Periodontal disease is a very unpleasant and complex disease, accompanied by various complications, such as gingival bleeding or teeth loosening.
The reason for the development of periodontal disease is quite simple, it is an infection. And the most common source of infection is dental plaque, in which gram-negative bacteria and other microbes begin to multiply. The formed pathogenic zone on the surface of the tooth penetrates the dental plaque and then into the gingival sulcus.
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Causes of disease
As a result of the formation of these dental deposits, or as they are also called dental stones, the inflammatory process begins in the dental tissues and gum tissues. Further, thanks to these bacteria, the connective tissue of the gums is damaged. As a result, most often and periodontal pockets are formed, or as they are called the periodontal pocket.
If the depth of the periodontal pocket is not very deep, about 3 mm, then in the process of daily hygiene it can be self-cleaning. But, if the depth of the periodontal pocket exceeds this depth, then it will hardly be possible to clean it with the help of a toothbrush. As a result, the deposits will accumulate until the inflammatory process begins.
Features of the disease
Next, infection of epithelial cells occurs, which, plunging into the periodontium, begin to surround the root of the tooth with their pathogenic flora. At the same time, the inflammatory process continues to deepen, which further leads to a decrease in bone tissue and makes the periodontal pocket even more.
The next stage is the destruction of the connective tissue ligament, which leads to the absorption of the cement itself. Damaged bone tissue is replaced by epitheliumThus, the body tries to fight the pathological process and overgrow the affected area, but the result is only much worse. Epithelial cells are not able to hold a tooth in place. The walls of the gums go down so low that the entire tooth is exposed. And since the tooth does not hold, the tissue and gum is broken - the tooth falls out.
The formation of periodontal pockets is fraught with its pathology, so in the case of generalized periodontitis it is also fraught with complete adentia. This means the absence of teeth in both dental rows. In this case orthopedic treatment is recommendedwhen missing teeth are replaced with removable and non-removable prostheses.
In patients with inflammatory diseases of the oral cavity, often there is discomfort when eating, an unpleasant smell from a mouth and all this can be accompanied by suppurations of tissues and, as a result, an abscess is formed.
Periodontal pocket treatment methods
In order to cure the periodontal pocket, first you need to determine the extent of the disease, this will help the dentist. At the very beginning of the disease, when the inflammatory process is not yet very much started, can do and conservative therapy, that is, the treatment, the process is aimed at facilitating disease symptoms. Conservative therapy in this case will include if it is a treatment for periodontal disease:
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ultrasonic cleaning of teeth.Having chosen the necessary parameters, the dentist with the help of an ultrasonic scaler acts on the dental stone with radiation, destroying it, but at the same time very carefully and without disturbing the integrity of the gums; - further prescribed medication. A good antiseptic that very popular in the treatment of periodontal disease, chlorhexidine. Its antiseptic and antibacterial properties in the treatment of periodontal disease are indispensable. With a solution of this drug, you can rinse your mouth, and to improve the effect, you can apply the gel directly on the inflamed gums.
In the case of a more severe disease, additional treatment is prescribed, in the form of a course of antibiotics.
After the treatment, in order to avoid the resumption of the disease, it is necessary to observe oral hygiene very carefully. If, after all, after some time appeared again periodontal disease symptoms, such as blood from the gums, pain appearing during tooth brushing, it is better not to postpone to consult a dentist. The reason may be optional periodontal disease, and a badly fitted crown and, if it is fitted, then all the symptoms will go away.
Curettage
There is also a surgical method for the treatment of periodontal pockets - this is curettage, which is used specifically for the treatment of gums. With it, you can treat not only periodontal disease, but also gingivitis. Gingivitis is also an inflammatory disease of the gums, but in this case there is no violation of the integrity of the dentition.
The main indications for curettage are the following symptoms:
- pocket depth exceeds 3 mm;
- strong deposition of tartar on the gums;
- inflammation of the gums, bleeding.
Many people confuse curettage with professional teeth cleaning. As a rule, professional cleaning of teeth is recommended to be carried out 2-3 times a year, this will effectively help to fight against the occurrence of caries in the future. With its help you can get rid of tartar, from the color that gives tea, coffee and tobacco, returning healthy natural color and shine to your teeth. Unlike professional cleaning, curettage not only helps get rid of tartar and polishes the teeth, but also removes the pathological tissues of the periodontal pocket. Depending on how severe the case is, the doctor determines how and how many times it is necessary to carry out this procedure.
When the depth of the periodontal pocket does not exceed 5 mm, the method is carried out closed curettage. The doctor can still clean the pockets without surgery. In this case, the procedure is carried out in several stages and almost painless. Right away it is necessary to diagnose, to determine the stage of inflammation. After the diagnosis, an anesthetic medicine is injected that will help to dull the pain with the further carrying out of the procedure.
Directly cleaning of periodontal pockets is performed using special dental instruments, while trying not to disturb the basic structure of the gums. After the main cleaning, as a rule, the roots are still polished. The method of closed curettage very well helps to remove the pathological deposits and significantly reduce the depth of the periodontal pocket.
The method of open curettage is used when the depth of the pockets already significantly exceeds 5 mm, or, for example, if the procedure of closed curettage performed was not as effective as expected. It takes place in several stages, as a rule, already with surgical intervention. Before starting the procedure, as in the previous case, it is necessary to diagnose gums. When conducting open curettage anesthesia injection, to numb the desired area of the gums.Then, using surgical instruments, an incision is made to get to the pathological pocket, and with the help of special dental instruments they clean the pocket.
In order to stimulate the growth of damaged bone tissue, it is applied drugs that can play the role of a passive matrix for a new bone, in other words, osteogenic drugs. The operation ends, as is all with surgery, stitching the cut gums.
Patchwork operation
There is another method of treatment for the removal of pathological pockets - flap surgery, which involves two vertical incisions on the gum. This operation is necessary when the root has already been exposed. Accordingly, the root becomes very sensitive and begins to respond to various external stimuli. To avoid this, many experts recommend doing a tissue transplant from the sky, to the place where part of the gum was lost. It should be noted that not only transplantation is useful for this, but also by the fact that it prevents the appearance of deep periodontal pockets in this place again. With the help of transplantation, a loose tooth can again be fixed in the hole.
Prevention of re-illness
After all the measures taken to treat the periodontal pocket, must visit the dentist, after a certain time, which the doctor himself will install based on the neglect of the disease. On this examination, the doctor will determine the success of the procedure and, if necessary, prescribe a second treatment.
Nowadays, given all the modern technologies, many dentists prefer to do curettage with the help of ultrasound equipment, then this procedure is less painful, more effective and performed much faster than those described above. And additional polishing of the root will help in the future to prevent the formation of tartar. Also, as a prophylaxis, a course of treatment using antiseptic preparations may be prescribed.
Proper care and high-quality daily oral hygiene will help avoid the formation of tartar on the tooth root and further treatment of pathological pockets. Professional cleaning of teeth at least a couple of times a year at the dental clinic will also be helpful.
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