Chronic periodontitis: symptoms and treatment
Periodontitis — inflammation of periodontal tissues, characterized by progressive destruction of periodontal and alveolar bones of the jaws. Periodontitis affects individuals starting from 11-12 years of age (8-10%), the most intensive development reaches the age of 20-30 years (60-65%). Pathological process caused severe destruction of the tissue structure, which are the natural latch tooth is in the hole (the alveolar processes, the periodontal). Upon detection of the first signs of periodontitis, it is important to undergo a dental examination and to preserve the natural tooth.
The nature of the disease
For periodontal disease always involve the development of inflammation. Pathological changes in the soft tissues, as well as, apical (basal) part of the tooth is rather long, gradually affecting all layers of the gums. Chronic periodontitis with the full destruction of tissue and resorption of alveoli indicates the beginning of the terminal stage of the disease, when to save a tooth is not possible. There are two forms of periodontitis:
- sharp periodontitis;
- chronic periodontitis.
Acute periodontitis rarely observed. Always the connection of current changes with the presence of a traumatic factor. A breach of periodontal compounds, changes of the bone tissue there. Chronic periodontitis has an unpleasant symptoms such as itching, increased bleeding, existence of deep periodontal pockets and dental plaque under the gum and others. In the early stages of the disease the pathological process progresses relentlessly flowing in the latent phase (asymptomatic). In the long destruction without first symptoms lies the insidiousness of the disease. Chronic process can be combined with microbial Allergy. The main serious consequence for patients with periodontitis — an irreversible loss of teeth.
Principles of dental classifications
For the basic classification in chronic periodontitis accept the level of tissue damage on the localization of the disease. In dentistry there are two types of chronic process:
- focal periodontitis (localized) — develops under the influence of local causes.
- diffuse periodontitis (generalized distribution) — developed with a long process on the background of common diseases.
Isolated active current periodontal disease and remission. Under active currents, depending on the severity of the process it is possible to allocate following stages of periodontitis:
|0 degree.||The beginning of the process is accompanied by softening of the fiber compact plates, the appearance of a symptom of osteoporosis. Along with this marked reduction in the height of the partitions between the teeth. Periodontal cavity reaches 2.5 cm.|
|Grade I (mild).||Diagnosis the first degree occurs at the depth of the periodontal cavity from 2.5 to 3.5–4 mm, thinning of the alveolar bone, slight mobility of the tooth root.|
|Degree II (medium-heavy).||The parameters of the depth of periodontal cavities vary from 3.5–4 to 5-5,5 mm. a Destructive process of the alveolar bone extends nearly half the apical part of the tooth, and the motor activity of the teeth becomes noticeable in the chewing load, and the feeling.|
|Grade III (severe).||Periodontal pocket depth exceeds 5-5. 5 mm, perforation of the alveolar bone density is more than half the root length of the tooth. The patient notes the strong mobility of the bones. When periodontal disease in the terminal stage comes atropatia ligaments, which contributes to the tooth space along the line of the gums.|
Principles of classification of chronic periodontitis allow dentists to quickly identify the form of the disease to start the treatment depending on the degree of destruction of dental or gingival tissues.
The causes of periodontitis
In the mouth of a person 24 hours there is live microflora. In addition to the natural bacterial layers with food fall other microorganisms, which can initiate the pathogenic process in the oral cavity. After a few hours after eating you can feel the plaque on your teeth. Even after the hygienic cleaning such a coating is formed again. Plaque on the teeth — is the result of microorganisms. If you neglect your daily hygiene, a day later, this plaque turns into Tartar. The main causes of periodontitis include:
- lack of oral hygiene or the lack of it;
- Smoking or chewing tobacco;
- hereditary factors;
- antibiotics, and other hard drugs;
- pathology of salivary glands;
- diabetes mellitus;
- poor diet without a vitamin rich diet;
- sexual infections (STDs).
First plaque on the teeth causes discomfort, irritation, or gingivitis, and then progressive inflammatory process extends, forming a kind of periodontal «pockets» (the space between the gingival and apical part of the tooth). This space is filled with pathogens, remnants of food, and then run a destructive process that contributes to the loss of the tooth.
The clinical picture
The period of remission or exacerbation are often accompanied by special symptoms, which have different intensity, duration of the flow. When inflammation of the periodontal status of the patient is divided into acute and chronic. The symptoms during exacerbation of the pathological process include:
- itching of the gums;
- pulsating sensation in the gums;
- the sensitivity of the apical part of the tooth at the slightest load;
- the appearance of putrid smell;
- obvious tooth mobility.
An acute condition may not occur unnoticed, so when feeling the first signs of periodontitis is important to seek help from a specialist. Symptoms of chronic process include:
- tenderness in the region of the gingival margin;
- swelling of the gums around the affected tooth;
- bleeding gums when brushing;
- sharp pain at any load;
- change the color of the gums in the area of the affected tooth;
- education openings between the teeth;
- a feeling of weakness, fatigue, malaise;
- maintaining a high body temperature.
Chronic periodontitis is much more expression and more intense. Soreness and discomfort becomes tormenting form. The depth of the periodontal cavity becomes deeper and may exceed 7 mm. To complications of periodontitis, especially in patients with a complicated clinical history, identify symptoms of heart failure and the emergence of parodontale changed parts of the gums, purulent exudate.
Diagnosis and treatment process conducted by a dentist-periodontist. In severe periodontitis and the presence of the patient burdened with clinical history, diagnosis experts from the field of gastroenterology, cardiology, rheumatology, endocrinology and Hematology. The diagnosis consists in the following:
- visual inspection of the oral cavity:
- aiming the x-rays;
- the fence is functional samples Schiller-Pisarev;
- drafting parodontogramma;
- the definition of hygienic and periodontal indexes.
- PCR-scraping from the affected gums;
- bacteriological sowing content of «pocket» on a special environment;
- blood sugar (glycemic index);
- biopsy of the altered tissue.
Diagnostics allows to reliably identify periodontitis from other diseases of the oral cavity, for example gingivitis or periodontal disease. With proper diagnosis, successful treatment is completely predetermined. In some severe cases the experts can save the tooth the patient.
The treatment algorithm
After extensive diagnosis, the dentist will appoint adequate therapy. It should be noted that periodontitis cannot be cured with traditional methods. Any funds for treatment at home may be only an additional tool to care for the oral cavity. In the treatment of periodontitis with slight destruction of the alveolar processes apply the following tactics:
- removal of dental plaque;
- professional teeth cleaning;
- polishing of the enamel;
- processing the crown and root of the tooth fluoride treatments;
- ultrasonic cleaning of hardened deposits.
Chronic periodontitis treatment in advanced cases, especially with the increase of cavity volume is carried out surgically and may have a quite favorable prognosis. The purpose of this operation is the elimination of the cavernous structure, stability of the tooth. Treatment of severe cases of periodontitis may include the following activities:
- surgical intervention (if the pocket depth over 5 mm);
- curettage (the use of special hooks for the removal of deposits);
- the imposition of temporary tires and permanent prostheses for secure attachment of the tooth;
- assignment of vitamin complexes and immunostimulatory drugs:
- treatment and filling of carious cavity;
- bite correction.
As rinsing you can use a decoction of chamomile, succession, celandine, lime. You can do a rinse with baking soda and add few drops of essential oils (tea tree, rose, peach).
It is permissible to rinse the mouth with water solution of chlorhexidine miramistina or to prevent the appearance of purulent stomatitis. The appearance of ulcers in the mouth caused by the intensive growth of pathogenic microflora and the formation of purulent exudate.
When Troubleshooting the true cause of periodontitis is possible to avoid its recurrence (e.g., abnormal occlusion, generalized caries). In other cases, requires complex therapy directed on the maximum strengthening of the tooth in the gingival hole and the sanitation of the oral cavity.
Forecast and prevention of chronic periodontitis
Prediction and prevention represent two simple truths: visit the dentist 2 times a year, and observance of hygienic regime in the oral cavity. Compliance with all recommendations of the dentist in case of chronic periodontitis will help the patient to achieve remission and to reduce the intervals between exacerbations. The sooner action will be taken on the treatment of the disease, the more favorable will be the prognosis for the patient. The main measures include:
- regular brushing;
- the sanitation of the oral cavity (removal of Tartar);
- timely treatment of caries;
- the elimination of tobacco and alcohol;
- the consumption of vitamins and other nutrients;
- replacement of defective or broken dentures;
- treatment of chronic diseases of the oral cavity (stomatitis, gingivitis, etc.).
Patients with a history of chronic periodontitis, are at the dispensary and need regular proper oral hygiene, the implementation of adequate supporting dental therapy.
It is impossible to predict the course of the disease due to the specific structure of the jaw bone, the width of the tooth and the root structure of the incisors. In any case, a chronic course of the process dangerous as its slow lose all of the morphological structure of soft and hard tissues of the base of the tooth.
Chronic periodontitis is an insidious disease that not only leads to possible tooth loss, but also to the development of various diseases of internal organs. You should not resort to self-treatment at home is impossible to achieve high-quality cleansing of periodontal pockets. When the first symptoms the patient should consult a doctor for qualified help.