Almost everyone is aware of the need to visit the dentist at least once every 6-12 months for the purpose of prevention. However, few adhere to this rule: permanent employment, lack of time, etc. Yes, and the dentist's office itself is not a pleasant place ...
So it turns out that we are asking for help not at the last stages of the development of any dental disease, one of which is periodontitis.
Content
What is periodontitis: types
Periodontitis is inflammatory processwhich occurs in the circulatory tissue connecting the bone of the tooth with the retaining element of its root. At the very beginning of development, periodontitis may not manifest itself or have erased symptoms that do not allow time to detect the disease and consult a doctor.
Classification of Periodontitis
By type of origin, the following types of disease are distinguished:
- Medication;
- traumatic;
- infectious.
By the type of the course of the disease, periodontitis is defined by the following forms:
Acute - rarely occurs.
Chronic - requires quite a long therapy. The chronic form develops when the treatment of acute periodontitis is ignored. There are two periods of chronic illness:
- The process of inflammation subsides for a while;
- exacerbation of the disease with the spread to the entire oral cavity.
Exacerbated chronic. According to the shape of the fluid formed in the periodontal tissues, the disease may be purulent or serous. In the chronic course of inflammatory processes in the tissues surrounding the tooth, a center of inflammation may form over time, filled with granulation or coarse-fibered tissue with a large number of different pathogenic cells.
By the nature of the changes in the apical periutric tissues, the following types of disease are distinguished:
- Chronic granulating periodontitis;
- chronic fibrous periodontitis;
- chronic granulomatous periodontitis.
This form of the disease has a focus of inflammation limited by a capsule of connective tissue. The granuloma develops slowly and is always clearly visible X-ray image. The shape of the structure of the granuloma is divided into simple, cystic and epithelial.
Causes of the disease
Periodontitis has a different mechanism of development, but, as a rule, this disease is a consequence of complicated pulpitis. Simply put, periodontitis is a kind of reaction of the body, indicating the occurrence of a serious health problem, for example, the source of the infection.
Infectious periodontitis develops as a result of the penetration of harmful microorganisms into the dental specimens. The most common types of microbes such as fusobacteria, spirochetes, fungi, non-hemolytic and hemolytic streptococcus, Staphylococcus aureus. The toxic substances secreted by them, together with the products of the decay of the pulp, several times increase the degree of inflammation.
If we talk about periodontitis as a result of other diseases, it may appear due to the penetration of the periodontal infection:
-
traumatic; - through the bloodstream in pathologies such as scarlet fever, typhoid;
- contact with sinusitis and osteomyelitis;
- when strong drugs that are used in dentistry for dental treatment: formalin, acids, arsenic, are inhaled into the circulatory tissues.
Traumatic periodontitis manifests itself as an acute process due to the sharp bite of a hard object, bruise, hitting the tooth, etc. In some cases, the pathology results from non-professional actions of the dentist: insertion of infected contents from the internal tooth cavity to the root apex, injury to the root canals, removal a small amount of filling material in the periodontal tissue.
Also a microtrauma of the tooth may appear. as a result of improper sealing or prosthetics, in which the filling or crown are in an exaggerated position. This creates additional stress and pressure on the tooth while chewing food.
Drug-induced periodontitis develops with the ingress of strong chemicals into the apical tissues of the tooth. These can be substances such as eugenol, chlorhexidine, iodine, resocin-formalin or arsenic paste, formalin, phenol, etc. The clinical signs of the disease in these cases are clearly associated with the duration of dental treatment. Often secondary periodontal inflammation is a consequence of pathologies such as periodontitis, gingivitis. In children, the disease in most cases occurs against the background of caries. In addition, periodontal inflammation may be caused by such factors as micronutrient deficiencies, vitamin deficiency, and non-compliance with the rules of oral hygiene.
There is and a number of somatic diseasesprovoking the development of periodontitis:
- Chronic diseases of the broncho-pulmonary system;
- diabetes;
- diseases of the cardiovascular system;
- pathologies of the digestive tract;
- chronic endocrine disruption.
Symptoms
The symptoms of acute and chronic forms of the disease vary greatly. The main manifestation of the acute form of periodontitis is strong pain. Moreover, it is permanent and increases with the closing of the jaws, biting on the tooth and the slightest touch to it. As a rule, patients complain about the feeling of pressure inside the bone and internal spreading, the feeling of a seemingly grown tooth. Over time, exudate accumulates in the affected tissues and pus appears.
Pain syndrome captures surrounding areas: infraorbital region, temple, ear. A throbbing pain appears and reddening and swelling of the dental-toothed tissue is observed. A carious cavity may appear under an artificial crown or filling.
If the purulent discharge does not find an exit through the tooth and accumulates inside, the patient has a worsening condition: the body temperature rises, tissue swelling increases.
If time does not take measures to treat acute periodontitis, there may be complications such as sepsis, cellulitis, osteomyelitis, the development of which can be fatal.
Chronic form characterized by the absence of obvious clinical signs. The affected tooth can be under the filling or have a carious cavity, but in almost all cases it can be easily distinguished from the others by the altered grayish shade. A person may notice that the tooth periodically aches a bit, but calms down after taking medications, sometimes a fistula forms on the gum next to the sick tooth (a small capsule with white-gray content).
In some cases, there is an unpleasant smell of rot from the oral cavity. When tapping the crown of the tooth a peculiar sound is heard.
An accurate diagnosis is established by conducting additional examinations. The exacerbation of chronic periodontitis is characterized by the same manifestations as in the acute form, with the exception of some differences: the frequency and duration of pain, the color of the tooth (the longer the process, the darker the crown), the X-ray picture (with an exacerbation there is a change in bone pattern) , the presence of a fistula. In addition, with the exacerbation of the chronic form, there is a slight mobility of the tooth.
Exacerbations of the chronic form of periodontitis may occur for the following reasons:
- reduced immunity;
- injury to the inflammatory envelope of the hearth;
- the opening of the fistula and the ripening of the abscess;
- violation of the outflow of purulent content.
Periodontitis in children
Children's periodontitis is fixed in 50% of cases of referral to dental clinics. The most common cause of periodontitis in children is caries. Periodontal inflammation in children conditionally divided into two categories:
- Periodontitis of milk teeth;
- periodontitis of permanent teeth.
The rest of the childhood periodontitis is systematized according to the same principle as in adults.
Complications
Periodontitis are quite strong sources of infection and can trigger the development of various pathologies of systems and organs. (ex. septic endocarditis is a heart disease). Periodontitis is most dangerous for pregnant women.
Complications after the inflammatory process of the periapical tissues can be divided into general and local.
Complications of a general nature
- Temperature increase, sometimes as much as 39-40 degrees.
- Persistent headache.
- General poisoning of the body (mainly in case of acute purulent periodontitis).
- Chronic periodontitis provokes the emergence of a multitude of autoimmune pathologies, among which endocarditis and rheumatism stand out in particular, kidney disease is sometimes encountered.
Local complications
- osteomyelitis;
- fistulas, cysts;
- odontogenic sinusitis when the contents in the maxillary sinus;
- the development of purulent inflammation can provoke neck phlegmon;
- education (with purulent contents) in the form of abscesses.
The most dangerous consequences arise from purulent inflammation, when the pus spreads all over the jaw and goes under the periosteum. Melting and necrosis of tissues cause extensive phlegmon of the cervical region. Common complications of purulent periodontitis are odontogenic sinusitis and submucosal abscess.
Since the movement of microorganisms occurs fairly quickly and they, localized in the jaw bones, spread to adjacent areas, the outcome of the complications of periodontitis is very difficult to predict. Process speed depends on the protective properties and condition of the body, as well as the form and type of periodontitis.
Timely diagnosis and timely treatment help to minimize the risk of complications, however, to a greater extent this applies to the patient, rather than to the doctor: the sooner the patient goes to a specialized clinic, the better for him.
Diagnosis of Periodontitis
Diagnostics is of paramount importance and is one of the main criteria on which the result of periodontitis treatment depends. Diagnosis of the disease involves the inspection of the oral cavity, history taking, additional methods and methods of examination to assess states of periapical zones and apex.
In addition, diagnostic activities are carried out to identify the root causes of the inflammatory process, however, due to the late appeal of citizens to the dental clinic, it is rather difficult to detect the factors that provoked periodontitis. Acute diagnostics is easier to diagnose than a chronic running process.
In addition to the above actions, the diagnosis includes The following important points:
- The presence of acute or chronic pathologies of internal systems and organs;
- the general condition of the patient and the presence of associated pathological changes;
- intolerance to dental material or drugs;
- conditions that pose a threat: impaired blood circulation in the brain, heart attack;
- evaluation of the red border of the lips; inflammation of the oral mucosa in the acute form.
The main role in the diagnosis of periodontitis is given to X-ray research, which helps to accurately determine the diagnosis of the disease.
Periodontitis is quite a serious and dangerous disease of the oral cavity, which affects not only the periodontal and surrounding tissues, but also penetrates the bones of the jaw areacausing complications. At the slightest suspicion of the development of the inflammatory process, an urgent need to contact the dental clinic, where you will have expert help.
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