What Is Periodontium?

Periodontitis is mainly a chronic inflammation of periodontal support tissue caused by local factors. The age of onset is more common after 35 years of age. If gingivitis is not treated in time, the inflammation can spread from the gums to the periodontal ligament, alveolar bone and cementum and develop into periodontitis. It is easy to be ignored because there are no obvious conscious symptoms in the early stage, and it is more serious when symptoms are present, and it is even impossible to retain teeth. Therefore, education must be strengthened to enable patients to seek early treatment and timely treatment.

latest news

2019-11-29 11:11 Periodontitis may cause Alzheimer's disease 2019-11-29 11:11

A few days ago, the research team first discovered amyloid beta (A), a component of senile plaques in the brain, in macrophages in gum tissue of patients with periodontitis. Pg bacteria is one of the main pathogenic bacteria of periodontal disease. There is a positive correlation between severe periodontal disease and cognitive decline. Pg bacteria have been detected in the brain of patients with Alzheimer's disease. Gum tissue in patients with periodontitis can produce senile plaque components in the brain of Alzheimer's disease. The research team is also continuing to explore the possibility of Pg infection participating in A brain transport. The results have been published recently in the Journal of Alzheimer's Disease. ... more

Basic Information

English name: periodontitis
Visiting department: Stomatology
Multiple groups: 35 years and over

Common causes: Caused by plaque, calculus, traumatic occlusion, food impaction, etc.
Common symptoms: Bleeding gums, bad breath, periodontal pockets, periodontal pus, loose teeth

Causes of Periodontitis

Plaque

Microorganisms adhering to the tooth surface cannot be removed by rinsing, washing with water, etc.

Calculus

Toothstone refers to the mineralized plaque deposited on the tooth surface, and it is divided into two types of gingival calculus and subgingival calculus according to its deposition site and properties.

(1) The gingival calculus is located on the tooth surface above the gingival margin and can be seen directly by the naked eye. It is more deposited in the neck of the tooth, especially at the opposite side of the opening of the salivary duct, such as the buccal side of the maxillary molar and the lingual side of the mandibular anterior tooth. The main source of inorganic salts in gingival calculus is mineral salts such as calcium and phosphorus in saliva.

(2) The subgingival calculus is located below the gingival margin, on the root surface of the gingival pocket or periodontal pocket. The naked eye cannot directly look at it. You must use a probe to detect the location and amount of deposition. The main source of inorganic salts in gingival calculus is gingival crevicular fluid.

The harm of calculus to periodontal tissues mainly constitutes a good environment for plaque attachment and bacterial growth.

3. Traumatic occlusion

In the case of occlusion, if the occlusal force is too large or the direction is abnormal, it exceeds the total force that the periodontal tissue can withstand, and the occlusion that causes damage to the periodontal tissue is called traumatic occlusion. Traumatic occlusion includes early contact during occlusion, occlusal interference, and night molars.

4. Other

Factors including food impaction, poor restorations, and mouth breathing also contribute to inflammation of periodontal tissue.

Periodontitis clinical manifestations

Early symptoms are not obvious, and patients often only have secondary gum bleeding or halitosis, which is similar to symptoms of gum inflammation. Swelling and softness of the gingival margin, gingival nipples, and attached gingiva were found during the examination, which were dark red or dark red, and bleeding was easy to detect. As inflammation spreads further, the following symptoms appear:

Periodontal pocket formation

Due to the expansion of the inflammation, the periodontal membrane is destroyed, the alveolar bone is gradually absorbed, the gums are separated from the roots of the teeth, and the gingival sulcus is deepened to form a periodontal pocket. The depth of the periodontal pocket can be measured with a probe.

2. Periodontal overflow

Periodontal pocket walls have ulcers and inflammatory granulation tissue formation, and purulent secretions remain in the pocket, so lightly press on the gums to see the pus. And often have bad breath.

3. Loose teeth

Due to the destruction of periodontal tissue, especially when the alveolar bone resorption is increased, the strength of supporting teeth is insufficient, and the phenomenon of tooth loosening and displacement occurs. At this time, patients often feel weak bite, dull pain, bleeding gums and bad breath.

When the body's resistance is reduced and the periodontal pocket fluid is not drained smoothly, periodontal abscesses can form. It is a common symptom of deep periodontal pockets when periodontitis develops to advanced stages. At this time, the gums were oval-shaped protrusions, red and swollen, and the surface was bright; the looseness of the teeth increased, and there was palpitation; the patient was accompanied by local severe jumping pain. At the same time, patients may have symptoms such as elevated body temperature, general discomfort, enlarged submandibular lymph nodes, and tenderness.

Periodontitis examination

X-ray examination of alveolar bone with horizontal absorption. In severe cases, loose teeth and disordered occlusal relations occur.

Periodontitis treatment

(A) local treatment

1. Targeting local irritants

It can be used for upper gingival cleansing or subgingival curettage. If necessary, adjust the occlusion, eliminate food impaction, and correct bad restorations.

2. Handling of periodontal pockets

When the periodontal pouch overflows, it can be rinsed with 1% to 3% hydrogen peroxide solution. The bag contains 10% iodine mixture or spiramycin, metronidazole and other medicine films. After removing local factors, shallower periodontal pockets can be cauterized with iodophenol solution; deeper periodontal pockets require periodontal surgery to eliminate periodontitis. When the periodontal pocket is deep to the apex and the teeth are loose, you can consider extraction.

3. Fixing loose teeth

If the teeth are still loose, it can be used as a temporary or permanent periodontal splint to fix the loose teeth.

4. Management of periodontal abscess

When the abscess is confined, drainage can be performed by incision. Periodontal pockets should also be used for rinsing, filming, or iodine glycerol.

(Two) systemic treatment

Strengthen the body's resistance and actively treat systemic diseases related to periodontitis. When periodontal abscess occurs, patients with severe systemic reactions should take relevant antibacterial drugs orally.

In short, the treatment of periodontitis includes a series of comprehensive treatment measures. In order to consolidate the curative effect and prevent recurrence, oral hygiene education should be carried out and regularly reviewed.

Periodontitis prevention

Prevent and reduce systemic diseases, strengthen nutrition, improve the body's resistance, thereby enhancing the disease resistance of periodontal tissues; strive to maintain oral hygiene; resolutely quit bad habits that are harmful to periodontal tissues such as smoking, drinking, unilateral chewing, etc. .