What's wrong with the gums - periodontal disease, periodontitis or occlusal injury?

From this article you will learn:

• What is the difference between periodontal disease and periodontitis?
• causes and symptoms of its development,
• how to treat periodontal disease at the dentist, as well as home therapy products.

The article was written by a dentist with more than 19 years of experience.

Periodontal disease is a disease of the gums, which is based on the process of sclerosis of blood vessels, which leads to a decrease in the supply of oxygen and nutrients, and as a result, there is a slow degeneration of all periodontal tissues (i.e., the bone tissue around the tooth, periodontal fibers attaching the tooth to bones, as well as soft tissues of the gums).

Typically, patients incorrectly use the term “periodontal disease” to refer to any existing gum disease. In fact, periodontal disease is a fairly rare disease, and most patients who complain about problems in the gums do not have periodontal disease, but actual chronic generalized periodontitis.

Periodontal disease: photos of teeth and gums

You can very easily check whether you have periodontitis or periodontal disease - the symptoms of the latter are a gradual decrease in the height of the gums and exposure of the roots of the teeth, which occurs due to the gradual process of sclerosis and dystrophy - usually in the absence of any inflammation in the gums. In turn, the presence of bleeding and soreness of the gums when brushing, swelling and redness of the gums indicates the presence of inflammation in the gums, i.e. about Periodontitis.

Diagnosis of periodontal disease

To identify signs of periodontal disease in adults, the following diagnostic procedures are usually performed:

• inspection;
• probing of the gingival sulcus;
• assessment of tooth mobility;
• X-ray examination (orthopantomography);
• biomicroscopy of the gums to determine the degree of microcirculation impairment.

The patient will also need observation from a general practitioner and endocrinologist to detect and treat general somatic pathology.

After a diagnosis of “dental disease periodontal disease” is made, further examination should be aimed at finding the causes of disturbances in the processes of cellular tissue nutrition, predicting the further development of the disease and the likelihood of inflammatory complications.

Symptoms of dental periodontal disease

The main symptom of the disease is detected during x-ray diagnosis of periodontal disease. The image shows a uniform decrease in the height of the interdental septa with alternating foci of osteosclerosis and osteoporosis in the deep parts of the alveolar process and the body of the jaw, as well as in other bones of the skeleton. Traditionally, changes are accompanied by the presence of diseases of the cardiovascular or endocrine systems and metabolic disorders.

There are other symptoms of severe periodontal disease that are more noticeable to the patient and others:

• gum retraction;
• exposure of the necks and roots of the teeth;
• pale gum color;
• lesions of teeth of non-carious origin (wedge-shaped defects, hyperesthesia).

Stages of periodontal disease

In modern dentistry, there are three degrees of severity of periodontal disease.

Mild degree

How does periodontal disease begin? In the early stages, the disease occurs without pronounced symptoms with gradual atrophy of the gum edge and bone tissue. With periodontal disease of the anterior teeth, a slight exposure of the dental necks occurs; in some cases, patients experience increased sensitivity of teeth to food irritants (hot and cold, sweet and sour). On X-ray images, the onset of periodontal disease is indicated by the first signs of bone tissue atrophy.

Average degree

With an exacerbation of periodontal disease, not only the necks, but also the roots of the teeth are exposed - by 2 - 3 millimeters. X-ray images show destruction of bone tissue along half the length of the root and the presence of foci of sclerosis.

Severe degree

With severe periodontal disease, exposure of the roots of the teeth reaches 4–5 millimeters, bone tissue atrophy on X-ray photographs covers two-thirds of the root.

Always treat gum problems

When a patient comes to the doctor, he complains about something. What symptoms does he see a doctor with before receiving a diagnosis of periodontal disease? What worries him?

Literally, patients tell the doctor this: my gums have sagged, my gums have become exposed, my lower gums have receded. And for some reason the symptom of gum subsidence automatically means that the patient has the so-called. periodontal disease.

More experienced patients, who have already heard a lot of professional terms, who delve into the professional colloquial language of doctors, say this: “The necks of the teeth have become exposed a little, the teeth have become a little higher.” But, according to statistics, most patients complain about sagging gums.

And so, when patients come to the doctor with complaints about the problem of exposed tooth necks, the doctor diagnoses them with periodontal disease. Of course, he begins to treat them. And to treat it specifically for periodontal disease.

But time passes, money also goes away, and the question of why the gums recede and the necks of the teeth become exposed, why the gums recede, has not been resolved. And the patient still has periodontal disease.

Periodontal disease – what to do?

At the initial stage of periodontal disease, you should consult a periodontist. No folk remedies will help get rid of the disease. Only a specialist will be able to carry out the necessary diagnostic procedures and prescribe, based on the identified symptoms of periodontal disease, treatment aimed at slowing down degeneration in periodontal tissues and preventing inflammatory complications. It is also necessary to eliminate non-carious dental lesions and undergo a thorough examination by a therapist to diagnose and treat common diseases that provoke the development of periodontal disease.

Complex therapy of periodontal disease involves the following measures:

1. Timely removal of dental plaque.
2. Normalization of occlusal relationships (grinding teeth, prosthetics, splinting).
3. The use of vitamins and agents that improve microcirculation (nicotinic acid, aloe extract, heparin).

Introduction

The information world is very huge. Each of us is haunted by a million points of view

for any problem in any field of knowledge, you just need to ask a search query. The same thing happens in medical circles on the Internet - discussions of health problems are widely represented by both patients and doctors and often reach the point of absurdity:

For example, in questions:

• loosening of the tooth,
• exposure of the neck of the tooth,
• why are my gums and teeth exposed?

that is, in situations where the gums on a tooth have receded, patients are always confused: either they have periodontal disease
, then suddenly it changed to
periodontitis
, then periodontal disease returned again. And the search for an answer to the question becomes endless.

The problem of “how to treat periodontal disease” is picked up by doctors who only add fuel to the fire by recommending medications and even folk remedies for periodontal disease, without having sufficient competence to do so.

Let's consider these points of view professionally, and try to convey one simple truth, which for the vast majority of patients (and even some doctors) will be a revelation: the diagnosis of periodontal disease of the gums

» —
does not exist
.

An expert point of view is expressed by the famous periodontist, Doctor of Medical Sciences Laura Mikhailovna Tebloeva:

As a rule, for patients who come to me and say: “I have periodontal disease,” I always clarify - did you make this diagnosis yourself or did you see a doctor? Often patients answer that they have this information from their doctor. It turns out that the patient did not read somewhere and determine the diagnosis of “periodontal disease” for himself, but, unfortunately, such a diagnosis was made by a doctor.

Treatment methods

Methods and procedures used to treat periodontal disease in dentistry:

• exposure to high pressure oxygen in hyperbaric chambers;
• electrophoresis;
• diadynamic currents;
• amplipulse therapy;
• darsonvalization of gums;
• UHF therapy;
• gum massage;
• local hypo- and hyperthermia;
• ultrasound therapy.

Psychosomatics of periodontal disease

Based on the results of many years of research, American scientists have come to the conclusion that dental diseases such as periodontal disease are directly related to high anxiety, depression and an acute sense of loneliness. This is explained by the fact that increased levels of the stress hormone - cortisol - in the blood negatively affect the condition of the gums and jaw bones. In addition, during periods of nervous tension, people begin to pay less attention to oral hygiene and increase the doses of alcoholic beverages, nicotine and medications, which also contributes to the development of various diseases.

Clinical researches

The effectiveness of ASEPTA products has been repeatedly proven clinically. For example, clinical trials of ASEPTA gum gel have proven that using ASEPTA gum gel with propolis for a week can reduce gum inflammation by 31%.

Repeated clinical studies have also proven that the two-component mouth rinse ASEPTA ACTIVE more effectively combats the causes of inflammation and bleeding compared to single-component rinses - it reduces inflammation by 41% and reduces bleeding gums by 43%.

Sources:

1. The use of drugs from the Asepta line in the complex treatment of inflammatory periodontal diseases (N.V. Berezina E.N. Silantyeva S.M. Krivonos, Kazan State Medical Academy. Kazan.) N.V. BEREZINA, E.N. SILANTIEVA, S.M. KRIVONOS Kazan State Medical Academy
2. The use of adhesive balm "Asepta®" in the treatment of inflammatory periodontal diseases L.Yu. OREKHOVA*, Dr. med. Sciences, Professor, Head of Department V.V. CHPP**, Dr. med. Sciences, Professor, Head of Department S.B. ULITOVSKY*, Dr. med. Sciences, Professor A.A. LEONTIEV*, dentist A.A. DOMORAD**, O.M. YAKOVLEV** SPbSMU named after. acad. I.P. Pavlova, St. Petersburg - *Department of Therapeutic Dentistry, **Department of Microbiology
3. Study of the clinical effectiveness of treatment and prophylactic agents of the Asepta line in the treatment of inflammatory periodontal diseases (A.I. Grudyanov, I.Yu. Aleksandrovskaya, V.Yu. Korzunina) A.I. GRUDYANOV, Doctor of Medical Sciences, Prof., Head of Department I.Yu. ALEXANDROVSKAYA, Ph.D. V.Yu. KORZUNINA, asp. Department of Periodontology, Central Research Institute of Dentistry and Maxillofacial Surgery, Rosmedtekhnologii, Moscow
4. The effectiveness of the use of Asept “adhesive balm” and Asept “gel with propolis” in the treatment of chronic generalized periodontitis and gingivitis in the acute stage (Municipal Dental Clinic No. 4, Bryansk, Kaminskaya T. M. Head of the therapeutic department Kaminskaya Tatyana Mikhailovna MUZ City Dental Clinic No. 4, Bryansk

Consequences of periodontal disease - why is it dangerous?

• Firstly, due to the absence of pronounced symptoms, this disease can progress unnoticed over many years and lead to total destruction of the teeth and jawbone - and then teeth fall out with periodontal disease.
• Secondly, the destruction of bone tissue leads to disturbances in the functioning of the gastrointestinal tract with the subsequent occurrence of diseases of the digestive system.
• Thirdly, advanced periodontal disease can provoke periodontitis - acute inflammation of the tissue and tooth loss.

In addition to the above consequences, generalized periodontal disease in an advanced stage causes another dangerous disease - osteomyelitis, that is, purulent bone damage.

Types and classification of periodontitis

To prescribe adequate treatment, it is necessary to determine the type of periodontitis. The disease is classified according to:

• characteristics of the course of the disease - acute or chronic periodontitis;
• degree of severity of the disease (mild, moderate, severe), which takes into account the size of periodontal pockets (from 4 mm to 6 mm or more), destruction of the bone tissue of the interradicular septum (from <⅓ to >½ root length), pathological mobility of teeth (from absence up to lll degree);
• the prevalence of the inflammatory process - generalized and local periodontitis.

A separate group includes purulent periodontitis, when pus is released from the gum pockets. Its course is accompanied by the formation of abscesses and fistulas.

In acute periodontitis, the gums hurt, swell and bleed heavily, and there may be purulent discharge. Chronic occurs, either exacerbating or subsiding.

Periodontal disease - contagious or not?

To the questions “Is periodontal disease contagious?” or “Is periodontal disease transmitted by airborne droplets?” Doctors answer unequivocally in the negative. Therefore, you should not believe various dubious articles on the Internet about how periodontal disease is transmitted. The disease is associated with metabolic disorders, and not with the spread of bacteria. Therefore, those who believe that periodontal disease can be contracted or that the disease is transmitted through a kiss are deeply mistaken. However, despite this, we must not forget about the rules of daily oral hygiene in order to prevent the occurrence of other problems with teeth and gums.