Periodontal diseases are those diseases that affect one or more of the periodontal tissues:
• Alveolar bone
• Periodontal ligament
While many different diseases affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the vast majority of periodontal diseases and have traditionally been divided into two categories:
1. Gingivitis ("inflammation of the gum tissue") is a term used to describe non-destructive periodontal disease.
In the absence of treatment, gingivitis may progress to periodontitis, which is a destructive form of periodontal disease.
Symptoms of gingivitis:
Are non-specific and manifest in the gum tissue as the classic signs of inflammation:
-Bright red or purple gums
-Gums that are tender or painful to the touch
-May also emit an unpleasant odor(bad smell):halitosis
-Epitehilial becomes ulcerated and the gums will bleed more easily with even gentle brushing, and especially when flossing.
-Recurrence of gingivitis
-Infection or abscess of the gingiva or the jaw bones
-Trench mouth (bacterial infection and ulceration of the gums)
The focus of treatment for gingivitis is removal of the etiologic (causative) agent, plaque. Therapy is aimed at the reduction of oral bacteria, and may take the form of regular periodic visits to a dental professional
together with adequate oral hygiene home care.
Methods such as scaling, root planing, curettage, mouth washes containing chlorhexidine or hydrogen peroxide, and flossing. Interdental brushes also help remove any causative agents.
If these measures are not sufficient, gum surgery or treatment with metronidazole may be other options.
2. Periodontitis - Periodontitis is therefore the developing stage of gingivitis, where in addition to the inflammation of the gingiva, there is also inflammation at the bone, the "foundation" of each tooth.
However, even at this stage of the disease, once detected, may be treated with a large percentage of success.
Symptoms of periodontitis:
- Bleeding of the gingiva during brushing.
- Reddening and swelling of the gingiva.
- Absorption of the gingiva leading to an exposure of the roots, making the teeth appear larger.
- Bad breath, even after brushing.
- Loosening of the teeth, which become mobile.
- A drifting of the position of certain teeth, which is usually accompanied by the appearance of large gaps between them.
- Pus between the teeth and the gingiva.
Please be aware of the fact sometimes periodontitis does not cause particular pain, so that it often remains unnoticed by many patients
Effects outside the mouth:
Periodontitis has been linked to increased inflammation in the body such as indicated by raised levels of C-reactive protein and Interleukin-6.It is through this linked to increased risk of stroke,myocardial infarction,and atherosclerosis.
It also linked in those over 60 years of age to impairments in delayed memory and calculation abilities.
Educating the patient about a new programme of oral hygiene and the elimination of inflammation, through scaling and deep cleaning of the roots. The aim of this method is to remove the calculus from the teeth
and to polish the root in order for the detached gingiva to become re-attached.
Sometimes because of the severity of the disease, and the specificities of the teeth, the conservative method may not be sufficient.
For this reason, the problem can only be fully resolved with the help of surgery.
Periodontal surgery may be needed to stop progressive bone loss and regenerate lost bone where possible.
There are many surgical approaches used in treatment of advanced periodontitis, including open flap debridement, osseous surgery, as well as guided tissue regeneration and bone grafting.