Periodontal disease – an inflammation of the fabrics (parodont) surrounding tooth with the subsequent destruction of ligaments of tooth with a bone tissue of a jaw. It is shown by bleeding and an inflammation of gums, pain when pressing, an unpleasant smell from an oral cavity, mobility of teeth. Further development of a periodontal disease leads to formation of zubodesnevy pockets, a gnoyetecheniye, shaking and loss of teeth. Can be complicated by abscesses and fistulas on gums, periostity and lymphadenitis. Treatment of a periodontal disease consists in full sanitation of a mouth and cleaning of desnevy pockets, if necessary their tool curettage is made.
The periodontal disease is a disease of tooth from which destruction of zubodesnevevy connection results. Gingivit, that is the inflammation of gums, is an early stage of a periodontal disease, further inflammatory process passes to other fabrics of a parodont that leads to destruction of a periodontium and a bone tissue of an alveolar shoot. Loss of teeth at advanced age is in most cases caused by a generalized periodontal disease.
Periodontal disease reasons
The congestion of a dental plaque which hardens is the main reason for emergence and forms a scale. Smoking and chewing of tobacco for many reasons can promote development of a periodontal disease. So, tobacco reduces reactivity of immune system owing to what the risk of infection of a parodont with pathogenic microflora increases. The substances which are contained in tobacco, entering interaction with saliva, create favorable conditions for activity of pathogenic microflora. Also smoking significantly reduces process of cell regeneration that affects a current of a periodontal disease.
Hereditary predisposition seldom, but becomes the main reason for development. In this case, in spite of the fact that the patient carefully looks after an oral cavity, develops gingivit, and then – a periodontal disease.
Decrease in production of saliva can increase formation of a dental plaque and scale as process of natural clarification of an oral cavity is broken. Antidepressants, anti-inflammatory medicines especially at long reception significantly reduce production of saliva. Anticonvulsive medicines, immunodepressants, blockers of calcic tubules can cause a giperplaziya of gums that considerably complicates care of an oral cavity. As a result the scale is formed much quicker, as becomes the periodontal disease reason.
With diabetes the periodontal disease is diagnosed for patients several times more often, at the same time treatment practically does not bring results. Changes of a hormonal background because of pregnancy, lactations, menopauses cause change in immune system, as influences development of a periodontal disease and if before pregnancy at the woman was gingivit, then inflammatory process begins to progress.
Deficiency of vitamins C and In because of violation of their comprehensibility or because of bad food is one of factors which can become the main pathogenetic link in development of a periodontal disease. The lack of calcium negatively affects all bone system including on zubochelyustny as calcium is important for bones, especially for those which support teeth. The people who are receiving less vitamin C get into risk group on development of a periodontal disease because of decrease in durability of connecting fabric. At smokers the lack of vitamin C is more expressed.
The constant use of excessively soft food does not provide the necessary load of teeth in the course of chewing that reduces quality of self-cleaning of teeth. Promotes development of a periodontal disease also and the addiction to chew on one party as in this case functional loading is distributed unevenly. At people, with the wrong bite and with irregular shape of teeth the periodontal disease is diagnosed more often.
Periodontal disease symptoms
At a periodontal disease the pain syndrome is observed seldom. The inflammation from gums is shown by puffiness, reddening, local temperature increase and bleeding of gums. That is gingivit is the first stage. In the absence of treatment process progresses and a periodontal disease soft and bone tissues are surprised that can end with loss of tooth.
It is possible to diagnose a periodontal disease on early terms only during survey by the stomatologist as clinical manifestations are practically absent. And the main symptom after which patients ask for medical care is bleeding of gums during toothbrushing or during food.
Further puffiness of gums and their hypersensibility in response to irritation joins. If at this stage a periodontal disease not to treat, then gums begin to separate from teeth owing to what teeth look longer, between teeth intervals appear. In the subsequent at a periodontal disease also the unpleasant smell from a mouth appears purulent separated. Unpleasant smack in a mouth and loss of teeth are characteristic of late stages of a periodontal disease.
Any inflammatory process in gums including the periodontal disease, proceeds without serious consequences regardless of depth of defeat and a stage of destruction of parodontalny fabrics. Therefore even painless bleeding of gums is the first clinical manifestation of the developing periodontal disease. At this stage process is still reversible as the parodontalny sheaf is not involved in inflammatory process and tooth is connected with the next teeth that provides uniform loading on all tooth alignment, does not result from an overload in fabrics of a parodont yet.
In the absence of treatment of a periodontal disease inflammatory process gets more deeply, destruction of a parodontalny sheaf begins, there is a parodontalny pocket. In this pocket at a periodontal disease the dental plaque and a scale is postponed that promotes process progressing. Further parodontalny fabrics (a gum and a bone tissue) collapse, tooth begins to be loosened, the bone support in a jaw is lost. At this stage of a periodontal disease position of teeth in a tooth alignment changes, between them cracks appear.
Depending on features of the patient, the periodontal disease proceeds differently. So, the aggressive current of a periodontal disease is characterized by bystry, almost rapid destruction of teeth and gums. At other part of patients the periodontal disease proceeds incidentally, with long remissions and the periods of an aggravation of process.
The chronic current of a periodontal disease is characterized by the slow, but progressing destruction of the bone and muscular fabrics surrounding and supporting tooth. The chronic periodontal disease has slower current, than aggressive. If the periodontal disease is one of displays of system diseases, for example diabetes, then usually its symptoms are shown at early age and abate during correction of the main disease.
The Nekrotiziruyushchy periodontal disease is the most severe form of a course of a disease. Desnevy fabrics nekrotizirutsya, in the absence of treatment the necrosis of periodontal sheaves and a bone tissue is observed. The Nekrotiziruyushchy periodontal disease occurs generally at patients with severe forms of immunodeficiencies, for example, patients with AIDS.
Diagnostics of a periodontal disease
Existence of one or several symptoms is a reason for the fastest request for the dental help to define, defeats are how deep. Measurement of depth of a gap between tooth and a gum is the main diagnostic procedure which, despite simplicity, allows to determine defeat depth rather precisely. For carrying out a research parodontalny test which is placed between tooth and a gum is used and by that measure interval depth. Results of inspection of each tooth are written down and receive a parodontogramma.
If gap depth no more than 3 mm, then is not present signs of a gingivit and a periodontal disease and the gum is healthy whereas gap depth more than 5 mm demonstrates existence of a periodontal disease. Congestions of a dental plaque and existence of a scale are also considered at diagnostics of a periodontal disease. For complex assessment of a condition of a bone tissue of a jaw is shown to execute the orthopan-tomogram.
Treatment of a periodontal disease
Very often treatment begins at a stage when destruction of the supporting bone tissue and a gum already happened owing to what treatment of a periodontal disease drags on because of a congestion of pathogenic microorganisms in desnevy pockets. In such cases treatment of a periodontal disease is directed to prevention of deepening of desnevy pockets and to prevention of further destruction of a gum and bone tissue. For this purpose make careful professional hygiene of an oral cavity with cleaning of desnevy pockets of bacteria that prevents further destruction and progressing of a disease.
At in due time made diagnosis the periodontal disease well will respond to treatment by noninvasive methods. If depth of desnevy pockets no more than 5 mm, then is enough procedure for clarification of a fang from the inflamed pulp with use of antibiotics. Further it is required to observe hygiene of an oral cavity and to periodically visit the stomatologist for removal of a scale.
The curettage which is carried out by means of tools or ultrasonic toothbrushing deletes over - and poddesnevy a scale. Removal of a scale by means of ultrasound among other things polishes the surface of teeth, preventing emergence of a scale, and oxygen disinfects desnevy pockets and promotes the accelerated healing. After ultrasonic cleaning it is recommended to apply local gels with antibiotics. Local antibacterial medicines allow to suppress growth of bacteria in desnevy pockets, as is a main issue in treatment of a periodontal disease. The refusal of reception of system antibiotics for treatment of a periodontal disease in favor of local medicines allows to reduce probability of development of side effects.
If depth of a desnevy pocket at a periodontal disease exceeds 5 mm, then surgical intervention is required. For reduction of a desnevy pocket perform scrappy operation. The small section in a gum is made that allows to raise it and to bare a fang which needs to be cleared of a scale. If the periodontal disease already extended to a bone tissue, then before taking in a section, the bone tissue is leveled. Scrappy operation is performed under local anesthesia and lasts from 1 to 3 hours.
Transplantation of soft tissues of gum is necessary in that case when it because of an atrophy of desnevy pockets teeth becomes bare and visually looks longer. For replacement use a fabric rag from the sky. This procedure helps to stop deepening of a desnevy pocket and helps to close the bared fangs, preventing development of giperesteziya. For women, especially young age, transplantation of soft fabrics at a periodontal disease yields double result – treatment and disposal of cosmetic defect.
Application of a bone transplant for osteoplasticity at a periodontal disease is carried out at considerable destruction of a bone tissue when it cannot perform functions on keeping of tooth on the place. The transplant can be made both of synthetic material, and of own bone tissue. The bone transplant for treatment of a periodontal disease has indisputable advantage: it serves as a platform for formation of a new bone tissue that is called the directed regeneration.
The directed regeneration of a bone tissue at deep defeats by a periodontal disease restores a bone tissue. For this purpose the site between tooth and a bone tissue is filled with biocompatible material therefore on this site only the bone tissue grows, growth of other cages is completely suppressed. The second technique of the directed regeneration for treatment of a periodontal disease consists in maintaining proteinsoderzhashchy gel which in the structure is similar to enamel of teeth. As a result the organism begins to stimulate growth of a bone tissue in response to false information about formation of new tooth.
In prevention of a periodontal disease sanitary education of the population, training in the correct toothbrushing at children's age and good nutrition matters. It is necessary for timely identification of a periodontal disease and other diseases at least, than time in half a year to have planned examination of the stomatologist and a procedure for removal of a scale which provokes development of a periodontal disease.
If is available gingivit, then he needs to be treated as gingivit manifestation of a periodontal disease is the first. At this stage it is possible to prevent a periodontal disease using antibacterial toothpastes and anti-inflammatory conditioners for a mouth. Defects of tooth alignments it is necessary to treat in due time as it forms the correct load of teeth and promotes prevention.