Periodontitis (also pericementitis) is a disease of the oral cavity,
in which inflammation and/or severe suppuration of tissue occurs at the apex of the tooth root, mainly in the bone part. The name of the disease comes from the name of the tissues surrounding the tooth root - periodontium. Periodontitis is often accompanied by the formation of an abscess, granuloma, or cyst in the area of ​​connection between the tooth root and bone tissue, followed by its destruction.

The term periodontitis should not be confused with the name of another disease - periodontitis, during which the inflammatory process covers the upper tissues surrounding the tooth.

Causes or Why periodontitis occurs

The most common causes of periodontitis are the following factors:

1. Advanced stage of caries.
2. Advanced stage of pulpitis, when inflammation reaches the deep layers of the nerve ganglion of the tooth.
3. Infection in the area of ​​the apex of the tooth root. Usually these are staphylococci, streptococci that enter the tooth canal through which the nerve passes. These bacteria provoke the development of inflammation, even purulent and granulomatous.
4. Injury to the ligamentous apparatus of the tooth, which occurs when biting hard food or strong pressure on the tooth. In this case, the ligamentous apparatus of the tooth is not able to withstand the load, resulting in periodontitis.
5. Regular loads on the tooth, often not intense, but repeated (for example, the habit of holding nails, pins in the teeth, trying hard objects on the tooth)

What's happening? or How periodontitis occurs and develops

After infection or injury to a tooth, several options for the development of periodontitis are possible. This disease can develop acutely, that is, within a few days or even hours.

Periodontitis can be chronic, i.e. the development of internal inflammation occurs quite slowly, without causing pronounced symptoms, as in acute periodontitis.

Exacerbation of chronic periodontitis may also occur. In this case, a sluggish disease under the influence of certain reasons acquires pronounced symptoms of acute periodontitis.

It is worth distinguishing between the types of periodontitis. Doctors distinguish granulomatous, fibrous and granulating periodontitis.

Granulating periodontitis. Often, with this type of periodontitis, so-called granulating tissue occurs, which is a formation at the apex of the tooth root with a loose structure and a red color. This granulating tissue quickly spreads throughout the bone tissue of the jaw, destroying it. Granulating periodontitis is considered the most active. During the course of this type of periodontitis, fistulas are formed, which contribute to the latent course of the disease.

This type of periodontitis is dangerous because inflammation can affect not only the bone tissue of the jaw, but also spread to the oral mucosa. In this way, a fairly large area of ​​tissue is affected, which does not facilitate easy healing.

Fibrous periodontitis. Most often it is chronic. Usually occurs as a result of acute or chronic granulating and granulomatous periodontitis. However, it is not uncommon for fibrous periodontitis to develop separately, that is, as an independent disease.

Granulomatous periodontitis. This type of periodontitis is characterized by the appearance of granulomas - round-shaped destruction of bone tissue, which are usually visible on an x-ray.

How do you know if you have periodontitis? / Symptoms of periodontitis

With any type of periodontitis, the following symptoms are observed:

• some discomfort in the tooth or teeth;
• possible previous dental treatment or toothache.

In particular, the symptoms of each type of periodontitis are as follows:

For granulating periodontitis:

• discomfort in the tooth when biting;
• previous tooth pain;
• presence of fistulas in the oral cavity.

Symptoms of fibrous periodontitis.

• change in tooth color;
• probing of root canals is not painful;
• There may be slight tooth sensitivity or pain when biting.

Granulomatous periodontitis may be asymptomatic. However, if symptoms do appear, they are most often:

• discomfort in the root area of ​​a tooth affected by periodontitis;
• change in tooth color;
• carious cavity in the tooth (sometimes under a crown or filling);
• before an exacerbation, painful sensations are possible, as a reaction to hot or cold;
• the mucous membrane around the tooth may be swollen.

To diagnose periodontitis use:

It is not possible to cure periodontitis on your own. Treatment by a specialist is usually carried out in several stages.

1. Removal of soft tooth tissue from root canals or, if the tooth has been filled, filling material.
2. Removing pus (or cyst or granuloma) from the canal.
3. If necessary, expand the root canal. Usually used to completely clean it.
4. Antiseptic treatment of the tooth canal.
5. Filling of dental canals.
6. Filling a carious cavity.

Filling is usually carried out after inflammation in the root area has passed. Moreover, after treatment of periodontitis, pain in the treated tooth may occur, especially when biting. Sometimes relapse and exacerbation occur, requiring repeat treatment.

The success of treatment depends on the stage of the disease, the type of root canals and their patency. Sometimes, in particularly severe cases, a tooth affected by periodontitis must be removed. You should not leave a sore tooth, as this may lead to the development of a serious infection.

Treatment of periodontitis requires strict adherence to the recommendations of the attending physician.

Prevention of periodontitis

First of all, the prevention of periodontitis is timely treatment of teeth and oral cavity.

Also, one of the preventive measures is an attempt to protect teeth from injury.

– a dental disease manifested by inflammation of the root membrane. The cause of periodontitis is infection in the periodontium. This term refers to the system of connective tissues responsible for the strength of tooth fixation. Periodontitis is the stage of inflammation following pulpitis, which is characterized by an inflammatory process only of dental tissues, but not bone tissue and periodontium.

Not so long ago, this diagnosis was an unambiguous indication for tooth extraction. But times have changed. Nowadays, the possibilities of modern dentistry make it possible to save a tooth, but the treatment of periodontitis will require the most careful approach and painstaking work from the doctor.

A tooth cavity destroyed by caries and the development of periodontitis due to infection

Classification

Based on etiology, the following types of periodontitis are distinguished:

• infectious - mainly a complication of caries;
• traumatic - occurs as a result of both a single, for example, a blow to the face, and as a result of a chronic, for example, an inflated filling or constant biting of a wire, impact on the teeth;
• medicinal - most often develops with improper treatment of pulpitis, when potent drugs enter the periodontium.

Periodontitis is also divided into acute and chronic.

The acute form is characterized by sharp localized pain of a constant nature, which can become more intense over time, tearing and pulsating, which indicates a transition to purulent inflammation.

In chronic periodontitis, changes in the color of the tooth, a deep carious cavity are noted, probing is painless. There are no reactions to cold or heat. Necrotic pulp with a gangrenous odor is often found in the tooth cavity.

Reasons

The causes of periodontitis can be divided into local and general factors.

Local factors:

• mechanical injury;
• insufficient oral hygiene;
• complications of certain diseases of teeth and gums;
• poor quality dental treatment;
• lack of vitamins and microelements in the diet;
• bad habits.

General factors– these are various diseases: diabetes mellitus, diseases of the nervous and endocrine systems, cardiovascular diseases and a huge variety of other chronic diseases.

Symptoms

Depending on the manifested symptoms, acute and chronic forms of the disease are distinguished, on the basis of which the appropriate method of treating periodontitis is selected.

Symptoms of acute periodontitis

When visiting a doctor, most patients indicate symptoms of periodontitis such as increased sensitivity and tooth pain when pressed. At the initial stage, the pain is dull, alternating with periods without pain. The more acute the process, the stronger and sharper the pain, and it becomes prolonged and practically does not stop. This symptom indicates that the inflammation has progressed to a purulent stage, and the patient has developed a periodontal abscess. The patient loses his appetite, his sleep is disturbed, and swelling may develop.

Symptoms of chronic periodontitis

A patient diagnosed with chronic periodontitis, as a rule, does not experience much discomfort or pain. Only in some cases can a tooth become particularly sensitive to tapping. Chronic periodontitis is characterized by the formation of a fistula, from which purulent contents constantly flow.

The danger of the chronic form is that the patient hesitates to see a doctor until pronounced symptoms of periodontitis appear and, as a result, risks losing a tooth, since in most cases the resulting processes, in particular cysts on the roots, turn out to be irreversible.

With an exacerbation of the chronic process, the symptoms of the disease become similar to the acute form, however, after a fistula appears and pus begins to be discharged, the process will decline again, taking on a chronic form.

In addition to examining and interviewing the patient, the dentist makes a diagnosis using an x-ray, on which, in the case of periodontitis, a darkening will be visible at the top of the root - a purulent sac that forms during the development of a periodontal abscess.

Diagnostics

Diagnosis of periodontitis is carried out by a dentist. The diagnosis is based on typical manifestations in the oral cavity, as well as the patient’s complaints. An accurate diagnosis will help to establish an x-ray of the tooth and jaw in the adjacent area. An x-ray image determines the type and location of the lesion and determines further treatment tactics.

Periodontitis on x-ray

Treatment

Treatment of periodontitis depends on the form of the disease.

Treatment of chronic periodontitis

The doctor’s prescription in this case will be influenced by the form in which chronic periodontitis occurs. There are:

• Fibrous;
• Granulating;
• Granulomatous form.

Treatment of fibrous periodontitis may require no more than two visits. The thing is that at this stage of the disease the inflammation is weak, it can be easily stopped and the root canals can be filled at the second visit. As for the other two forms, they represent a more serious case that requires long-term treatment. At best, patients are limited to only 4 visits; it may also take several months.

Development and treatment of periodontitis:

1. Caries destroys the pulp and the infection penetrates into the tooth

2. The tooth is opened, the nerves are removed, the cavities are cleaned, expanded and ground down
3. The cleaned and disinfected cavity and root canals are filled with special material

Treatment of acute periodontitis

If a doctor, based on an x-ray, diagnoses acute periodontitis, treatment of periodontitis in this case will consist of several stages. At the first stage, the patient undergoes preliminary preparation of the tooth under local anesthesia: areas affected by caries are drilled, soft dental tissues are removed, the length of the root canals is checked and they are processed.

After this, until the second visit, the patient must undergo a course of therapeutic treatment, taking antihistamines and antibiotics.

On the next visit, the canals are washed with a special solution, after which an antiseptic is placed in them. The tooth is covered with a temporary filling.

After a few days, if the doctor sees that the inflammation has subsided, the canals are filled with a permanent filling, and the crown itself is temporary. At this stage, you should remember that simultaneous filling of root canals and installation of a permanent filling in the crown is a gross mistake.

A permanent filling can only be installed at the next visit, only after the doctor is sure that the problem has been eliminated.

Prevention

Of course, the first advice we can give for the prevention of periodontitis so that you do not experience these problems is thorough oral care. You need to brush your teeth in the morning and evening after eating. Secondly, do not forget to visit the dental office in order to remove tartar and plaque from your teeth in a timely manner. Well, thirdly, undergo periodic diagnostics at the dentist to identify and treat caries. After all, it is often the cause of the development of periodontitis.

Sincerely,

Periodontitis means inflammation of the periodontium (the connective tissue between the bone of the socket and the tooth), with destruction of ligaments and changes in structure. It rarely occurs in an acute form; patients usually have chronic periodontitis. It occurs at different ages, but is often observed in older people. They are more likely to have their teeth removed, which is one of the reasons for the development of the disease.

Now there is a large selection of dentists, where a qualified doctor will treat even advanced forms of periodontitis, and you can do without tooth extraction. Therefore, at the first suspicion of pain, you should make an appointment with a doctor to avoid possible complications.

There are many known causes of periodontal inflammation. The main one is poorly treated periodontitis in the acute stage. It can be infectious, traumatic and medicinal.

Often the mechanism of development of infectious periodontitis is the penetration of pathogenic microorganisms (streptococci, yeast-like fungi, staphylococci, etc.) into the connective tissue. They penetrate to the top of the tooth root through blood, lymph, and carious cavity. They also occur against the background of rhinitis, sinusitis, ulcerative pulpitis, osteomyelitis, tonsillitis, scarlet fever.

Periodontitis can develop as a result of mechanical trauma

Traumatic periodontitis becomes possible when the periodontal area is affected under the following circumstances:

• A blow to the teeth, bruising them
• Biting hard objects
• Simultaneous removal of several teeth (multiple edentia)
• Damage to dental canals by a doctor while using endodontic instruments
• Penetration of pin parts and filling materials into periodontal tissue

The appearance of chronic microtrauma is often associated with the patient having an oversized filling or crown, due to which the load on the teeth becomes higher than permissible limits.

The medicinal form of the disease appears as a result of strong chemicals contained in dental materials entering the apical tissues of the teeth. The disease usually appears after treatment associated with the use of aggressive drugs (paste containing arsenic, eugenol, strong antiseptics for burning canals, and others).

In addition to these factors, chronic periodontitis occurs if it has previously occurred in an acute form and the patient has a weakened immune system.

Types of chronic periodontitis

Classification of this disease by type implies its division as follows:

• Granulating: This type of disease is the most active, with a characteristic proliferation of granulations in the apex of the tooth, when the alveolar bone becomes thinner, the dentin of the tooth root begins to collapse. Possible aching pain, the appearance of a purulent fistula on the gum
• Fibrous: This is the next stage of the granulating form, when fibrous tissue replaces the collagen fibers of the periodontium. This type of disease has no obvious signs; there is usually no pain. Diagnosis can only be made by x-ray
• Granulomatous: A form of the disease in which a granuloma develops, then a cystogranuloma and a radicular cyst at the root. This formation resembles a purulent sac with a dense mucous membrane. It has a round appearance, a diameter of no more than 5 mm, and is granulation tissue in a dense capsule. With the transformation of the granuloma, the alveolar bone is resorbed, and the inflammatory process begins. As the pus increases, it develops into a cystogranuloma (0.5-1 cm), which can develop into a jaw cyst, whose diameter is over 1 cm

Depending on the location of the tooth, chronic periodontitis can be:

• Apical (apical) with the location of infectious foci between the apices of the roots and the walls of the alveoli
• Marginal (marginal), when the inflammatory process comes from the edge of damaged gums

Based on the type of exudate concentrated in periodontal tissues, the disease has a purulent or serous component.

Symptoms of the disease

Important! In the chronic course of periodontitis, there are often no clear signs. A problematic tooth may have caries or fillings, but it is distinguished from others by the grayish color of the enamel. It often gives off a putrid odor.

Chronic periodontitis can be differentiated from its acute form by the duration and frequency of pain

When an exacerbation of chronic periodontitis occurs, the patient’s complaints resemble those that arise during the acute stage of the disease. You can distinguish the chronic form from the acute form by the duration and periodic nature of the appearance of pain:

• Crown color (the tooth darkens more during a long process)
• The appearance of fistulas on the gums, indicating the presence of exudate in the bone
• X-ray picture (bone structure changes when the chronic form worsens)
• Development of easy mobility of problematic teeth
• The appearance of gaps between teeth due to misalignment

The disease is characterized by alternating exacerbations and subsidence. The acute form is possible with severe hypothermia, stress, concomitant diseases, or previous injuries. It is more difficult for the body to tolerate than the primary acute stage, since the connective tissues are already damaged.

It is accompanied by pain in the teeth, which intensifies when touching them, swelling, redness of the gums, and increased body temperature.

Signs of illness

Symptoms of chronic periodontitis depend on its type. Granulating periodontitis with its characteristic symptoms is most active and most diverse:

• Feeling of pain when biting, eating hot food, or putting pressure on the teeth while chewing
• Temperature rise
• General weakness of the body
• Swelling, hyperemia of the mucous membrane near the affected teeth
• Appearance of granuloma (subperiosteal, submucosal, subcutaneous)

With an exacerbation of this type of disease, a fistulous tract may occur on the gum, where the affected tooth is projected. A small amount of pus may leak from the fistula into the mouth. A fistulous tract in the skin can lead to damage to areas such as the neck, chin, and cheekbones. Their mouths can secrete purulent fluid interspersed with blood, serous discharge, and granulation tissue. When the exacerbation is relieved, the fistula tracts close, followed by the formation of small scars.

Only with exacerbation of toothache or swelling of soft tissues does the patient think about the problem with teeth due to fibrous periodontitis

The fibrous type of periodontitis is characterized by a minimum of symptoms and a complete absence of pain. This is the most favorable form of the disease. Therefore, people often do not know about dental problems. Only during exacerbation do pain, swelling of soft tissues, mobility of teeth occur, regional lymph nodes become enlarged, and intoxication is possible.

In the presence of a granulomatous form of the disease, people often have no complaints. The disease proceeds for a long time without symptoms until a granuloma is formed, gradually turning into more difficult to cure cystogranuloma, a jaw cyst.

The disease begins to manifest itself:

• Acute dental pain
• Swelling, redness, suppuration of the gums
• Changing the shade of teeth
• Flux formation

If the cyst is allowed to develop to a large size, it can lead to a pathological fracture of the jaw.

Diagnosis of chronic periodontitis

Establishing a correct diagnosis requires a thorough examination, consisting of interviewing the patient, examining his oral cavity, and probing for the degree of tooth mobility. Outside of exacerbation, the disease in chronic form is difficult to diagnose due to its slow progression. Such periodontal inflammation is often confused with pulpitis, osteomyelitis, periostitis, although during exacerbation they are clearly distinguished.

To obtain the correct diagnosis, an X-ray examination is used, which shows changes in tissue in the periodontium. An X-ray will not show noticeable changes in the periodontium if there is acute inflammation, but the chronic form of the disease will be better identified.

Granulating periodontitis will be revealed by extensive deformations of the periodontium with unclear round outlines, a visible decrease in bone density. The fibrous form of the disease manifests itself as a change in the lumen in the periodontal fissure; it is characterized by the presence of a thickened root at the apex of the tooth. In the granulomatous form, the image will show the presence of an overgrown granuloma under the root, next to it. If the formation has already developed into a cyst, then urgent surgical intervention will be required.

In addition to x-rays, they use:

• Electroodontodiagnosis (the condition of the pulp and periodontium is examined when the nerves are excited by the influence of electric current
• Radiovisiography (examination using digital equipment)
• Electroodontometry (the threshold of excitability of the dental pulp is measured)

Treatment

There are different ways to treat chronic periodontitis. It can be conservative, surgical, or alternative. Its complexity is determined by the degree of development, structure of the teeth, root system, and age of the patients.

Important! For any type of disease, treatment is aimed at relieving inflammation, eliminating problem areas, and treating root canals.

Endodontic treatment can be supplemented with physical procedures - electrophoresis, laser, magnetotherapy, UHF and other methods.

Opening the carious part of the tooth and treating the root is the essence of the conservative method

The method consists in organizing full access to the root canals, which are subject to treatment only if they are well patency. To open the cavity, the carious part of the tooth or the old filling, dentin (hard tissue of the teeth) inside the canal walls are removed using an endodontic instrument. Then it is treated repeatedly with an antiseptic solution (sodium hypochloride, chlorhexidine). An anti-inflammatory agent is injected into the cavity and a temporary filling is placed.

It is effective to use laser technologies during treatment to kill harmful microorganisms by inserting light guides into the lumen of the root canals. They irradiate the canal from the inside, which speeds up the effect of the procedure.

Conservative treatment at this stage includes taking medications. These are broad-spectrum antibiotics, antihistamines, metronizadol, non-steroidal anti-inflammatory drugs. At the next appointment (2 or 3 days later), the temporary filling is removed, the canals are washed and sanitized, and filled with temporary medicinal paste.

Final processing of the canals is possible only after 2-3 months. First, a control x-ray is performed, then the root canals are processed again. At the last stage of therapeutic treatment, the root canals are filled with gutta-percha and a permanent filling is placed. Successful therapy leads to the disappearance of signs of chronic periodontitis and the gradual restoration of connective tissue.

Surgical intervention

Therapeutic treatment is excluded if the patient has severely damaged tissue in the area of ​​the root apexes, their canals are impassable, there are peri-radicular cysts of the teeth, and old fillings cannot be removed from the roots. Therapy also becomes impossible if the canal becomes impassable as a result of the presence of a piece of instrument left in it by the dentist.

Surgical treatment is radical, since usually the diseased tooth is removed. But now dentists try to avoid removing teeth whenever possible. To do this, resection of the upper part of the root, root amputation, cystectomy, and other methods are used to preserve the tooth.

Root tip resection under local anesthesia is common. The old filling is removed and the artificial crown is removed (if any). The carious cavity is cleared of necrotic tissue. If the nerve is inflamed, it is removed completely, in one fiber. A filling made of a quick-hardening material is placed in the canal. The gums of the affected area are then cut, exposing the jaw. The part of the root that protrudes is cut off, and the granulations are scraped out. After filling the cavity with an antibacterial composition, the wound is sutured.

Treatment at home

This is one of the alternative methods that complements the main treatment. It allows you to reduce pain and slow down the inflammatory process in the soft tissues of the teeth. It is effective to rinse the mouth with potassium permanganate (dissolve it minimally, the solution should be slightly pink) 4 times a day. You can also use a warm soda solution (half a teaspoon per glass of water).

The condition is improved by adding drops of grapefruit seed extract, which has antimicrobial properties, to the toothpaste when brushing your teeth. The strong antioxidant coenzyme Q10 in the form of food supplements or oil-based capsules from the pharmacy can enhance cellular energy and relieve inflammation. At home, you should often drink cranberry juice or juice of at least 100 ml per day, as cranberry prevents bacteria from attaching to the gums and teeth.

Preventive measures, prognosis

Treating any chronic disease is long and expensive, especially periodontitis. This can be avoided by following preventive measures.

Regular visits to the dentist are the basis for the prevention of dental diseases and periodontitis in particular.

In the presence of chronic periodontal inflammation, such measures are:

• Regular visits to the dentist for dental examinations (at least 2 times a year)
• Compliance with the rules of caring for teeth, gums, and oral cavity
• Timely dental treatment
• Rational use of medications

The prognosis for treatment of periodontitis depends on its quality and timely contact with the clinic. With high-quality root canal treatment, teeth retain their functionality, and areas with bone resorption are restored. Otherwise, complications that threaten your health are possible.

Possible complications

There is a high probability of complications due to the presence of an infectious form of the disease. If treated ineffectively, it can lead to the development of serious problems, for example, intoxication of the body with the risk of blood poisoning (sepsis).

All types of periodontitis can cause the appearance of diseases with purulent processes: phlegmon, meningitis, abscesses of tissues of the face, neck, brain and others.

A jaw cyst often appears on the tops of teeth in the presence of granulomatous periodontitis and is dangerous due to serious complications. These include osteomyelitis, which destroys the bone tissue of the jaw. The appearance of a fistula in poorly treated granulating periodontitis, which is caused by growing granulations, can lead to the development of a facial defect with constant discharge of pus.

Therefore, it is not recommended to save teeth with frequent exacerbations of periodontal disease, the growth of bone tissue pathology, after unsuccessful treatment. They should be removed to avoid the spread of pathological lesions to the roots of the teeth located next to them.

Tooth inflammation of the ligamentous apparatus of the tooth (periodontal) in both children and adults.

The fact is that the tooth is located in special holes in the jaw and is strengthened in them by ligaments, which can also be affected by microbes. - a common disease that can cause many discomforts and painful reactions.

It occurs quite often in different forms, some of which require only constant monitoring, while others require urgent treatment. According to the course, periodontitis can be acute, fibrous and chronic.

Symptoms of periodontitis:

In acute periodontitis, aching pain in the area of ​​a tooth and increased sensitivity when biting on it may first appear. Then the pain becomes constantly intense, tearing and pulsating, biting on a tooth hurts, and sometimes it’s even impossible to touch it with your tongue. The pain can spread and then it feels like half the jaw or half of the face hurts. It seems that the tooth has lengthened, it may become more mobile and begin to sway. Often the gums around the tooth become red, swollen and also painful. After a few days, a wound may appear on the gum or even on the skin of the face, from which pus will periodically flow, and the pain will decrease or completely subside. This forms a fistula - a passage from the site of inflammation to the outside for the outflow of pus. More precisely, pus forms it itself, literally melting healthy tissue - such a protective mechanism of the body.

Chronic periodontitis can behave in different ways. Sometimes it does not appear at all and is accidentally detected on an x-ray. It may manifest itself in the form of unpleasant and mild pain (a feeling of heaviness, fullness, awkwardness), and it may be painful to bite on the affected tooth. The sensations are usually periodic and are accompanied by a fistula, which goes away on its own after some time.

Causes and factors for the development of periodontitis

It can occur as a complication of untreated pulpitis, when microbes manage to go beyond the apex of the tooth root, or as a complication of chronic pulpitis that is asymptomatic.

This is a frequent complication of poor-quality treatment of pulpitis, if the filling material is taken beyond the top of the tooth or, worst of all, it is not filled enough, leaving voids in the canal. Nature does not tolerate emptiness - microbes will not miss the chance to settle in it, which sooner or later will lead to periodontitis and its complications.

It can also occur as a result of tooth overload. If many teeth are missing, then the load falls on the chosen ones, they have to work hard “both for themselves and for that guy” and their resource is quickly exhausted.

Used to meet often periodontitis, caused by arsenic poisoning, but now almost never occurs, because instead of arsenic, if the need arises, arsenic-free pastes are left in the tooth, killing the nerve.

Prevention of periodontitis

If your tooth hurts, and even at night, you don’t need to endure it, swallowing tons of pills - it won’t go away on its own, you’ll just wait for complications, plus you’ll ruin your stomach, liver and nerves!

Do not disdain preventive examinations at the dentist twice a year; tell the doctor if you experience any unpleasant or unusual sensations in the area of ​​some teeth.

Be sure to replace missing teeth, especially chewing ones (the largest ones), if you don’t want to lose all the others.

Complications of periodontitis

Complications may be common:

general poisoning of the body (intoxication): persistent headache, weakness, increased body temperature to 38°C and above;

autoimmune diseases of the heart, kidneys, joints due to the fact that cells of the immune system (immunocompetent), the number of which constantly increases during chronic infection, can “confuse” some cells of their own body with microbes and begin to destroy.

Local complications often occur in the form of cysts and fistulas and, fortunately, much less often in the form of:

abscesses (purulent sacs);

phlegmon of the neck (diffuse purulent inflammation);

osteomyelitis of the jaw (inflammation of bone tissue);

odontogenic sinusitis (when the fistula opens into the maxillary sinus and pus and microbes enter it).

Diagnosis of periodontitis

In case of acute periodontitis, the doctor will find out from your words what kind of pain is bothering you, externally he will be able to see redness and swelling, wounds from which pus can ooze, he will feel them to determine which tooth is the source of infection. For the same purpose, he will lightly tap the teeth, check their mobility and take an x-ray.

Chronic periodontitis sometimes detected by chance on an x-ray during the treatment of adjacent teeth. If you have complaints, the doctor will do all the same manipulations as when diagnosing acute pulpitis and will see a fistula if it is present.

Treatment methods for periodontitis

In the treatment of chronic periodontitis First, the canal of the affected tooth is treated: infected tissue is removed, unfilled if it has been treated previously, and disinfected. Then anti-inflammatory and antimicrobial drugs are injected into the canal, physiotherapeutic procedures and antibiotics are prescribed. Typically, treatment of periodontitis lasts quite a long time, medications are applied several times (they dissolve over time). If it is still not possible to achieve recovery or the tooth is covered with a crown that you do not want to destroy, then apical root resection is performed. This is a small surgical operation in which, through a small incision in the gum, I remove the source of inflammation along with a piece of the tooth root (apex). With very advanced periodontitis, it is sometimes necessary to remove a tooth.

In case of acute periodontitis, the tooth is first left open for the outflow of inflammatory fluid and antibiotics are prescribed, and when the process subsides, treatment is continued according to the same scheme described above.