home Adviсe What causes dental periodontal disease? Periodontal disease: how to save teeth and what medications help. Professional teeth cleaning

What causes dental periodontal disease? Periodontal disease: how to save teeth and what medications help. Professional teeth cleaning

Periodontal disease is a dental disease associated with depletion of the periodontium (the tissue connecting the tooth to the gum). Periodontal disease is not accompanied by inflammation, which is why it differs from periodontitis. The suffix “-itis” at the end of the word indicates the presence of an inflammatory process (a similar word is appendicitis). The ending “-oz” is used in names associated with tissue destruction (osteochondrosis). How to treat periodontal disease and what are the causes of destructive disease in the oral cavity?

Patients often confuse periodontal disease with periodontitis. The similarity of the names is explained by the fact that in both diseases pathology is formed in the periodontal tissues. The best comparison of differences is provided by a table comparing diseases by signs and manifestations.

Table - Comparison of signs and symptoms

	Periodontal disease	Periodontitis
The essence of the disease	Destructive changes in the connective tissue around the tooth due to internal reasons caused by impaired blood supply or chronic diseases	Inflammation of periodontal tissue as a result of infection (from a carious cavity or directly through the mouth, into the gap between the tooth and the gum)
Symptoms of the disease	No swelling, no inflammation, no pus or bleeding	All symptoms of inflammation are present: swelling, redness, formation of pus and bleeding
Manifestations of the disease: periodontal destruction	The periodontium is destroyed slowly, and loose teeth appear only in the last stages of the disease. Bleeding gums are possible if periodontitis is combined with periodontal disease.	The periodontium destroys quickly, the teeth begin to loosen, interdental gaps appear, the apices become rotated, and finally fall out.
External manifestation: formation of “pockets”	As a rule, they do not form, or small “pockets” may form. No granulation observed	Deep periodontal “pockets” necessarily accompany periodontitis; granulation is often observed in them - pathological growth of the gums
External manifestation: wedge-shaped defect	Yes, present	No, not available
Associated diseases: caries	Can not be	As a rule, caries accompanies and often initiates periodontitis
Spreading	Typically along both rows of teeth above and below	Possible local disease, at the root of one or two, three teeth
Time of formation of the disease	Long-term, for several years	Fast, within one to two weeks or more
Treatment	It is necessary to treat the underlying disease and prevent infection and periodontal disease (prevent inflammation)	Suppress the source of infection, relieve inflammation

The photo shows a comparison of two types of periodontal diseases - gum inflammation and bone tissue destruction.

This is what periodontal disease looks like (above) - the teeth are bare, the gums along the teeth are lighter, but there are no signs of inflammation

Strengthening the tooth surface

One way to strengthen teeth is by grinding salt. Sodium chloride is a natural mineral that has a bactericidal effect. The first procedures may be painful. Subsequently, after 4-5 sessions, the amount of infection in the oral cavity decreases and the pain goes away.

Honey-salt massage to enhance microcirculation is performed with a small fabric bag, inside of which honey and salt are wrapped.

One of the ways to restore the tooth surface is to remineralize the tooth or saturate the dental tissue with the necessary elements. To do this, the wedge-shaped defect is covered with a special ointment, varnish or solution. The coating substance performs two functions: it is a source of minerals and protects the bare surface from painful touch.

Another method of protecting a tooth is filling. In this case, only high-quality composite materials with a high coefficient of adhesion are used. But the filling periodically lags behind a flat surface and requires restoration.

If the destruction process has gone too far, then the exposed necks of the teeth begin to thin out. This defect is covered with a ceramic plate (veneer). Sometimes an artificial crown is placed on a defective tooth.

Just a few decades ago, periodontal disease was the prerogative of older people. Today the disease has become younger. And although its prevalence is relatively low (10%), among patients susceptible to the disease there are many middle-aged people (30-45 years old). Chronic diseases - diabetes, vascular diseases, heart failure - have also become younger.

Periodontal disease is not as common a disease as gingivitis and periodontitis: it occurs only in 3-10% of people and does not develop in one day, month or even year.

It takes 10-15 and even 20 years for a clear clinical picture, so its course is always chronic. Periodontal disease can be mild, moderate or severe. The degree of severity can only be determined by a doctor by taking an x-ray and measuring the amount of root exposure.

How to treat periodontal disease correctly? Let's figure out what periodontal disease is and how to treat it using modern dental developments. We will learn how to get rid of the disease using traditional medicine, what measures are needed to prevent this disease, and which specialist should be consulted.

Causes

The causes of periodontal disease are not precisely established; it is believed that hereditary predisposition plays an important role. Often occurs with systemic diseases, diabetes mellitus and other disorders of the endocrine glands, with chronic diseases of internal organs (,), as well as bone lesions (osteopenia).

It is believed that the cause of periodontal disease is insufficient blood supply to the gum tissue, which in severe, advanced cases leads to its atrophy and, as a consequence, to tooth loss.

Symptoms of periodontal disease

The disease begins with thinning of the bone tissue of the dental alveoli, resulting in their atrophy. Radiologically, this is manifested by a decrease in bone marrow spaces, the appearance of a fine-mesh bone pattern, a decrease in the volume of bone tissue between the teeth, and foci of osteoporosis.

Following the bone changes, changes appear on the gums - they begin to thin out, sag, exposing the roots of the tooth. At the same time, teeth become sensitive to chemical and temperature factors.

Generally The following symptoms are typical for periodontal disease::

Minor plaque on teeth;
Partial exposure of the dental necks (sometimes with increased sensitivity in these places);
The gums are pale in color;
Presence of itching in the gums;
The necks of the teeth are exposed without the formation of gum pockets and without the accumulation of pus in them (that is, without an inflammatory process).

Periodontal disease develops very slowly and at first it doesn’t reveal itself at all. Conventionally, 3 stages of the disease can be distinguished:

Asymptomatic development of pathology. Changes occur in the periodontal tissues. Typically, destructive processes are not accompanied by pain or discomfort.
Slow displacement of teeth. Gum dystrophy leads to the neck of teeth showing through the gums. There is a gradual increase in the gaps between the teeth. The sensitivity of teeth and gums to external irritants increases.
Impaired fixation of teeth, their instability, possible loss. Until this point, periodontal disease “grows” in 10-15 years.

The earlier periodontal disease is detected, the more effective and painless the treatment will be.

Periodontal disease: photo

What periodontal disease looks like, a photo of the clinical manifestations of the disease is presented below.

Diagnostics

When making a diagnosis, the dentist relies primarily on the clinical picture of periodontal disease, which includes all of the above symptoms, as well as the patient’s complaints.

In the clinic, the most important sign by which the stage of the disease, further treatment and prognosis can be determined is alveolar process atrophy. In order to determine the degree of atrophy, a visual examination is usually not enough. The dentist prescribes an additional examination - radiography. The image clearly shows the degree of resorption of the bones that support the teeth.

Treatment of periodontal disease

Treatment of periodontal disease is carried out by a periodontist and should be aimed at restoring the gingival junction, while during the treatment of periodontal disease it is necessary to take into account the individual characteristics of the patient, concomitant diseases and age. Thus, in the group of older patients with periodontal disease, pathologies of the cardiovascular system, endocrine diseases and metabolic disorders are often present.

Treatment regimen for periodontal disease provides the following manipulations:

Initial examination.
X-ray photo, other diagnostic studies.
Removal of dental plaque and stone.
General and local pharmacotherapy - the use of anti-inflammatory drugs, vitamins, hormonal agents.
Physiotherapeutic treatment – activation of blood supply to the gums.
Sanitation of the oral cavity – treatment of caries, removal of damaged teeth and roots.
Splinting – reducing the mobility of loose teeth.
Surgery.
Prosthetics.

Thus, the dentist will carry out treatment aimed at improving the health of the oral cavity and preventing infection, inflammatory processes and other diseases from occurring in the mouth and spreading throughout the body. However, to exclude the opposite effect (deterioration of the condition of teeth and periodontal tissue as a result of internal malfunctions in the body), regular monitoring and treatment of the underlying disease is necessary.

How to treat periodontal disease at home

When we talk about periodontal disease, treatment at home with folk remedies is only possible in parallel with treatment in a dental clinic. According to reviews, complex therapy gives the fastest and most effective results.

We will present to you the most effective and well-founded folk recipes that our grandparents used:

Well proven folk treatment of periodontal disease with salt. After just three treatments, the symptoms of periodontal disease will become significantly less severe. Using fine salt or a strong saline solution, massage the gums. The massage is performed until all the ichor comes out of the gums. Then the mouth is rinsed with a solution of hydroperite, consisting of 1 tablet of hydroperite and a glass of water.
Treatment of periodontal disease at home can be carried out using ordinary sauerkraut. You should chew the cabbage for a long time, and also rinse your mouth with cabbage juice. In just 7 days you will feel significant relief.
Dried lingonberry leaves, an amount of six grams, you need to pour a glass of boiling water and boil for about 20 minutes. Strain and cool at room temperature and rinse your mouth with the resulting decoction at least 5 times a day.
This is a very effective folk remedy for dental treatment. Calamus penetrates into the roots of teeth and anesthetizes them, and propolis fills all microcracks. Take half a liter of 40% vodka and add half a glass of calamus roots. This is the first infusion. To prepare the second, take another half liter of 40% vodka and add 15–20 grams of crushed propolis. Both infusions need to be infused for 7–10 days. Both tinctures are used simultaneously. Mix one tablespoon of calamus tincture and a teaspoon of propolis tincture. Rinse your mouth with this mixture for 2-3 minutes. The procedure is done before bedtime, or can be done during severe pain. After 1–3 days, the pain will completely go away. The duration of treatment is 3–5 weeks.
If you want to cure periodontal disease with folk remedies, you can use alcoholic extract of propolis. To do this, dilute 20 drops of propolis tincture in 1 glass (200 g) of water. Used for rinsing the mouth.

Another way to take a periodontal medicine internally is to use hydrogen peroxide. You can also add a couple of drops of hydrogen peroxide to toothpaste or wipe your gums with a solution diluted in water. The most important thing in treating periodontal disease with hydrogen peroxide is not to overdo it in dosage:

One drop of hydrogen peroxide per 50 ml of water: taken half an hour before meals or 2 hours after meals and no more than 3 times a day. If there are no side effects within 1-3 days, then the course of treatment can be extended to 10 days.
To wipe the gums: no more than 10 drops of hydrogen peroxide per 50 ml of water.
General recommendation: no more than 30 drops of peroxide diluted in water per day.

Honey is also successfully used from beekeeping products: it is rubbed into the gums (honey and salt are taken by weight in a ratio of 2:1 and mixed until the salt is completely dissolved). Rub this mixture onto your gums (use a soft toothbrush or wrap a small dose (like a prison) in a small cloth.

Prevention

If we talk about the prevention of the occurrence of pathological changes in periodontal disease, then the main measure to prevent the disease is timely and high-quality treatment of common diseases described in the section on the causes of periodontal disease.

In addition, complete sanitation of the oral cavity is also important, that is, regular visits to the dentist, removal of dental plaque, treatment of caries, gingivitis, periodontitis and other similar ailments.

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Periodontal disease is a fairly rare disease that is characterized by a reduction in the volume of gum tissue. This exposes the teeth and looks as if they are moving out of the gums.

This disease can be identified only by external factors, since it does not cause any discomfort at the beginning of its development.

The action of the disease is aimed at the periodontal tissue (periodontium), which includes not only gums, but also bone tissue, as well as fibers that attach the tooth to the bones.

As the disease progresses, atrophic processes in the dental cells begin to occur, which leads to loosening and weakening of the teeth.

As the gums begin to decrease in volume, the roots of the teeth become exposed, the distance between them increases, and over time, the teeth may even begin to fall out if timely medical care is not provided.

In the video, a dentist explains what periodontal disease is:

Causes of periodontal disease

Periodontal disease can begin to develop for many reasons, the main one being deterioration of nutrition of periodontal tissues. This occurs due to the narrowing of the vessels located in them.

Tissues cease to receive enough oxygen and minerals necessary for normal life, and begin to atrophy and collapse.

The reasons that can lead to sclerosis of the blood vessels of these tissues are:

Presence of diseases Gastrointestinal tract, endocrine or cardiovascular system (especially atherosclerosis), diabetes mellitus, immune diseases.
Hormonal changes. Because of this factor, periodontal disease often occurs in adolescents during puberty, in women during pregnancy and some time after the birth of a child, during menopause, and also during monthly menstruation. At any of the listed periods of time, the sensitivity of the gums sharply increases, they become more susceptible to all kinds of destruction processes.
Anatomical disorders. The blood supply to the vessels of the periodontal tissues can be disrupted due to various anomalies in the structure of the teeth, malocclusion and other anatomical pathologies.
Tartar or excess plaque.
Medications. Long-term use of certain medications can lead to impaired salivation, one of the functions of which is to protect teeth and gums from bacterial factors. In addition, some anticonvulsant medications (such as Dilantin or phenytoin) can interfere with the normal growth of gum tissue.
Avitaminosis. A deficiency of certain vitamins, such as E, P and C, can provoke the development of dystrophic changes in the periodontium.
Bad habits, especially smoking, as well as genetic predisposition.

Since sclerotic phenomena rarely occur in a young body, periodontal disease is more common in adults, mature or elderly people.

How does it manifest?

Periodontal disease develops extremely slowly, but, having reached a certain stage, the process of destruction of periodontal tissues begins to progress rapidly, leading to such phenomena as loosening and tooth loss.

You should start worrying at the first signs of illness:

increased reaction to temperature or chemical stimuli;
difficulty chewing food;
pale gums;
exposure of the lower part of the roots of the teeth, the teeth seem to lengthen;
enamel erosion.

Symptoms of periodontal disease directly depend on the stage at which the disease is located. Each stage has its own specific characteristics.

Stages of periodontal disease

There are three main stages of development of this disease:

Stage 1 of periodontal disease:

In the first stage of the disease, there are practically no symptoms. There may be minor discomfort while eating food.
Slight exposure of tooth roots.
Increased sensitivity to hot or cold foods, as well as very sweet or sour foods.
Painful sensations do not appear. Patients rarely see a doctor at this stage, since there is little that worries them.

Stage 2 of periodontal disease:

Slow processes of gum atrophy begin, and their edges gradually move downward. The roots of the teeth themselves become noticeable, and not just their necks. The roots may be exposed by about 3 mm at this stage.
During the process of brushing teeth, the patient may periodically experience pain.
The gums become inflamed and...
Since the distance between the teeth is slightly increased, pieces of food can get stuck in the interdental spaces.
Saliva changes its color - it becomes brown, and sometimes you can see streaks of blood in its composition.
Slight tooth mobility appears.
The sensitivity of teeth becomes even higher; they react especially sharply to sudden temperature changes and external irritants.
In rare cases, pus may be released from the periodontal tissues.

Stage 3 of periodontal disease is the most severe:

Irreversible processes begin in which periodontal tissue is actively destroyed, bone tissue atrophies, gums become inflamed, and festering ulcers form on them, which often lead to the appearance of bad breath.
The roots of the teeth are already so exposed that the teeth are very loose and can move. The distance between them has been significantly increased.
Due to the fact that teeth can shift, the bite changes.
Teeth mobility is very high, teeth can fall out. Medicines won't help much here. In most cases, it is necessary to resort to tooth extraction and installation of dentures.

If periodontal disease treatment is not started promptly, various complications may occur., the greatest danger of which is periodontal abscess.

It occurs due to enlarged periodontal pockets, which characterize the last stages of periodontal disease.

These pockets are almost impossible to clean with normal hygiene procedures; purulent discharge accumulates inside them, which provokes the formation of an abscess.

Advanced periodontal disease can cause vascular and heart diseases, gastrointestinal disorders, disrupt lung function, and cause various complications during pregnancy.

To prevent the development of diseases caused by severe forms of periodontal disease, it is necessary to start treatment as early as possible, at the slightest sign of illness.

It must be remembered that at certain stages the bone tissue is so affected that it becomes almost impossible to cure the teeth.

Timely medical care, as well as compliance with all medical recommendations, will certainly stop the progression of the disease and return your teeth to a healthy appearance and your smile to its natural beauty.

Quite often, people who have reached adulthood begin to notice their teeth lengthening, their necks becoming exposed, and their gums receding. The reason for this may be gum diseases, such as. However, not everyone knows how these diseases differ, how they appear and how to treat gum periodontal disease. In this article we will try to understand these issues.

Among periodontal diseases (that is, the tissues of the oral cavity surrounding the teeth), the main part is occupied by inflammatory processes associated with disturbances in the microbiological balance in the oral cavity. Their occurrence is always somehow connected with dental plaque, which has accumulated over the years, forming tartar. All this hard and soft plaque causes inflammatory periodontal lesions such as gingivitis and periodontitis. The ending “-itis” in the name of the pathology just indicates the presence of inflammation. However, even people who practice good oral hygiene can develop severe periodontal disease. How and why does this happen?

Possible causes of gum periodontal disease

The nature of periodontal disease, as scientists believe, is not associated with inflammation. This means that most often patients suffering from this type of gum pathology do not experience significant plaque deposits. Such patients can carefully follow all the rules of dental care, visit the dentist once every six months, and undergo prosthetics and treatment on time. However, unfortunately, all these measures are not enough to maintain a beautiful smile until old age. On the other hand, the good news is that periodontal disease is not that common, occurring in only 3 out of 100 cases.

What causes the intense loss of gums and jawbone height during periodontal disease? In fact, a reliable and exact reason for the development of this pathology has never been identified. Abroad, it is customary to call periodontal disease a sluggish form of periodontitis, when signs of inflammation are clearly not visible. The very concept of “periodontal disease” was rejected by Western dentists 50 years ago. In the CIS countries, this diagnosis is still identified as a separate form and is treated with slightly different methods than periodontitis. Whether this division of terms is correct or not is not so important, the only important thing is whether the treatment will lead to improvement for the patient.

In our country, periodontal disease is understood as a process in which degeneration of the bone tissue of the jaw occurs, that is, a sharp disruption of its nutrition. In most cases, this is directly related to various diseases that a person accumulates during his life. Few people can boast of excellent health in adulthood and old age, which is caused by a predominantly sedentary lifestyle, hard work for many years, numerous stressful situations, chronic fatigue, and a lack of vitamins in the diet of a modern person living in the city.

Of course, if a person also has bad habits, his chances of acquiring dystrophic diseases increase sharply. Intensive smoking for several decades practically guarantees the development of one or another pathological process in the oral cavity.

When diseases such as cardiovascular hypertension, chronic obstructive pulmonary disease, diabetes mellitus, atherosclerosis and others appear, many systems in the body suffer. First of all, these chronic diseases affect the condition of blood vessels, especially the smallest ones - capillaries. These small vessels also nourish our gums and jaws, bringing not only the substances necessary for cell growth and renewal, but also oxygen for breathing. Long-term general diseases of the body can not only directly affect blood vessels, but also reduce the supply of oxygen to the blood, for example, in lung diseases. As a result, this leads to the fact that the vessel wall becomes weak, loses its shape and elasticity, and worse allows oxygen to pass through, which is already in a reduced concentration in the blood. The lumen of microvessels becomes significantly smaller than normal, up to complete closure or blockage with blood clots. The tissues of the gums and jaws, without receiving nutrition, gradually die.

Unfortunately, this degenerative process is irreversible. It is also difficult to prevent due to the fact that it directly depends on common chronic diseases of other organs and systems. However, in no case should you despair, because periodontal disease can be stopped if it is diagnosed in time.

Periodontitis - photo

Video: Periodontal disease: definition, causes, symptoms

How does gum periodontal disease manifest?

Externally, with periodontal disease, as with periodontitis, one can notice exposed necks or even roots of the teeth, due to the loss of the jaw bone. However, it is worth distinguishing between these two phenomena in order to understand the key distinguishing features.

Table. What is the difference between periodontal disease and periodontitis?

	Periodontitis
Occurs due to bone dystrophy.	Occurs due to bacterial inflammation.
The gums are calm, have a normal or somewhat pale color, without swelling, and there is no bleeding.	The gums are irritated, bright red, may have a swollen, inflamed appearance and bleed.
Bone loss does not form pockets along the roots of the teeth.	There are clearly measurable periodontal pockets along the tooth roots.
Plaque and stones may be present in small quantities.	Most often, there is abundant plaque and tartar in the area of most teeth.
Always extends to the entire jaw or both jaws.	It may appear limitedly near several teeth or throughout the entire jaw.
The teeth sit tightly in the sockets.	In later stages, teeth become loose and fall out.
More often occurs in adulthood and old age.	Can occur at any age.

How does a dentist diagnose gum periodontal disease?

Firstly, the doctor will have to inquire about the presence of chronic diseases of the respiratory, cardiovascular, endocrine and other systems. Sometimes the patient may not be aware of their presence, but an attentive dentist, having assessed the condition of the gums, may suspect the presence of a general pathology and promptly refer the patient for examination to specialized specialists. You should not ignore these recommendations, since the health of not only teeth and periodontal disease, but also the health of the entire organism may be at stake. Early detection of diseases and their prevention is the key to success in the fight against periodontal disease.

The next step is to interview the patient, with the help of which the doctor will find out how the unpleasant symptoms began, how the disease developed, and how treatment attempts ended. It is important to remember all the factors that could influence the development of periodontal disease and mention them to the doctor, as this will help determine the prevailing cause and act on it.

The dentist will also examine your mouth and look for all or most of the signs described in the table above. One of the modern methods for diagnosing periodontal disease is X-ray examination using computed tomography. It will help to distinguish dystrophy from inflammation by the form of jaw destruction and characteristic changes in the structure and density of bone tissue. This technique is somewhat more expensive, but it is much more effective than conventional panoramic radiography.

For the most accurate diagnosis, if periodontal dystrophy is suspected, the doctor may prescribe a test to measure blood flow in the vessels of the gums and jaw bone or electroplethysmography. Thus, arterial and venous blood flow is assessed, disturbances in individual microvessels are identified, and the general condition of the vascular network in the area under study is determined. This method is good not only for diagnosis, but also for assessing the results of treatment of periodontal disease.

Rheography (electroplethysmography) is a non-invasive method for studying blood circulation

Video: Diagnosis and treatment of periodontitis

How is periodontal disease treated?

As already mentioned, periodontal disease is not a disease that can be reversed, so every effort must be made to stop the process of bone loss.

First of all, the dentist will suggest professional oral hygiene. This stage is required before almost any dental intervention, and for good reason. What can professional oral hygiene achieve?

After this, the doctor should explain to the patient how to properly brush his teeth every day. This is extremely important for people with periodontal disease, since in their case personal oral hygiene is greatly complicated by exposure of the roots. Large gaps appear between the teeth that cannot be reached with a regular brush. At the same time, patients with periodontal disease experience severe pain in their teeth when eating cold, sour or sweet foods, which is associated with exposure of the surface of the tooth root. To do this, the dentist recommends pastes and medications that reduce the hypersensitivity of dental dentin, which often have to be used on an ongoing basis.

In parallel with the treatment of gums and teeth directly, a patient with periodontal disease will definitely receive a recommendation for examination by a therapist and more specialized specialists in order to identify the pathologies that have caused poor circulation in the bones. Treatment of common diseases may require a long time, but with proper and timely therapy, the effect of improving the condition of the gums will not be long in coming.

In order to improve the nutrition of the gums and bones, you can also use physical treatment methods, namely vacuum therapy, hydrotherapy, exposure to ultra-high frequencies, and electrophoresis. Some of them can and should be used at home, in particular, the massaging effect of directed water jets. To do this, the doctor recommends purchasing an oral irrigator. With its help, you can achieve a significant improvement in nutrition and oxygen saturation of blood in the gums, increase blood flow, and start extinct metabolic processes. Without constant home use of this device, it is hardly possible to achieve lasting improvement in getting rid of periodontal disease.

Vacuum and UHF therapy differ in the method of physical impact, but in general they are aimed at increasing blood flow to the gums and jawbone. In the first case, negative pressure trains the vessels and periodontal tissues, stimulating their intensive restoration. In the second, tissues are stimulated by an electromagnetic field, promoting the launch of metabolic mechanisms, healing and strengthening of the vascular wall.

Electrophoresis for periodontal disease allows you to directly introduce medications into dystrophic gum tissue, enriching them with nutrients, vitamins and restorative components. In addition to the local administration of drugs, this type of physiotherapy can cause active renewal of gum cells, removal of toxins and affected tissue, helping to effectively stop the worsening of the process.

In some cases, doctors, most often together with a dentist, may prescribe tablets for oral administration. Vitamins are used individually and in complexes, drugs to increase the availability of oxygen to periodontal cells, drugs that increase the lumen of blood vessels, as well as drugs that lower the concentration of cholesterol in the blood.

All of these methods, used together and in a certain order, make it possible to counteract dystrophy, which means they preserve a smile for many years, even in the presence of concomitant diseases. you can find out by following the link.

Periodontal disease– a disease characterized by damage to the periodontium – a complex of tissues surrounding the root of the tooth. It is non-inflammatory in nature. It occurs relatively rarely, in 1–8% of cases.

Periodontal disease is often confused with periodontitis, a pathology of inflammatory nature. Periodontitis is much more common than periodontal disease.

Periodontal structure

Periodontium- a complex of tissues that surrounds a tooth.

Anatomical formations that make up the periodontium:

alveolar processes of the upper and lower jaw– bony protrusions that contain tooth sockets
gums
periodontium– soft tissues surrounding the tooth root inside the alveolus
cement– outer layer of tooth root

Alveolar processes

Located on the upper and lower jaw. They contain tooth sockets separated by partitions. If the root of a tooth branches, then there is also a partition that separates its branches from each other. The alveolar processes of the jaws are constantly rebuilt throughout a person’s life. This is due to the stress they experience during chewing.

Gums

The gum is a mucous membrane that covers the alveolar processes of the jaws. In the place where the gum is adjacent to the neck of the tooth - the place where the crown of the tooth passes into its root, it contains a large number of collagen fibers. Thanks to them, the gums fit more tightly to the tooth and help keep it in place.

Periodontium

Normally, between the root of the tooth and the walls of the alveoli there is a small space, the width of which is 0.2 - 0.25 mm. It is filled with soft tissues - periodontium. The basis of periodontal tissue is made up of collagen protein fibers, which help fix the tooth root in the socket. The periodontium contains blood and lymphatic vessels and nerves. Here are the cells responsible for regeneration processes (fibroblasts) and immune cells.

Cement

This is the outer layer of the tooth root. It is also classified as periodontal, since it is in contact with the gum, periodontium and alveolar walls, ensuring fixation of the tooth root in the alveolus. 30–32% of cement consists of mineral substances. The remaining 68 - 70% are represented by proteins and other organic components. Due to this, cement has high strength.

Periodontal functions

Nutrition and innervation of the tooth. The periodontium contains a large number of blood and lymphatic vessels and nerves. The neurovascular bundle, located in the periodontium, penetrates through the apex of the tooth into the root canal and is located in the pulp.
Fixation of the tooth root in the tooth socket. Collagen fibers, which are part of the gums and periodontium, are responsible for this function. The root of the tooth practically does not come into contact with the walls of the alveoli - due to numerous ligaments, it is, as it were, in a suspended state.
Uniform distribution of loads on the teeth in the dentition and alveolar processes of the jaws. The periodontium creates a kind of shock-absorbing cushion due to the fact that it contains loose connective tissue and tissue fluid.
Protecting the tooth from external influences. A healthy periodontium is a barrier that prevents the penetration of various cells and pathogens from the oral cavity into the periodontium and back. The periodontium contains many immune cells.
Regeneration. Periodontium has a high restorative ability. Regeneration occurs with the participation of cells: fibroblasts (connective tissue cells, mainly found in the periodontium), cementoblasts (dental cement cells), osteoblasts (bone tissue cells).
Reflex regulation of chewing force. The nerve endings of the periodontium regulate the force of chewing movements and the load on different teeth, depending on the nature of food and the condition of the dentition.

Causes of periodontal disease

The causes of the disease are not yet fully understood. It is believed that periodontal disease is a systemic disease that develops at the level of the entire body, not just the gums.

Main causes of periodontal disease:

A child has an increased likelihood of developing periodontal disease if at least one of his parents has the disease.

Regular, thorough oral hygiene reduces the risk of periodontal disease.

Symptoms of periodontal disease

During periodontal disease, three stages are distinguished, corresponding to the severity of the disease.

First stage (mild)

There are most often no symptoms. The disease develops gradually, so the patient does not seek medical help for a long time.

Symptoms that may occur in the early stages of periodontal disease:

itching and burning
sensation of pulsation in the gums and roots of the teeth
feeling of discomfort while chewing

Second stage (middle stage)

Bleeding gums are noted - a characteristic sign of periodontal disease. At first, the process is not accompanied by destruction of dental ligaments. There is a feeling of discomfort while chewing. At this stage the process is still completely reversible.

Over time, the patient notes that more and more food particles begin to get stuck between his teeth. This indicates the beginning of destruction of the periodontium, bone alveoli, and gums surrounding the tooth. The teeth begin to loosen, their necks are exposed.

The mucous membrane of the gums becomes pale in color due to the fact that less blood begins to flow to it.
A pocket forms between the tooth and gum where plaque accumulates.

Stage three (severe)

The teeth become very loose. Their necks and roots become exposed over a large area, their sensitivity to chemical (sour, sweet, etc.), thermal (cold and hot food, going out into the cold from a warm room), and mechanical (hard food) irritants increases. Gingival pockets increase in size, plaque and tartar accumulate in them. Gradually the teeth fall out. Chewing and articulation (sound production) are impaired.

At the third stage, periodontal disease is often complicated by the development of inflammatory processes. They are localized mainly in periodontal pockets.

Differential diagnosis of periodontal disease and periodontitis

Patients often use the term “periodontal disease” to refer to periodontitis, an inflammatory process in periodontal tissues. Periodontitis is much more widespread than periodontal disease.

The main differences between periodontal disease and periodontitis:

absence of inflammation - it occurs as a complication only at the last stage of the disease
bleeding gums and bad breath with periodontal disease are absent in the initial stages - they occur only when periodontal destruction reaches a certain degree of severity
with periodontal disease, loosening and loss of teeth does not occur even with a significant decrease in the height of the interalveolar septa: this symptom occurs in the later stages of the disease, in severe cases (if the height of the septa decreases by the height of the tooth or more)

Diagnosis of periodontal disease

Type of diagnosis	Description
Questioning the patient and taking anamnesis.	The doctor finds out: Do the patient's relatives suffer or have suffered from periodontal disease in the past? What other dental diseases does the patient have? What concomitant diseases of other organs and systems are there (their treatment may be required in order to prevent relapse of periodontal disease in the future)? What complaints does the patient have at the moment (they may indicate the stage and activity of the process)?
Dental examination	Points that the dentist identifies: condition of the gums (color, presence of pathological formations, sensitivity to irritants, presence of soreness, etc.); the degree of exposure of the necks and roots of the teeth; condition of tooth enamel (color, sensitivity); sizes of periodontal pockets; the presence of bleeding and other pathological signs.
Radiography	For periodontal disease it is carried out intraoral or panoramic radiography. Signs that are revealed during the study: reduction of interalveolar septa; narrowing of the gaps between the teeth and the walls of the sockets in which periodontal tissues are located; the presence of tartar in the neck area of the teeth.
Rheoparodontography	Methodology for studying blood flow in periodontal vessels. Vascular disorders are identified that lead to dystrophic changes in the tissues surrounding the tooth.
Laser Doppler fluorometry	Examination of the condition of periodontal tissues using a laser.
Ultrasound high-frequency Dopplerography	Ultrasound examination of blood flow in the periodontium based on the Doppler effect.
Echoosteometry	Ultrasound examination based on measuring bone density in the alveolar area.
Polarography	A method aimed at studying the content of certain substances in living tissues. With periodontal disease, there is a decrease in oxygen tension in the tissues that form the periodontium.
General blood analysis	General clinical routine examination, which is prescribed to all patients. With periodontal disease, erythrocyte sedimentation rate may be noted.

Most often, they are limited to a dental examination and intraoral radiography.

Treatment of periodontal disease

How to choose the right toothpaste for periodontal disease

There are special toothpastes that are designed for patients with periodontal disease. They contain substances, mainly plant extracts, that have antiseptic properties that increase the regenerative capabilities of periodontal tissue.

When choosing a paste, patients with gum damage need to pay attention to the content of abrasive substances. Usually they are found in large quantities in whitening toothpastes. They are not suitable for periodontal disease.

It is advisable to select toothpaste together with your dentist.

Toothpaste	Description
"Lesnaya"	Compound: chlorophyll– plant pigment responsible for the formation of oxygen; beta carotene– biologically active substance, precursor of vitamin A coniferous-carotene concentrate set of vitamins(A, C, E, P) biologically active resins– have antiseptic properties, causing the bitter taste of toothpaste. Effects: expressed hemostatic(hemostatic) effect, combating increased bleeding gums anti-inflammatory effect– fight against inflammatory processes in the oral cavity increased regeneration– restoration of periodontal tissues; deodorizing(refreshing) effect – combats bad breath antiseptic effect – destruction of viruses that enter the oral cavity Lesnaya toothpaste is recommended for daily brushing of teeth and for gum massage in case of periodontal disease.
"Forest Balm"	Compound similar to the composition of Lesnaya toothpaste: more than 20 extracts of medicinal plants that have a beneficial effect on periodontal tissue pine-keratin extract fir extract oak bark extract Toothpaste “Forest Balm” has a healing, antiseptic, and general stimulating effect. It is used for the treatment and prevention of periodontal disease.
"Extra"	Compound: A set of pine extracts that contain large amounts of chlorophyll. They have antiseptic, healing, and general strengthening properties. "Extra" toothpaste can be used daily in patients with periodontal disease.
"Chamomile"	Compound: infusion of St. John's wort camomile tea Effects: anti-inflammatory antiseptic light astringent
"Pearl"	The main feature of the composition: “Pearl” toothpaste contains components that reduce the sensitivity of tooth enamel. “Pearls” is well suited for patients with periodontal disease whose teeth are hypersensitive to hot, cold, sour, sweet, etc. foods.
"Balm"	Toothpaste is made from mineral substances obtained from mud extracted in the Kuyalnitsky estuary.
"Mary" and "Pomorin"	Toothpastes that are produced on the basis of a concentrate obtained from mineral water.
"Parodontol"	“Parodontol” is a series of toothpastes that have slightly different compositions and are used for different purposes: "PARODONTOL antibacterial protection" contains the antibacterial drug Triclosan "PARODONTOL Active" contains a set of biologically active substances that have various effects on the periodontium, primarily activating regenerative processes "PARODONTAL medicinal herbs" contains a set of plant extracts that protect tooth enamel “PARODONTAL with green tea” provides reliable protection against periodontal disease and caries

How to choose a toothbrush for periodontal disease?

Toothbrushes vary in their level of hardness. The softest ones are designated as “very soft”. They are the ones that should be chosen by patients with periodontal disease.

How to properly brush your teeth with periodontal disease?

To prevent periodontal disease and in the presence of disease, brushing your teeth should be done at least twice a day: morning and evening. The cleaning process should last at least 3 minutes. The mistake many people make is that they move the toothbrush horizontally along the teeth. This should not be done under any circumstances, since such movements do not remove plaque, but drive it deeper into the tooth crevices.

In order to effectively remove plaque, you need to make vertical movements with the bristles of the brush, from the root of the tooth to its apex.

To clean the gaps between teeth, you need to use dental floss.

To prevent dental disease, dentists also recommend brushing after every meal. In case of periodontal disease, when there is increased bleeding of the gums, you can replace cleaning with rinsing with special solutions. They can be purchased at the pharmacy.

Gum massage for periodontal disease

You can do gum massage yourself. It is advisable to first visit a dentist who will show you how to perform this procedure correctly. Daily gum massage is useful not only for periodontal disease, but also for healthy patients, in order to prevent gum disease.

Effects achieved during gum massage:

improving blood circulation in the gums
improved nutrition of gums, periodontium, alveolar processes and teeth
reflex effect: in the mucous membrane of the gums there are nerve endings, when pressed, the condition of internal organs and systems improves (by analogy with acupuncture points on the soles of the feet).

Gum massage technique for periodontal disease

Finger massage is carried out with the index and thumb, which are used to grasp the gums on both sides.

Apply light pressure and the following types of movements:

on the upper jaw: down-up-down
on the lower jaw: up-down-up

The fingers are moved so that all areas of the gum are massaged. Gum massage should be done at least once a day, preferably before bed, when all hygiene procedures have been completed.

During the massage, you can use toothpastes containing biologically active substances and folk remedies (for example, honey and salt).

Massaging has a beneficial effect not only for periodontal disease, but also for other gum diseases. It is useful for preventive purposes even in absolutely healthy people.

Conservative treatment of periodontal disease

Boosting immunity

According to statistics, periodontal disease most often develops in people with reduced immunity. Therefore, the doctor may prescribe:

vitamin and mineral complexes, biologically active food additives: they strengthen the body in general and help increase immune strength
immunostimulants– medications that increase immune strength should be prescribed strictly according to indications by an immunologist

Antibiotics for periodontal disease

Antibiotic therapy is prescribed if periodontal disease is accompanied by an acute inflammatory process. Before prescribing antibacterial drugs, a bacteriological study can be performed. It will help identify the causative agents of the disease and prescribe the most effective treatment.

Injections of drugs into the gums

Medicines that are injected into the gums for periodontal disease:

quinineurethane, sodium salicylic acid, ethyl alcohol, concentrated glucose solution– drugs that cause scarring and reduction in size of the gums when it is hypertrophy(proliferation)
antibiotics– used for periodontal disease complicated by an inflammatory process of infectious origin
biogenic stimulants (the most common is aloe extract) – substances that stimulate growth and regeneration processes
lidase – enzyme that breaks down scar tissue
ribonucleases– enzymes that promote tissue repair and blood vessel growth
methyluracil- a substance that has anabolic effect (stimulates growth and recovery processes).

Oxygen therapy and physiotherapy for periodontal disease

Procedure	Description
Electrophoresis	The tissues are exposed to a weak electromagnetic field, under the influence of which the permeability of cell membranes for medicinal substances increases. The essence of the procedure: two electrodes are applied - the cathode and the anode - which are moistened in solutions of medicinal substances. Under the influence of an electromagnetic field, the medicine enters the periodontium. Drugs used during electrophoresis: calcium enzyme trypsin tannin - tannin vitamins The main effect of electrophoresis: anti-inflammatory. During the procedure, electrodes are placed on the skin and also in the oral cavity (special gingival electrodes are used).
Infrared laser therapy	Effects of laser radiation on periodontium: stimulation of metabolism in tissues strengthening repair and regeneration stimulation of the proliferation of fibroblasts - cells that play a central role in the restoration of affected periodontal tissues Laser irradiation is performed percutaneously or directly in the oral cavity, using special dental attachments.
Ozocerite therapy	Ozokerite is a substance whose properties are very similar to paraffin and can retain heat for a long time. Ozokerite, heated to a temperature of 45 - 50 ⁰C, is placed on the skin in the affected area for 20 - 40 minutes. The total number of procedures is 10 – 14. Effects of ozokerite therapy: improving blood and lymph flow increased tone of blood vessels improvement of nutrition of periodontal tissues strengthening regenerative processes
Darsonvalization	Darsonvalization is an effect on the mucous membrane of the gums using pulsed high-frequency currents. In dentistry, devices with special attachments are used. Effects of darsonvalization in periodontal disease: dilation of small vessels, improvement of blood circulation stimulation of metabolic processes in periodontal tissues increased tone of venous vessels
Vacuum therapy	The gums are massaged using a special tip that creates a vacuum (negative pressure up to 730 mm Hg). Under the influence of a vacuum, blood circulation improves in the mucous membrane of the gums and in the periodontium: reserve blood vessels open, and the active formation of new ones begins. As a result, reparative processes are intensified.
Hydrotherapy	The procedure is a hydromassage of the gums using medicinal solutions. Effects of hydrotherapy: mechanical impact: the pressure exerted by the water jet during hydromassage stimulates blood circulation and nerve endings located in the periodontium medicinal effect: periodontal tissues are saturated with useful substances contained in solutions used for massage
Oxygen therapy	Inhalation of 100% oxygen from a special cylinder under atmospheric pressure. The procedure is carried out for 30 minutes, alternating breathing with pure oxygen and ordinary air is carried out. Effects of oxygen therapy: blood oxygen saturation periodontal oxygen saturation destruction of anaerobic (existing in oxygen-free conditions) pathogenic microorganisms enhancing the respiration of periodontal tissues, stimulating restoration processes Contraindication to oxygen therapy for periodontal disease: the presence of closed ulcers in the oral cavity.
Oxygen barotherapy	Almost the same as oxygen therapy, but the oxygen is supplied at increased pressure. For this purpose the patient is placed in pressure chamber for 30 minutes. Number of sessions – 12 – 15. Oxygen barotherapy provides a more pronounced effect compared to conventional oxygen therapy.

Attention! It must be remembered that the use of any physiotherapy procedures is carried out strictly as prescribed by the attending physician. Self-medication is unacceptable and can lead to negative consequences!

Traditional methods of treating periodontal disease

Mouth rinses with infusions of medicinal plants

Rinsing your mouth with infusions of medicinal plants for periodontal disease should be done every 3 hours. You must first brush your teeth.

Medicinal plants that are used to rinse the mouth for periodontal disease:

Features of periodontal disease	Used medicinal plants
All types and stages of periodontal disease	infusion of lingonberry leaves infusion of calendula flowers infusion of violet tricolor flowers oak bark infusion agrimony infusion Effects: elimination of the inflammatory process, pain. Features of application: the infusion used for rinsing should be warm.
Periodontal disease accompanied by severe loose gums	An infusion of walnut leaves is used. Cooking method: take 2 tsp. walnut leaves and pour 250 ml of boiling water over them. Leave for an hour, then strain. Mode of application
Periodontal disease, accompanied by severe destruction and looseness of teeth	An infusion of a mixture of medicinal plants is used: Potentilla erecta - 4 tbsp. l. horse sorrel - 2 tbsp. l. sauerkraut solution – 300 ml Cooking method: mix the ingredients and let it brew for 24 hours. Mode of application: rinse your mouth with a warm solution 6 times a day, at approximately equal intervals.
Periodontal disease, accompanied by severe increased bleeding of the gums	St. John's wort leaves blackberry leaves sand sedge leaves burnet leaves blood red geranium leaves Cooking method: take a handful of any herb and brew it in 1 liter of boiling water. Let it brew for 2 hours. Rinse your mouth with the resulting infusion throughout the day.

Folk remedies for gum massage with periodontal disease

Means with which you can massage your gums:

A mixture of fir oil with fish oil or sea buckthorn oil. It has an antiseptic effect and promotes the regeneration of damaged tissues.
A mixture of alcohol tincture of galangal and glycerin. 20 g of galangal rhizomes should be poured with 125 ml (1/2 cup) of alcohol and allowed to brew for a week. Take 10 tbsp. l. the resulting tincture and mix with 5 tbsp. l. glycerin. The resulting ointment is rubbed into the gums 2 times a day.
Honey sprinkled with sea salt. It has an antiseptic, anti-inflammatory, healing effect.

Gymnastics for teeth with periodontal disease

Gymnastics of teeth in case of periodontal damage is carried out using a small pine twig. Perform three sets of exercises in sequence:

in the first three weeks it is necessary to chew the twig from top to bottom, alternately with different teeth
the second exercise is performed for two months: hold the twig between your teeth and move your jaw sideways, forward, backward
third exercise: take one end of the twig in your hand, and grab the other with your teeth, try to tear off part of the twig with your teeth.

Oral irrigation for periodontal disease

Irrigation of the oral cavity during periodontal disease is carried out using a small syringe.

Folk remedies with which you can carry out irrigation:

oak bark decoction
burnet decoction
nettle decoction

Attention! Before using folk remedies to treat periodontal disease, it is highly advisable to consult a specialist!

Products	Effect
sorrel salad cowberry currant carrot apples	Cleansing tooth enamel from soft deposits. Sources of vitamins, biologically active and mineral substances.
greens (parsley, green onions, dill, cilantro, etc.) nettle leaves dandelion leaves.	Sources of vitamins and biologically active substances that are necessary for teeth.
Birch juice	In an amount of at least 1 liter per day, it helps remove plaque and prevents the formation of tartar.
radish fresh lemons	Helps remove tartar. Contains vitamin C and other substances beneficial for teeth.
Kohlrabi cabbage	Contains phosphorus and calcium, which are essential for teeth.
lingonberry juice rowan juice	They help eliminate the inflammatory process, strengthen the gums and saturate the body with vitamins.

Dental prosthetics for periodontal disease

Indications for dental prosthetics for periodontal disease

The main indication for dental prosthetics for periodontal disease is tooth loss and numerous dentition defects.

There are many types of dentures. They are divided into removable and non-removable. The specific type is selected by the dentist and orthodontist, depending on the condition of the patient’s dentition.

Stages of installing a prosthesis for periodontal disease

Preparing the patient for prosthetics for periodontal disease:

preliminary conservative treatment of periodontitis
professional teeth cleaning in the dentist's office, removal of plaque and tartar
treatment of carious teeth and other inflammatory diseases of the oral cavity
wearing temporary dentures to restore normal loads on the dentition and normal chewing

Prosthetics itself

In case of periodontal disease, it is advisable to choose removable dentures, and ones that do not put pressure on the gingival papillae of the affected teeth.
However, the location and size of the dentition defect due to periodontal disease may require the installation of a fixed prosthesis. It is advisable to choose metal-ceramic bridges, as they cause the least damage to the gums.

The goals of installing dentures for periodontal disease:

fixing loose teeth
correct distribution of the load on the teeth during chewing
exclusion from the act of chewing certain teeth

Prostheses for fixing mobile teeth with periodontal disease

There are different models of dentures and splints for fixing mobile teeth. They are secured using caps, pins, rings, and crowns.

The most popular are splints and mouth guards. Orthoses with fastenings in the form of crowns and rings are more expensive.

Prevention of relapse of periodontal disease

In order to prevent the recurrence of periodontal disease in the future, the patient should regularly visit the dentist, carefully care for his teeth, observing all the rules of hygiene.

Surgical treatment of periodontal disease

Surgical treatment is most effective in the early stages of periodontal disease. If the disease is in an advanced stage, then such interventions will have to be repeated from time to time.

Surgical treatment for periodontal disease involves cleaning the periodontal pockets from plaque and tartar. The manipulation is performed under local anesthesia.

Can periodontal disease be treated with hydrogen peroxide?

Does medicine have such a large number of effective, proven remedies? Periodontal disease should be treated only under the supervision of a dentist.

Is periodontal disease transmitted from person to person?

Periodontal disease is not a contagious disease. It cannot be transmitted from person to person, including through sharing utensils or kissing. Such contacts, on the contrary, are dangerous for the patient with periodontal disease. If “foreign” microorganisms from a person with caries or other inflammatory processes in the oral cavity enter his oral cavity, the course of the disease may worsen.

What gels can be used for periodontal disease?

There are special gels, but they are not used for periodontal disease itself, but in cases where it is complicated by inflammation (for example, gingivitis– inflammatory process in the gums):

Gel name	Description
Dentamet	Mechanism of action: antiseptic, antibacterial drug. Indications: periodontitis complicated by gingivitis (inflammation of the gums). Contraindications: children under 6 years old; pregnancy and breastfeeding. Mode of application:
Metrogil Denta	Mechanism of action: antibacterial, bactericidal, antimicrobial drug. Indications: periodontal disease complicated by gingivitis. Contraindications: individual intolerance to the components included in the drug; pregnancy and breastfeeding. Mode of application: Apply to inflamed gums 2 times a day, after which do not eat or drink anything for 30 minutes. The course of treatment lasts on average 7-10 days.