Health, Diseases and Conditions
Periodontal disease: features, causes, pathogenesis, diagnosis, treatment and prevention. Classification of periodontal diseases
When there are problems with the oral cavity, it is extremely difficult to ignore such unpleasant changes. It is for this reason that the prevention of periodontal diseases and their subsequent treatment will always be relevant. After all, the diseases of this group are quite common, both in adults and in children.
What is the essence of the disease?
For a better understanding of this problem, you need to pay attention to several key concepts. You can start with periodontal disease.
This term is used to refer to tissues adjacent to the tooth and securely fixing it in the jaw. In fact, we are talking about the periodontal ligament (connects the bone socket and the root of the tooth), gums, bone tissue, alveolar processes and the cement itself. To pay attention to various compound tissues is meaningful for the reason that such a disease is able to hit each of them separately.
As for the process itself, which has a destructive effect on the elements of oral fatigue, in most cases it is inflammation of the entire structure or tissues of the gingival margin.
By their nature, diseases associated with the gums and teeth can be tumorous, dystrophic or inflammatory.
It should be understood that periodontal disease is one of the most common problems with which patients come to dentists. Having studied the data of WHO, one can learn the following fact: diseases of this kind in children Are found in 80% of cases in many countries of the world. Adults, too, are often forced to deal with the diseases of this group.
Causes
Of course, problems with the gums and other tissues of the oral cavity do not arise by themselves - they are caused by certain processes.
With regard to specific factors related to the etiology of diseases of this group, they can be divided into two key categories: local and general. In fact, we are talking about dental plaque, trauma, subgingival and supragingival tartar deposits, defects in prosthetics, missing teeth, anomalies of attachment of the bridles of the tongue and lips, etc.
Any periodontal disease Is often a consequence of the imbalance of the biological system (plaque and the state of the oral fluid).
More specifically, about the general factors, it is worth highlighting the lack of vitamins of groups B, C, E. Their deficiency has a negative impact on the structure and function of periodontal tissues. The lack of necessary vitamins can cause such problems as the violation of protein, phosphoric-calcium, carbohydrate and lipid metabolism. We should not exclude the risk of organic and functional changes in the digestive, nervous, vascular, endocrine, and nervous systems of the body.
It makes sense to pay attention to the fact that periodontal disease can be caused by such problems as hereditary predisposition, blood diseases, allergic reactions, changes in the reactivity of the organism, immunodeficiency state and disruption of the hormonal system.
Periodontal disease
The basis of this disease is an atrophic-dystrophic process in the tissues of periodontal disease. The course of this disease can be characterized as slow, without bright symptoms.
In most cases, periodontal disease is manifested by exposing the roots of the teeth or visually increasing their length due to the gingival subsidence. Sometimes patients may feel pain in the teeth and itching in the gums.
Treatment and prevention of periodontal diseases in this case is reduced to symptomatic effects through special medications. It can be "Floogel", "Ftorlak", etc. As a result, the increased sensitivity of the teeth. A doctor can also prescribe an auto-massage of the gums. This is done in order to correct trophic disorders. In some cases, vestibuloplastic operations are relevant, but the effect of their use can not be long. It is possible and sealing wedge-like effects.
Antiotropic treatment is not used, as the causes of the development of periodontal disease are still not clearly understood.
Periodontitis and gingivitis
If we talk about such a manifestation of problems associated with the tissues of the oral cavity, as periodontitis, it is worth noting that this is an inflammatory disease in which all types of tissues in the jaw region are affected. For such a state, the progressive destruction of the alveolar processes of the jaw bones, as well as the destruction of the dentogingival joint, is characteristic.
As for gingivitis, it can be characterized as an inflammatory process that affects only the tissues of the gingival margin. This means that only the surface tissues of the gum are affected.
It is worth knowing about the following fact: these forms of the disease are often interconnected. The bottom line is that the inflammation that has appeared in the tissues of the gum, over time, can affect other elements of the periodontal structure. For this reason, one should not ignore such a diagnosis as gingivitis, since subsequently it can lead to a much more tangible problem.
Explaining the causes of periodontal diseases, it is necessary to note the influence of a whole complex of factors, both external and internal. So, as for gingivitis, most often to such a state leads neglect of oral hygiene, leading to the deposition of calculus and accumulation of plaque.
This means that in the implementation of elementary preventive measures, it is possible to prevent a serious problem.
Atrophic gingivitis
Continuing to consider the features of periodontal diseases, it is worth paying attention to this form of the disease. It develops against the backdrop of a chronic inflammatory process that affects both the entire dentition and individual teeth.
In this case, the mucous membrane acquires a pale pink color, and the gingival papillae are completely absent or smoothened. In this state, the patient does not feel much discomfort. Complaints, as a rule, are associated with mild pain or slight itching in the gum area.
Chronic gingivitis
Classification of periodontal diseases includes such negative changes in the state of the tissues of the oral cavity.
Such a problem is most often recorded in patients with pathology of the digestive or cardiovascular system. To the causes of the development of the disease can be attributed immunodeficiency states, as well as the impact of environmental factors, including industrial factors. This is a chronic poisoning with lead, mercury and other harmful elements. Therefore, it is important to pay attention to working conditions and not to take lightly into the possible risks of negative health effects.
The pathogenesis of periodontal diseases of this type is reduced to the fact that after exposure to an unfavorable factor, bleeding occurs on the tissues during tooth cleaning and solid food intake, as well as bad breath and burning sensation.
To eliminate chronic gingivitis, it is necessary first of all to neutralize the factors that cause the development of the disease. Attention should be paid to occupational hygiene of the oral cavity. A full-fledged competent diet, detoxification of the body and constant consumption of water will be actual.
Ulcerative necrotic gingivitis
This is another form that can be taken by inflammatory periodontal disease. Preceding this state is dysbiosis, a decrease in the resistance of the body, hypoavitaminosis, influenza, hypothermia, immunological problems, various stressful situations and angina.
It is not superfluous to know that in the case of gingivitis on the background of blood diseases, it is necessary to conduct differential diagnosis.
Treatment involves the rapid elimination of the inflammation focus and the necessary measures to stop its effect on other tissues of the oral cavity. Also worth paying attention to reducing total intoxication. As measures having a local effect, it is possible to use the removal of necrotic tissues, anesthesia and treatment with broad-spectrum antibacterial agents of those gum sites that have been affected.
Do not forget about prevention: to prevent the recurrence of the disease, it is necessary to avoid the occurrence of infectious diseases and not to delay with dental treatment with obvious problems.
Focal juvenile periodontitis
Those who are interested in the classification of periodontal diseases should pay attention to this form of inflammation.
The essence of this problem is reduced to selective damage to the support apparatus of the first permanent teeth. Provoke such a disease of bacterium-actinomycetes. In the overwhelming majority of cases, such a problem makes itself felt in those children whose parents are carriers of the above-mentioned microorganism.
Inflammatory reaction in this case is minimal, but suppression of immune system reactions occurs. Over time, specific antibodies are formed in the child's body, which allows the following permanent teeth to remain protected.
Treatment of periodontal diseases of this type is reduced to the use of antibiotics for 21 days or more, as well as the conduct of local interventions. Speaking about the long-term administration of antibiotics, it is worth noting that this measure is necessary because harmful microorganisms penetrate not only into the dentogingival groove, but also into the periodontal pocket and even deep into the bone structures and tissues. This negative state is fairly persistent, and therefore the effect is long-lasting.
Drug-resistant and fast-progressive periodontitis
This problem is a consequence of the influence of a specific microflora of several species. If several types of pathogens act simultaneously, then the effect of each of them is enhanced, which leads to tissue destruction and suppression of the immune response.
Given the pathogenesis of periodontal diseases of this species, the most effective treatment strategy will be intensive antimicrobial therapy (at least 3 weeks) and thorough mechanical treatment of periodontal pockets.
Surgical intervention is also possible. In this case, it will be important to carry out patchwork operations, which are done only after the patient has completed the full course of antimicrobial therapy.
In order for the treatment to be most effective, it is necessary to initially carry out a microbiological analysis of the contents of tissue biopsy specimens and periodontal pockets.
Tumor lesions of periodontium
Such diseases are especially significant because they are extremely difficult to predict due to the development of this disease only in people who initially have a predisposition to such manifestations.
As a factor provoking the development of tumor and tumor-like lesions, it is possible to determine hormonal changes. This can be, for example, the accumulation of growth hormone during pregnancy or puberty. To the causes of the appearance of tumor lesions can also be attributed to the inflammation that precedes the disease, or the effect of a traumatic factor that is chronic.
Recently, doctors have documented another cause of manifestation of such a pathology as periodontal lesions. We are talking about the active use of anabolics, which young people often use during bodybuilding and other power sports.
Methods of treatment of periodontal diseases in the case of this pathology are reduced to the elimination of inflammation and trauma (in the presence of the latter) and, if necessary, surgical removal of the expanded tissue. The operation is the most relevant method with such diagnoses as "hypertrophic gingivitis", "gum fibroids " and "inter-root granuloma".
After the operation, it is important to carefully follow the rules of oral hygiene and apply antibacterial as well as special antiseptic rinses.
Diagnosis of periodontal diseases
In the process of diagnosis, the degree and nature of the process, as well as the clinical picture as a whole, are taken into account.
If we are talking about periodontitis, then differential diagnosis in this case will focus on identifying the three main symptoms by which you can determine the severity of the disease. We are talking about the resorption of bone tissue, abnormal mobility of teeth and the depth of the dentogingival pocket.
Acute and chronic forms are identified through the generality of the following symptoms: edema and hyperemia of the alveolar mucosa, pain in the particular tooth during compression or chewing food, infiltration and worsening of the patient as a whole.
As a distinctive feature that indicates periodontal disease This type, you can identify abscesses, which are manifested in different places. First one passes, and after another 5-7 days another appears. The location of their localization is close to the gingival margin, but there is no communication with the parodental pocket.
The definition of various forms of gingivitis was presented above. But as for the diagnosis of traumatic nodes, in this case, in addition to the degree of defeat of periodontium, it is necessary to establish an etiological factor. For these purposes, a standard survey and a survey method are appropriate. After that, you need to pay attention to the pathogenesis of the disease.
Treatment
In principle, the diagnosis and treatment of periodontal diseases come down to identifying specific symptoms, determining the form of the disease, its characteristics and then neutralizing the inflammation along with the painful symptoms.
But, depending on the situation, the methods of overcoming the disease may have some differences.
It is also worth noting that the key goals of the treatment are the restoration and preservation of the chewing function, the normalization of aesthetics and neutralization of the negative impact of pathological processes both on the body as a whole and on periodontal tissue in particular.
It is difficult to single out a particular method of influencing the problem as the most urgent, since only the complex treatment of periodontal diseases can provide the desired result.
It is also important to know that there are a number of basic principles on which the process of overcoming the disease is built. This individuality, complexity, pathogenetic, as well as etiotropic therapy. A series of measures of a restorative nature closes the treatment process.
With regard to the key tasks that provide clinical periodontics, they look like this:
1. Pathogenetic justification.
2. Effects on the microbial (etiologic) factor.
3. Measures to prevent the progress of the destructive process.
4. Therapeutic effect on the entire body and periodontal tissue in particular. The essence of entiotropic therapy in this case is reduced to eliminating the root cause of the disease.
5. Restoration of functional and morphological characteristics of periodontium.
At the moment, many different antimicrobials are available that have the required degree of exposure, which are presented in a variety of forms (threads, gels, elixirs, plates, ointments, etc.). But it is important to understand that the haphazard use of such drugs can aggravate periodontal diseases in children and people of mature age, triggering the development of oral candidiasis and impaired oral microbiocenosis.
It is for this reason that after professional diagnosis the treatment plan should be made by a qualified doctor who is able to take into account all the individual characteristics of the condition of the patient who has periodontal pathology. These features include the prescription of the disease, the general condition of the patient, the treatment that was conducted before, its results and other factors.
An example is the effect on catarrhal gingivitis. First of all, the patient is taught proper oral hygiene, then the elimination of irritating factors of a local nature is carried out. It can be a filling of teeth affected by caries, with the restoration of contact points, as well as the removal of dental deposits.
The next stage of treatment, which will help eliminate periodontal disease, is the local anti-inflammatory therapy, during which the use of phytopreparations is applied. Physiotherapeutic treatment in the case of catarrhal gingivitis will improve microcirculation. For this reason, the patient can be shown electrophoresis, hydro massage of gums and other procedures.
With appropriate indications, it is possible to eliminate the wrong position of the teeth, the anomaly of soft tissue development and bite. In this case, drugs can be significantly helped. For example, the gel contains components that have a fairly high therapeutic effect. The method of its application is not difficult: after the antiseptic treatment of the gingival margin is completed, the teeth are isolated with cotton rollers, after which they are dried. To apply the gel, use a syringe or an ironing pad. As a place of application, a gingival sulcus or marginal gingiva is selected.
It is also recommended the use of new generation keratoplastics 3-5 days after the onset of the disease. The result will be the stimulation of reparative processes.
Results
The prevention of periodontal diseases and the treatment of this pathology are important for many subjects, as diseases of oral tissues disturb people of different age categories quite often.
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