil has proved to be effective when used for mouthwashes, reducing plaque and lowering gingivitis; 2-3 drops in a glass of water are enough, rinsing the mouth with this mixture for 30 seconds and repeating several times / day;
• sage washes significantly reduce the number of bacteria that cause tartar; a daily rinse with sage tea, for 60 seconds, is sufficient without causing irritation; through its anti-inflammatory properties, it can help heal swollen gums.

4. Food supplements

• Coenzime Q10, administered in combination with folic acid (which is an adjunct in reducing inflammation), contributes to faster healing and regeneration of the gums;
• zinc prevents the formation of bacterial plaque and is recommended to be administered with Vitamin A;
• selenium fights free radicals that damage the gums; is administered with Vitamin E, for better absorption;
• Vitamin C can help solidify the tooth root;
• Tolpa Expert Parodontosis gum concentrate is recommended for daily dental hygiene for people with inflamed gums, helping to strengthen the enamel and prevent the occurrence of periodontitis or other oral complications;
• Interherb (Herba House) is based on grapefruit seed extract; it is enriched with echinacea extract and is antimitotic, antiviral, antiseptic, antifungal, antibacterial and immunostimulant, with a beneficial role in improving blood circulation, so effective in gingival diseases; in addition, it helps strengthen immunity and promotes wound healing;
• tooth powder Dentiren (Indian Herbal) is indicated for painful sensitivity of the teeth, gingivitis, gingival bleeding, but also if there is an unpleasant mouth odor or dental abscesses; effectively destroys bacteria by stimulating the action of the salivary glands;
• Medozon Parodont contains 100% natural organic ingredients, combating gingival bleeding, periodontitis, gingivitis; the list of ingredients includes ozonated oils of hemp, turmeric, oregano, rosemary, sage, lemon, tea tree and cloves;
• Oral Herbal Prop is a natural antiseptic, containing propolis, bee wax, vitamin C, oregano; the mixture is indicated for oral conditions, including gingivitis, stomatitis, canker sores and periodontitis.

Tips for preventing periodontitis

Periodontitis is a disease that can be prevented by following the instructions below:

• making regular visits to the dentist, at least 2 times / year;
• brushing the teeth must be done for at least 2 minutes, covering all the surfaces of the dental arches, by vertical movements, from the gum to the tip of each tooth;
• dental floss and mouthwash should be used every day after brushing;
• the diet must be rich in Vitamin C and calcium, include vegetables, fruits, dairy products and whole grains
• sugars and flours should be avoided as much as possible;
• professional scaling should be done every 6-12 months.

Did you know that...?

• From a dental point of view, does the word “periodontal” mean “around the tooth”?
• Can periodontitis be transmitted from mother to fetus? Therefore, many doctors recommend visits and dental examinations during pregnancy, in order to identify the condition in the early stages.
• Can anyone be affected by this dental condition, not only the elderly but also the children?
• Can periodontitis also affect animals? It is one of the most common diseases in dogs, affecting 80% of specimens aged 3 years or older.
• Periodontitis and not incorrect brushing (as wrongly assumed) is one of the main causes for bad breath?
• Various archaeological studies have shown that mankind has suffered from periodontal disease for thousands of years? Apparently, gum disease began to develop when man began to eat grain.
• Periodontitis is an asymptomatic condition?
• This is a contagious disease that can be transmitted from one person to another? This happens in rare cases, the transmission taking place only when the body is susceptible and immunity is compromised.
• Although treated, periodontitis can relapse?
• Tooth loss can shorten your life? Researchers have shown that the fewer natural teeth a person has, the longer his life expectancy decreases.