Introduction:
Gum diseases are one of the common diseases in oral cavity and periodontitis is one of them. But In order to understand the meaning of periodontitis we need to know, what the periodontal tissue is.
Periodontium is “the alveolar bone, periodontal ligament, and gum surrounding and supporting a tooth”.
What is periodontitis?
The inflammation of any of the mentioned tissues around the tooth is called periodontitis. So what can cause periodontitis? Basically any inflammation is caused by bacterial infections, but what are the specific etiological factors of periodontitis? In general periodontitis almost refers to bad hygiene of oral cavity or to say more exact, the accumulation of plaque around the teeth which causes gingivitis at first and the exacerbation of it leads to periodontitis, but still there are many other factors causing periodontitis. The next factor which we need to mention next is the situation which periodontitis is caused in result of another infectious process such as pulpitis. When inflammatory process in pulp spreads to periodontal tissue through the apex of a tooth and causes inflammation in other regions. The other factors which can cause periodontitis are general diseases. Diseases such as diabetes, HIV, and cancer. As we know cancer and HIV affect the immune system and if any infection happens in periodontal tissue the immune system will not be able to fight against it so it leads to periodontitis. About diabetes, as a common rule patients suffering diabetes are at a higher risk of developing infections and that’s due the fact that their body is not able to use the blood’s sugar properly. Bad habit which also might refer to oral hygiene also can become other etiological factors, for example smoking which makes it hard for gums to repair.
The other group of factors which can cause periodontitis is the hormonal changes. During puberty, monthly menstruation, pregnancy and menopause, some hormonal changes happen which make gums sensitive, and in result gingivitis develops easier.
The next and and the last etiological factors refers to medications. Any drug that makes any changes in structure, secretion or even viscosity of saliva which has a very important protective effect on teeth and gums, can affect oral health. As we know some drugs lessen the flow of saliva. Also using some medications directly affect the normal growth of gum tissue, such as the anti-angina drug Procardia and Adalat or anticonvulsant medication Dilantin. We should also mention that family history of dental disease also may contribute the development of gingivitis.
Signs and Symptoms:
Unfortunately gum disease may progress painlessly, why unfortunately? It’s obvious, because it may develop and due to the fact that the patient doesn’t feel any pain, it can get to severe degrees of periodontitis. But still there are other signs and symptoms which are noticeable and can help diagnose and treat it before it’s exacerbation.
Basically the signs might be local or general. What does it mean? Sometimes signs of a periodontal disease can be seen in all parts of oral cavity or at least in a major part of it then it is general, when the disease affects the whole oral cavity. Sometimes the signs can be seen only near a specific group of teeth for example molars, then only a dentist or hygienist can distinguish it.
But in general all gum diseases can have these symptoms:
1. Bleeding of gums during or after brushing.
2. Gums become swollen, red and/or tender.
3. Gums atrophy
4. Formation of deep periodontal pocket
5. Mobility of the teeth
6. Bad breath, which is called halitosis or unpleasant taste in the mouth.
Once again we need to mention that even if you do not feel any pain or do not notice any signs, it doesn’t mean that you do not have any degree of gum disease.
Bu how we can prevent periodontitis?
Once again let’s remember the major cause of periodontitis, yes poor hygiene. So we can say upkeeping the oral hygiene is the best way of preventing periodontal diseases. Proper and regular brushing of the teeth, and when we say regular it means at least 2 times a day. As we know tooth brushing can help disrupt the mycotic and bacterial growth and therefore the formation of subgingival plaque. Flossing and using interdental brushes also play important role in oral hygiene especially when the space between teeth is large enough for food debris to stick in there.
Using antiseptic mouthwashes help prevent gum diseases. Also as we said gum diseases can develop with subtle signs so regular check-ups and regular professional teeth cleaning is essential. A professional dental hygienist or dentist by using special instruments can remove dental plaques which you can’t do by your own.
Treatment:
So if for example the factor causing the periodontitis is diabetes, then it is necessary to control and manage diabetes and its effects on oral cavity, so the treatment includes a general therapy which is the underlying factor and local treatment which is done in oral cavity. So after cleaning the dental plaques and calculus, medication such as different types of antibacterial chips, antibiotic gels and etcetera can be used. The next treatment is the surgical treatment, sometimes in severe cases it is needed to remove cysts or pus or necrotic tissues or even it might be necessary to do bone grafts or soft tissue grafts.
Prognosis:
Dentist use periodontal probe to determine the depth of gingival pocket. the instrument should be entered gently in the space between the tooth and gum and if the depth is more that 3mm then we can say that the patient has gingival pocket, if the depth is less than 3 mm then it is considered to be natural and self-cleansable. But if the depth is more than 3 mm around the tooth then the home care would not be sufficient for cleansing so professional care by a professional is needed. If the depth reaches 6 to 7 mm then only hand instruments and cavitrons should be used to remove the plaque causing the gingival inflammation. In such situations other therapies such as surgical methods might be needed and if the depth becomes more than 7 mm, then there is high risk of tooth loss over the years.
References
Periodontium. (n.d.). The Free Dictionary. Retrieved January 6, 2014, from http://www.thefreedictionary.com/periodontium
Gum Disease (Gingivitis and Periodontitis) Symptoms, Treatments, Causes. (n.d.). WebMD. Retrieved January 4, 2014, from http://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease
Periodontitis: MedlinePlus Medical Encyclopedia. (n.d.). U.S National Library of Medicine. Retrieved January 7, 2014, from http://www.nlm.nih.gov/medlineplus/ency/article/001059.htm
Patient Education:. (n.d.). Periodontitis. Retrieved January 7, 2014, from http://www.colgateprofessional.com/patienteducation/Periodontitis/article
Gum Disease (Gingivitis and Periodontitis) Symptoms, Treatments, Causes. (n.d.).WebMD. Retrieved January 4, 2014, from http://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease
