Periodontitis: types and stages of severity

Inflammatory periodontal diseases to stop with minimal losses is possible only if the initial degree of periodontitis. Unfortunately, the primary symptoms of the disease are not very bright, and in the hectic days many people do not pay attention to them. It can develop rapidly, and the consequence of running of periodontitis is tooth loss and gum damage. In this case, it is not always possible to install dental crowns and dentures — not a very convenient thing, especially for people of young age.

What is periodontitis and its variants

Each tooth is surrounded by a complex of tissues, called the periodontium:

  1. the gums are mucous membrane surrounding the cervix of the tooth and covering the jaw;
  2. the periodontium — the tissue between the wall of the alveolus and the cement covering the tooth root;
  3. the alveolar processes in the maxilla and the alveolar part of the lower, which is the place where the tooth;
  4. the cement — bone special part, surrounding the tooth root and his neck.

Periodontitis is an inflammatory process in these tissues. As a result of inflammation which usually progresses rapidly, collapse the alveoli where the teeth. This leads to loss of the tooth, any, even healthy.

The first sign of this disease is the appearance of periodontal pockets, which are formed as a result of resorption of bone tissue. The second symptom is the loosening of the teeth. It is accompanied by bleeding gums and pain.

Types of periodontitis classified according to several factors:

Classification of periodontitis
  • place of distribution:
  • severity:
  • form development:

Characteristics of the disease at the place of distribution

In focal (localized) periodontitis affects several teeth that are next. The reason it is usually the mechanical tissue damage, which occurs in the following cases:

  1. incorrectly installed crown;
  2. broke off and got stuck between the teeth portion of the seal;
  3. after medical intervention left a drug containing arsenic;
  4. damage to solid food at a meal;
  5. malocclusion, the presence of Tartar, the sharp chipping of adjacent teeth and others.

Focal inflammation typically occurs in the acute form occurs suddenly. Common, treatment lends itself to the easiest. Sometimes it is enough to remove external cause, apply painkillers and anti-inflammatories.

Generalized periodontitis as a local because the damaged tissue only the periodontal, the symptoms are more pronounced, and the reasons for his domestic and quite serious. Often generalized form is the result of gingivitis that has not been treated and passed into the chronic stage.

Another likely cause is the violation of the microflora of saliva and the oral cavity. In this case, the mouth is dominated by parodont-pathogenic microbes, are exposed to stress or a weakened immune system, adversely affect periodontal tissues.

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Also this type of periodontitis can be the consequence of somatic diseases: diabetes, diseases of the gastrointestinal tract, cardiovascular system, disorder in the thyroid gland.

The treatment is carried out only as a whole. It is impossible to cure, removing the symptoms but ignoring the cause of periodontitis.

Classification by severity

The severity is determined by the depth of periodontal pockets, resorption of bone tissue and the radius of the reel teeth.

  1. Periodontitis mild severity is weak: pocket depth not more than 3 mm resorption (resorption) in the initial stage, the height of the interdental partitions changed slightly, no more than 1/3 of the height of the tooth root. Wiggle teeth almost imperceptibly, there is not always the case. Pain weak, small bleeding appears at the time of brushing or solids. The danger is that the initial stage is usually left unattended, eventually the disease progresses and becomes moderate.
  2. In mild cases, periodontal pockets depth is increased to 5mm, the bleeding does not stop long, painful sensations arise from cold or hot food and drinks. Tooth staggers more than 1 mm in any direction. The root of the tooth becomes bare to a height of 1/2 to 1/3. Between the teeth the formation of large gaps.
  3. In severe (suppurative) degree the depth of gingival pocket is increased to 6 mm and more, there is persistent bleeding and swelling of the gums. When you press on the gums of the pockets of pus. The interdental septum are virtually absent. Teeth gradually, in the absence of adjacent teeth can be in an inclined position. You can rotate them around its axis. This degree of the disease is not treated, to stop the process require surgical intervention, most of his teeth falls out itself, or they are removed to stop the inflammatory process.

Form of the disease

Periodontitis is acute or chronic.

  • The acute form occurs suddenly, is accompanied by pain, bleeding, sometimes there may be abscess at the site of localization. Causes often external mechanical damage and infection. Usually in the acute form is the focal periodontitis. Treated quickly, without complications, if the time to go to the doctor.
  • Chronic periodontitis protracted form of the disease, alternating exacerbations and remissions. During remission, the signs slabovrajenna pain will go away, but the destructive process continues. At any time may be worsening without apparent reason.

Without therapy, the disease passes into the severe stage, resulting in a loss of teeth, deformation of the jaw. In the chronic form is generalized periodontitis, alopecia, but rarely.

Other forms

Other forms of the disease. In children and adolescents is prepubertal periodontitis and juvenile.

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Prepubescent as occurs in primary teeth and permanent. The cause — a weak immune system. The treatment is carried out comprehensively, to appoint immunomodulators and treating the symptoms of the disease.

In juvenile form affects the permanent teeth. The disease can be hereditary, more common in girls. With timely treatment the teeth can be saved.

Common signs of periodontitis

In different stages of the disease the symptoms of periodontal disease are manifested in different ways. In mild disease, some may not be, and when hard there is the whole complex:

  1. education suboticanec pockets;
  2. the staggering of the teeth;
  3. bleeding gums;
  4. pain;
  5. reaction to cold or hot food, sour or sweet;
  6. breath;
  7. the increase in the interdental spaces;
  8. the denudation of the tooth root;
  9. inflammation of the gums;
  10. purulent abscesses;
  11. fever, swollen lymph nodes.

Diagnostics in the clinic

In the clinic, the doctor conducts a visual examination, appoints a panoramic x-ray and blood test.

During the inspection check the depth of periodontal pockets, tooth mobility, bleeding gums, presence of pus in the pockets, increasing the space between the teeth, the degree of denudation of the tooth root. On these grounds establish the disease itself, but to determine its form and severity of the required additional surveys.

To determine whether glycogen gums are examined for the sample Schiller-Pisarev. On gums Lugol is applied, which stains them brown. The degree of the color saturation indicates the amount of glycogen. The darker the color, the more glycogen. If when checking the color of gums is not changed, then periodontitis is excluded.

A blood test will establish the presence of leukocytes. If white count is high, this suggests that the disease has a generalized character. Norma leukocytes in Sacramento. A blood test will determine the condition of the immune system — check phagocytic activity of cells.


Panoramic x-ray can determine the extent of damage to teeth. The picture shows the destruction of the walls, horizontal and vertical resorption, and deposition of subgingival Tartar, bone fracture, osteoporosis.

Based on this comprehensive survey, it is possible to establish a complete picture of the disease and even to detect periodontal disease at an early stage.


In the choice of treatment regimen is necessary to establish the cause of the disease. Treatment is complex: Troubleshooting factors, symptoms and therapies.

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First and foremost, carry out hygienic procedures, which include:

  • removal of Tartar and caries lesions;
  • the restoration or replacement of old fillings;
  • removing defective or damaged crowns;
  • curettage;
  • grinding of the teeth;
  • drug withdrawal inflammatory processes;
  • physiotherapy;
  • splinting at the time of treatment.

Splinting is a bond between adjacent teeth. This is necessary in order to ensure their immobility.

Curettage is the removal of content from the dental-gingival pockets and purification of their walls. It is carried out in three ways:

  1. with the help of surgical instruments;
  2. with the help of vacuum;
  3. cryosurgical method — with the help of liquid nitrogen, oxygen, or freon.

In some cases the dissection of the pocket with subsequent curettage, or excision of the damaged tissue completely.

Physiotherapy is prescribed depending on the severity of the disease. In the acute form: the directed irrigation medicines, UHF, laser therapy. In the chronic course of conduct hydrotherapy, electrophoresis.

For stimulation of regenerative processes fermentoterapiya prescribed drugs.
To eliminate the defects and restore damaged gums are conducting patchwork operations. Use them if the need arises to clean the entire area from the inflamed tissue in the area of damage and to implant artificial materials with strong bone damage. While most of the operations used analgesic in the form of injection or application.

In severe form of periodontitis loose teeth that strongly deviates from its axis, will be deleted.


After the full course of treatment prescribed re-examination. It is conducted 1 to 3 times per year, depending on the form of the disease and its severity. If necessary, appoint additional examination and a repeated course of treatment.
At home, you should carefully monitor the oral cavity. Daily hygiene procedures include:

  • brushing your teeth twice a day. The brush is recommended to be changed 1 time per month;
  • cleansing the space between your teeth after each meal using dental floss;
  • after eating it is desirable to use a special mouthwash.

Tartar should be removed twice a year. It is necessary to maintain immunity. This will help exercise, fresh air and proper nutrition.