Periodontitis - symptoms, causes, treatment, prevention

Dental periodontitis is an inflammation of an infectious nature that occurs at the membrane of the tooth root and affects the tissues of the oral cavity located next to it. Periodontitis is difficult to confuse with other dental diseases, because it has a clear symptom – severe and constantly increasing pain, which cannot be relieved by taking tablets from the pharmacy.

Treatment of periodontitis must be carried out urgently, because you risk not only losing a tooth, but also acquiring complications that are dangerous to the overall health of the body! How periodontitis occurs, what signs will help to identify the disease in a timely manner, how periodontitis is treated in dentistry, at what prices the service is offered in Moscow - we will talk about this in detail in this article.

Symptoms of periodontitis

Despite the fact that experts distinguish several types and stages of periodontitis, there are a number of symptoms, the presence of which most likely indicates the development of this disease.

Clinical manifestations of periodontitis:

• pain due to periodontitis;
• weakness;
• enlarged lymph nodes;
• the temperature may increase by 1 - 2 degrees;
• tooth mobility;
• affected teeth often change color.

Almost all complaints with periodontitis are associated with the occurrence of pain, but patients often go to the doctor only with very severe pain, when the disease is in an advanced stage.

Diagnostics

Almost all methods for diagnosing periodontitis are associated with x-ray examination, since it is quite difficult to visually determine the disease. The most obvious signs:

• change in tooth color;
• the presence of carious cavities;
• fistula due to periodontitis;
• pus during periodontitis (purulent discharge from the gums in the place where the root tip is located).

Be that as it may, the stage of periodontitis can only be accurately diagnosed using x-rays: this is crucial, since the treatment plan is drawn up depending on the type of disease.

Causes

Complications of oral diseases

As a consequence of untreated gingivitis, periodontal disease, tooth root cysts and pulpitis.

Infection

Bacteria penetrate the gums through the bloodstream during inflammatory diseases of the nasopharynx and upper respiratory tract (sore throat, sinusitis, etc.).

Deep caries

As a rule, it leads to the occurrence of granulosa or fibrous forms of periodontitis due to decay products that accumulate daily in the dental canals of severely damaged teeth.

Dentist mistakes

Poorly performed treatment of tooth canals, when fragments of dental instruments, etc. accidentally remain there.

Injuries

The bad habit of constantly pressing on the tooth with a ballpoint pen, a smoking pipe, or a filling that is too high and injures the periodontium can also provoke non-infectious periodontitis.

Professional factor

In professions such as a brass musician or a tailor, pathological pressure on the tooth occurs on a regular basis: in the first case when playing an instrument, and in the second due to the habit of biting off the thread with teeth instead of cutting with scissors.

Attention!!

Patients with reduced immunity and chronic diseases of the endocrine system are also at risk.

How is this pathology treated?

The key to successful therapy is a thorough diagnosis of periodontitis, which is based on radiographic studies. Treatment of this disease takes place in several stages. In case of exacerbations of periodontitis, it is necessary to first relieve the pain reaction and eliminate inflammation. For this use:

• physiotherapeutic approaches;
• antibacterial therapy to destroy pathogenic microflora.

After this, the root canals of the tooth should be filled. First, to isolate the working area from saliva, SM-Dentistry specialists resort to using a rubber dam system. It ensures the sterility of all manipulations and also does not allow dental preparations to enter the patient’s oral cavity.

Then you need to remove all areas of dental tissue that are affected by caries. If the degree of destruction of the dental crown is too great, the possibility of its complete removal and subsequent replacement with an implant is considered. Next, the doctor cleans the tooth canal and at the same time tries to give it as even a shape as possible. This will make it easier to install the filling, and will also significantly reduce the risk of developing complications of periodontitis.

The next stage is temporary filling of the dental canal. The doctor places a drug with an antibacterial effect in it and seals it with a seal. The drug remains in the tooth canal for two weeks. During this time, it will penetrate the hard shell of the teeth and destroy pathogenic bacteria in the periodontium. After the infection has been eliminated and the inflammatory process has been suppressed, the temporary filling is replaced with a permanent one, or if the tooth is destroyed by more than 50%, it is recommended to restore the tooth with a crown. For its production, the SM-Dentistry clinic uses modern and high-strength composite materials, and the shape of the filling will correspond to the natural and familiar shape of the tooth for the patient. Quality control of treatment at all stages is carried out using computed radiography.

Classification of periodontitis

It is believed that the main cause of periodontitis is complications from caries (pulpitis), when the inflammatory process moves to the apex of the root and tooth root periodontitis occurs. This is indeed one of the most common reasons, but this does not always happen.

Classification of periodontitis by reason of occurrence

Acute periodontitis

Rapid development of the disease (literally in 48 - 72 hours). The tooth may change color and become mobile; swelling of the gums and unbearable pain are often observed. It is quite difficult to detect acute periodontitis on an x-ray, since the bone in the affected area has not yet begun to deteriorate. An enlarged periodontal gap can be seen on x-rays.

Stages of periodontitis (acute)

• Stage 1. Pain, increased sensitivity.
• Stage 2. Exacerbation of periodontitis. Severe inflammatory process, the occurrence of mobility, possible appearance of fistulas and purulent discharge.

Prevention

Prevention of periodontitis is not much different from the prevention of caries. To prevent the development of the disease, it is necessary to pay increased attention to the following factors:

• Proper brushing of teeth. Maintaining oral hygiene helps prevent the appearance of plaque, which is an optimal environment for the development and growth of microorganisms that cause damage to enamel and hard tissues.
• Regular visits to the dental clinic. By detecting periodontitis in a timely manner, it can be cured with minimal surgical intervention. During preventive examinations, the doctor will perform a professional teeth cleaning, removing hard deposits in the form of tartar, which will reduce the risk of developing the disease.
• Your own diet. Sweet foods rich in carbohydrates promote the growth of microorganisms responsible for the appearance of plaque, which provokes the appearance of periodontal disease. An excellent preventive measure would be to include in your diet a large amount of vegetables, fruits, and foods high in calcium, which strengthen tooth enamel.

Following these recommendations does not imply serious costs, but it allows you to avoid serious problems in the future.

Chronic form of the disease

Chronic forms of periodontitis occur much more slowly and are partly asymptomatic. It often occurs with caries, under a filling or crown, so visually detecting the disease can be quite difficult. Sometimes a fistula is observed on the surface of the mucosa in chronic periodontitis. However, the disease can be easily diagnosed using x-rays. In addition, chronic periodontitis in the acute stage causes pain, as well as a feeling as if the tooth is being torn from the inside.

Types of chronic periodontitis

Types of dental periodontitis

Based on localization, the disease is divided into the following types:

1. Regional periodontitis. In this case, tissue damage occurs near the edge of the gums. Often occurs due to injury.
2. Apical periodontitis. The tissues are affected near the apical part of the root or at the base. In some cases, it is misdiagnosed as pulpitis.

According to stage, the disease is divided into:

• acute form;
• chronic form.

Acute periodontitis

May be purulent or serous. The first type is especially dangerous, as it can lead to the destruction of periodontal tissue. As a result, the teeth become mobile.

Chronic periodontitis

The chronic form is divided into granulomatous, granulating and fibrous periodontitis. The first two types are the most dangerous, as they are accompanied by pronounced bone resorption.

Treatment methods

Treatment algorithms for periodontitis vary depending on what form of the disease is acute or chronic.

Stages of treatment of acute periodontitis

1. Expansion of the root canal.
2. Removal of affected tissue.
3. Antiseptic treatment.
4. Application of a periodontal bandage.
5. Antibiotic therapy.
6. Inspection of the canals after 3 days and installation of a temporary filling.
7. Control X-ray after 2 months and installation of a permanent filling.

Treatment of chronic periodontitis

1. Emphasis on canal drainage.
2. Endodontic treatment of root canals.
3. Impregnation methods (treatment of canals with a solution of silver salts).
4. Tooth extraction if therapy is ineffective.

Disease prevention – at the very end

• Maintaining a hygienic regime: brushing your teeth twice during the day, using mouthwash and floss.
• Balanced diet: minimum carbohydrates and maximum fresh vegetables and fruits.
• Regular self-massage of the gums using your finger.
• Scheduled consultation with a dentist once every 6 months.

Treatment

Acute treatment involves getting rid of severe pain that causes discomfort. The procedure begins with cleaning the root canals from the remaining pulp, which allows the exudate to flow freely, reducing the pressure of the purulent masses inside the gums. In complicated situations, when this measure is not enough, a specialist may resort to cutting the soft tissue in the area of ​​the root apex and installing drainage. To prevent the spread of infection released along with pus, the patient is prescribed oral antibiotics.

For apical periodontitis, the doctor performs instrumental treatment of the root canals, removing the affected areas of tissue. Then medications are administered and filling is performed.

Treatment of marginal periodontitis involves eliminating the traumatic factor that led to its appearance. Next, the gum surface is treated with antiseptics and medications that prevent the subsequent growth of bacteria.

In the chronic form, treatment is carried out according to the same algorithm as in the case of the acute form, but in addition the periodontal pocket is cleaned of accumulated pus.

At some stages, treatment may be limited to the use of drugs based on calcium oxide hydrate, penetrating into the focus of the inflammatory process through a mechanically cleaned root canal.

Prognosis for periodontitis treatment

In dentistry, periodontitis is considered a very difficult disease to treat, especially its advanced chronic forms. If in mild forms it is enough to depulpate the tooth and remove the affected tissue, then to treat severe forms it is necessary to carry out a number of more complex manipulations. In the acute form, the doctor, as a rule, opens the body of the tooth, cleans the canals and leaves them open for the release of accumulated pus. The patient is then prescribed antibiotics for periodontitis, as well as mouth rinses.

Rehabilitation for the granulating and granulomatous type takes a longer time (up to 2 - 3 months). This is due to the fact that inflammation and bone lesions are neutralized with the help of special medications based on calcium hydroxide, the effectiveness of which appears only after long-term use.

Unfortunately, conservative treatment of periodontitis is impossible if there are cysts and granulomas. Here only invasive interventions will save you, in particular, removal of the apical part of the tooth root along with the formations. Remember that complications of periodontitis take much longer to treat (and are more expensive): do not let your problems get worse and consult a doctor on time.

What to do if you have periodontitis

If the diagnosis is confirmed, the disease must be treated. How dental periodontitis is treated depends on the form and stage of inflammation. The correction program may include therapeutic and surgical techniques.

Conservative therapy

Conservative methods are aimed at maximizing the preservation of the structure of the unit and restoring its functionality. The program includes elimination of the source of inflammation and endodontic treatment. All manipulations are performed under local anesthesia. Treatment regimen:

1. Conducting anesthesia.
2. Opening the crown, providing access to the root canals.
3. Expansion of the cavity.
4. Pulpectomy (if the segment has not been previously treated) or unfilling of the canals.
5. Antiseptic, medicinal treatment of cavities.
6. Temporary filling (for the period of anti-inflammatory treatment).
7. Removal of temporary filling, filling of root canal.
8. Restoration of the coronal part of the unit.
9. Prescribing a course of antibiotic therapy.

Surgical intervention

Invasive methods are used when other methods are ineffective. The operation can be carried out using different protocols:

1. Resection of the apex of the tooth root followed by filling the cavity with special bone-forming materials.
2. Extraction of the diseased segment.

If periodontitis is not treated, complications are possible: odontogenic periostitis (inflammation of the periosteum), abscess, phlegmon, etc. The infectious process spreads to nearby lymph nodes, and lymphadenitis occurs. In severe cases, possible: tooth loss, osteomyelitis, sepsis.