Periodontal disease (periodontal disease)

In the Periodontal diseasewhich is popularly often incorrectly also referred to as Periodontosis is called, it is actually a Periodontal disease. This form of gum disease causes inflammation of the gums and the tooth bed. The cause of this disease is mostly inflammation of the gums caused by bacteria. If the periodontal disease is not treated, it can lead to tooth loss.

What is Periodontal Disease?

If the gums bleed repeatedly, this can be an indication of periodontitis.
© Henrie - stock.adobe.com

The Periodontal disease or Periodontal disease is a bacterial inflammation of the tooth support system.

If left untreated, this would be destroyed, but the decay process can now be stopped. One form of the disease can start at the root tips, while the other starts at the gum belt and extends into the roots.

Periodontitis brings sensitive gums and bleeding gums with it, as well as bad breath and pus formation in the area of ​​the gums. With advanced periodontitis, the tooth loosens noticeably.

causes

The Periodontal disease can only arise if there is sufficient plaque containing bacteria. Tartar can form from this, which means that the bacteria can damage the tooth unhindered. They penetrate into the interior of the teeth and cause inflammation there. The body tries to fight off the bacteria by breaking down the tissue in which they exist - in this case, this affects the tooth itself. Therefore, the detection of periodontitis consists in diagnosing the radiologically visible bone decline.

Among other things, the body forms defense enzymes that are intended on the one hand to destroy the bacteria, but on the other hand also have harmful effects on the tissue itself. The causes that increase the risk of periodontal disease include tobacco consumption, generally inadequate oral care, inappropriately localized piercings and a general weakness in the immune system. Tooth decay also increases the risk of an illness - especially if it is open.

Symptoms, ailments & signs

Periodontitis (parodontosis) often goes unnoticed at first. The first signs are only weak and are ignored when you brush your teeth every day. If the gums bleed repeatedly, this could be an indication of inflammation of the gums (gingivitis). These abnormalities can be discovered especially if you bite into an apple.

Gum inflammation makes the gums more sensitive to touch and even more susceptible to the spread of bacteria. The inflamed area of ​​the oral cavity could represent a preliminary stage of periodontal disease. Brushing your teeth is perceived as painful. Accumulated bacteria cause a strong smelling bad breath. An unpleasant taste also occurs.

These complaints are aggravated if purulent spots develop in the further development of the disease. As the bacterial inflammation progresses, the gums recede in the area of ​​the tooth bed. If the inflammation affects the fibers of the periodontal membrane, so-called gingival pockets develop. This will make it easier for bacteria to enter. Late signs of periodontitis are regression of inflamed jawbones.

As the gums and jawbones recede, the necks of the teeth are increasingly exposed. The teeth react more and more to cold and warm stimuli. In the event of severe, untreated periodontal disease, the teeth holding apparatus no longer functions. The teeth loosen and misaligned teeth form, which can lead to tooth loss. With a rarely occurring aggressive periodontitis, the acute inflammation of the gums also manifests itself with fever and swelling of the lymph nodes.

Course of disease

Schematic representation of healthy pelvic tissue, periodontal disease and gingivitis. Click to enlarge.

The Periodontal disease or. Periodontal disease is usually a chronic, intermittent health condition that develops over a long period of time and is often only noticed after years.

It is largely painless, the first symptom recognized by the patient himself is the loosening of the teeth. In the first phase of periodontal disease, most of the bacteria in the plaque can still be fended off; they do not penetrate the tooth.

Over time, however, the body's defense cells die, as do the bacteria - these are stimuli to which the body reacts. He starts by breaking down the tooth in order to rob the bacteria of their habitat.

Reddened gums, bleeding and bad breath initially occur the further the bacteria penetrate the tooth. A special form is the aggressive periodontitis, which leads to the first symptoms much more quickly and can appear in childhood.

Complications

If certain risk factors are present, periodontal disease can be difficult and not heal properly despite dental treatment. One of the biggest risk factors is smoking.Those affected who suffer from metabolic disorders such as diabetes mellitus or who suffer from a weakened immune system must also expect a more difficult course. An unbalanced diet, particularly the regular consumption of sweets, is particularly counterproductive in this case.

Periodontitis can become chronic and last a lifetime. Due to the chronic inflammation, the gums usually bleed profusely and gum pockets also develop. In the next stage, the gums recede. This makes the teeth look longer and sometimes larger.

At this stage, those affected often suffer more from the aesthetic impairment than from the disorder itself. However, further complications are to be expected as the periodontitis progresses. In the medium term, the inflammation destroys the connective tissue and the bony structures of the jaw. The teeth begin to loosen and eventually fall out.

There is also evidence that untreated or chronic periodontitis can lead to serious complications. A statistical connection with respiratory diseases and atherosclerotic vascular diseases such as heart attacks and strokes has been demonstrated.

You can find your medication here

➔ Medicines against tartar and tooth discoloration

When should you go to the doctor?

The control and cleaning of the teeth should always be done by a doctor at regular intervals. If there are no other disorders, an annual visit to a dentist is recommended. If repeated or sudden bleeding gums occur despite the checks that have taken place, this indicates an irregularity. A dentist should be consulted so that the cause can be investigated. If you have bad breath, an unusual taste in your mouth and pus formation, you should see a doctor.

Open wounds must be treated sterile, otherwise there is a risk of sepsis. If there are discrepancies such as bleeding, discomfort or pain immediately with the daily teeth cleaning, clarification of the complaints is advisable. If the gums recede continuously, action is required. Any loosening of the teeth or an existing denture must be presented to a doctor.

An examination is recommended as soon as possible, as the symptoms will increase as the disease progresses. If the jawbone changes or the jaw is shifted, a doctor is required. If left untreated, there is a risk of teeth loss, which should be prevented in good time. If the person concerned complains of a fever or if swelling of the lymph is noticed, a visit to a doctor is recommended. The germs and bacteria from the mouth and throat have already spread in these cases and cause sequelae and other diseases.

Treatment & Therapy

The aim of treating the Periodontal disease consists in eliminating the inflammatory factors in the mouth, which in the long term will restore health. To do this, the patient's teeth are first carefully analyzed in order to determine the severity of the disease. Once the bacteria are detected and systemic disease has been ruled out, the dentist will remove any visible evidence above the gumline.

Fillings may also have to be made during this phase if cavities have caused holes in the teeth. Then the same treatment is carried out with all plaque that lies below the gums in order to also rid them of bacterial deposits. Depending on the severity of the periodontitis, it may be necessary to additionally treat the periodontitis with antibiotics in order to eliminate all bacteria that have accumulated in the tooth in the long term.

Aftercare

Pardontitis follow-up is very important. The colonization of bacteria that can trigger periodontitis must be prevented consistently even after treatment. In this respect, aftercare is the same as in the essential points.

This applies above all to consistent oral hygiene. But brushing your teeth regularly with the right brushing technique is not enough. There are places that the toothbrush cannot grasp. This applies in particular to the so-called gum line (the transition between tooth and gum) and the sometimes very fine interdental spaces.

Here the PZR (Professional Tooth Cleaning) is the right method for maximum oral hygiene. Hard plaque (tartar) and soft plaque (biofilm) in hard-to-reach areas are thoroughly removed. Due to its efficient effect, the PZR is not only reimbursed by many health insurance companies during aftercare.

Outside of oral hygiene, there are a few things to consider in the aftercare of periodontal disease. Ideally, smokers will consider giving up nicotine. Nicotine has a habit of constricting blood vessels. This means that bleeding gums as an alarm signal for periodontal disease may not occur or only appear much later than with other affected persons and valuable time is wasted. Intensive chewing of the food for optimal saliva production is important and can also become a useful routine in aftercare.

Outlook & forecast

Patients with periodontal disease must consult their dentist at regular intervals. The prognosis depends, among other things, on the type and severity of the disease. For example, apical periodontitis can develop into numerous secondary diseases. These include apical cysts, abscesses or granulomas, which can lead to bone or root dissolution. Other forms of the disease can also lead to diseases such as diabetes or rheumatism. Even cardiovascular diseases are not excluded.

If periodontitis is detected and treated early, the prognosis is relatively good. The symptoms should have largely disappeared after a few treatments. Long-term effects are not to be expected with early therapy. However, patients must see their doctor regularly and should endeavor to maintain good oral and dental hygiene.

The prognosis is usually made by the dentist who does the treatment. With periodontitis, patients have the prospect of a symptom-free life. It should be noted, however, that long-term consequences can occur if the teeth are still not well cared for after the treatment. Periodontitis does not reduce life expectancy.

You can do that yourself

Periodontitis usually requires dental treatment. In mild cases or in addition to conventional medical therapy, self-treatment with home remedies can be tried: Mouthwashes with sage, thyme or a one-percent hydrogen peroxide solution, like tea tree oil, have an antibacterial effect - they can relieve inflammation and in some cases prevent gum disease. Massaging in pain reliever and inflammation relieving aloe vera gel on the reddened areas several times a day has also proven itself, clove oil can be used against bleeding gums and painful tooth necks. The effectiveness of green tea has been proven in some studies: According to this, two cups a day can prevent the progression of incipient periodontal disease.

A varied diet with lots of fresh fruit, vegetables and dairy products provides the body with all the minerals and vitamins necessary for the health of teeth and bones. In addition, the immune system is strengthened, so the body can fight the triggering bacteria more effectively. Proper oral hygiene is also very important: To protect sensitive gums, the use of a soft toothbrush is recommended, brushing should always be done from the gums to the teeth. Brushing your teeth immediately after eating can do more harm than good, especially after consuming acidic drinks or foods: We recommend waiting at least half an hour.