PERIODONTITIS

CAUSES

nflammation is caused by plaque deposited by the gums, from which harmful substances penetrate the gums. Inflammation includes tissues holding the tooth in the alveolus. The epithelial attachment dislocates occurs, as well as the loss of periodontal fibres and its attachment to bone and cement. This leads to resorption of the alveolar ridge bone of the jaw and mandible, and consequently to loosening and loss of teeth.

SYMPTOMS OF PERIODONTITIS

  • BLEEDING (spontaneous, when brushing teeth, biting hard foods). In the dental examination: bleeding during intubation of gingival pockets and palpation examination.
  • A change in the colour of the gums from the normal pale pink through the vivid red in the acute and blue in the chronic stage of inflammation.
  • Change in gum cohesion ("soft” gum, lack of the so-called graining of the gum surface, which gives a picture of "slippery" gums).
  • Swelling and proliferation of the gum, resulting in covering the tooth crown and the creation of the gum pocket. In the initial phase of the disease without bone loss and sliding of the epithelial attachment along the root of the tooth.
  • Hypersensitivity of the dental necks to mechanical, chemical and especially thermal stimuli.
  • he progressive inflammatory process leads to the creation of a periodontal pocket (supra-dental and infra-dental), caused by the wandering of the epithelial attachment along the root of the tooth. The periodontal pockets deepen (even up to 10-12 mm), the amount of liquid in the pockets increases. Serous, serous-bloody or purulent secretion appears in the pockets. Accompanying bacterial infection may lead to the formation of a periodontal abscess.
  • INSTABILITY OF THE TEETH The extension of the inflammatory process deeper into the periodontal tissues damages the tooth suspension system. With numerous teeth missing, the rest of them wander, which leads to the formation of trauma nodes that worsen the state of periodontium. Instability of the teeth is accompanied by the feeling of "growing” of the tooth, the sensitivity of the tooth when tapping horizontally and the pain when biting hard foods.
  • BONE LOSS Bone loss leads to "enlarging" the tooth crown and lowering the roots of the tooth, where plaque builds up. This leads to the deepening of the periodontal inflammatory process.

DIVISION OF PERIODONTITIS

I Chronic periodontitis (the most common).

II. Aggressive periodontitis (family-occurring, rapid progression of the disease, excess plaque, increased secretion of pro-inflammatory cytokines).

Periodontitis occurs with periods of remission and exacerbation of the disease. The more severe course is observed in tobacco smokers, with incorrect anatomical structure of the tooth, in people with malocclusion and wearing braces.

PREVENTION OF PERIODONTITIS

Periodontal diseases have been recognized as social diseases resulting in tooth loss.

PREVENTION AT HOME

Proper oral hygiene:

1. The selection of a proper toothbrush (preferably by a dentist, depending on the condition of the gums).

2. The proper way of brushing the teeth.

3. Selection of toothpaste - medicinal toothpaste – sulphodent.

4. Supplementary measures: dental floss, toothpicks, gum stimulators for massaging gingival papilla, oral water irrigators removing food debris from inaccessible places.

5. Gum massages (always after removal of plaque) peloid gel – pelogel or massaging with the brush or with fingertip.

DENTAL PREVENTION

1. Period checks with oral hygiene control (assessment of hygiene indicators - indicator of plaque and sediment), staining of dental deposits with tablets or solutions, which facilitates their accurate removal. 2. Removal of dental deposits (scaling) with hand tools and with ultrasounds. 3. Polishing crowns, necks, bare roots (toothbrushes, erasers, professional tooth polishing pastes). 4. Removal of discolouration of crowns and necks of the teeth - so-called sanding. 5. Varnishing - chlorhexidine and fluoride varnishes, reducing the excessive sensitivity of crowns and necks of the teeth.

TREATMENT OF PERIODONTITIS

The basis of treatment is the fight with the bacterial plaque deposited on the teeth. The course of the disease depends on the composition of the bacterial plaque. Bacteria depositing on plaque secrete enzymes that break down components of the epithelium and connective tissue of the gums, as well as bacterial toxins. The breakdown of bacteria releases lysosomal enzymes that damage periodontal tissues. Bacteria weaken the defence reactions of the body, increase the concentration of proinflammatory cytokines. As a result, the bone elements of the dental apparatus are destroyed. Treatment requires cooperation between the doctor and the patient. Systematic medical check-up and dental treatment can prevent teeth loss.

BASIC TREATMENT
  • Removal of dental deposits over and under the gums.
  • Correction of subgingival elevations of fills
  • Removal of dead root cement.
  • Polishing the surface of the necks and roots of the teeth
  • Correction of trauma nodes
  • Immobilization of loose teeth/li>
PHARMACOLOGICAL TREATMENT

GENERAL:

  • antibiotic therapy and chemotherapy

LOCAL: 1.  medicinal toothpaste – sulphodent the medication reduces bleeding, swelling of gingival papilla, reduces the amount of gingival fluid, thoroughly cleanses teeth from dental plaque. The toothpaste has anti-inflammatory, astringent effect, it regenerates the epithelial lining of the mouth, clearly refreshes the breath. It heals and additionally perfectly cleans teeth from deposits, effectively delays the loss of teeth. It contains the Bochnia medicinal iodine-bromine salt and sulphide brine from the Solec Shaft boring of the health resort Solec-Zdrój Sp.j.. 2.peloid gel  – pelogel medication based on concentrated aqueous peloid extract - concentrate of biologically active ingredients of peloids. It has anti-inflammatory and astringent effect. Massaging the gums using the gel improves microcirculation in pathologically changed tissues, which is conducive to the absorption of exudates and infiltrates in inflammatory focal points. It prevents loosening and falling out of teeth. It leaves a long-lasting feeling of freshness (contains natural peppermint oil). 3. Rinsing the gingival pockets with a 3% solution of hydrogen peroxide.

4. Ozonation

5. Balneological treatments – rinsing with sulphide waters, showers, water irrigations, peloid compresses, iontophoresis e.g. peloid from the medication peloid gel – pelogel.

SURGICAL TREATMENT

Includes treatment that reduces periodontal pockets, regenerates periodontal tissues, plastic treatment, correcting trauma bite, and fixing teeth (splinting).