Periodontitis

Introduction to periodontitis Periodontitis is mainly chronic inflammation of periodontal support tissue caused by local factors. The age of onset is more common after 35 years of age. If phlegm is not treated in time, inflammation can progress to periodontitis by spreading the gums deep into the periodontal ligament, alveolar bone and cementum. Because it has no obvious symptoms in the early stage, it is easy to be neglected, and it is already serious when the symptoms are present, and even the teeth cannot be retained. Therefore, it is necessary to strengthen the mission to enable patients to see early and timely treatment. Loss of teeth is the end result of untreated periodontitis. It is generally believed that periodontitis accounts for 30% to 44% of the cause of tooth extraction, which is the primary cause of loss of teeth in adults in China. However, most adults have mild to moderate periodontitis. Severe cases account for only 5% to 20% of the population. Only a few people have a few stages of active destruction, and very few parts have made rapid progress. The most susceptible teeth are the mandibular incisors and maxillary molars. basic knowledge Sickness ratio: 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: periodontal abscess

Causes of periodontitis

Chewing habits (15%):

It can cause the dental side teeth to accumulate a large amount of plaque and calculus, which causes periodontal disease. At the same time, the conventional side teeth can be severely worn, causing teeth, causing or aggravating periodontal disease.

Professional habits (5%):

For example, if the cobbler, woodworker, etc. are working, they are used to bite iron nails, shoe needles or wires, etc., which may damage the tooth and the periodontal, such as a gap in the crown or loosening or displacement of the anterior teeth.

Therefore, patients with periodontal disease should pay special attention to correcting the bad habits that have been developed. Only in this way can the treatment effect of periodontal disease be consolidated. People without periodontal disease should also quit the above habits to avoid damage to periodontal tissues.

The etiology of periodontitis is complicated, and the total is divided into local and systemic factors. Local factors have a very important role, and systemic factors can affect the response of periodontal tissues to local stimuli. There is a close relationship between the two.

Partial eating habits (20%):

It can cause a deficiency in protein and vitamins A, C, and D, which can cause or aggravate periodontal disease.

Night molars, clenched teeth (10%):

It can cause severe wear of the teeth, increase the burden of periodontal tissue, can cause food impaction, or make the original periodontal lesions worse.

Biting the lip, biting the pen, biting the nail, opening the mouth, etc. (10%):

These can increase the load on the periodontal tissue, and can also shift the anterior teeth, cause symptoms such as teeth, or aggravate the original lesions of the periodontal tissue.

Smoking habits (25%):

Smoking has an effect on the whole body bone, which can aggravate the absorption of bones. The absorption of alveolar bone is a pathological process of periodontal disease.

Local factors:

1. Plaque: refers to a microbial group that adheres to the surface of a tooth and cannot be removed by mouthwash, water rinse, or the like. It has been recognized that plaque is the initiator of periodontal disease and is the main cause of periodontal disease.

2. Dental calculus: is a mineralized plaque deposited on the tooth surface. The calculus is divided into two types: iliac calculus and subgingival calculus according to its deposition site and nature. The upper calculus is located on the tooth surface above the gingival margin and can be seen directly by the naked eye. There are more deposits in the neck of the teeth, especially in the opposite side of the opening of the large parotid duct. The buccal side of the maxillary molars and the lingual side of the mandibular anterior teeth are deposited more. The underarm tartar is located on the root surface below the gingival margin, in the sac pocket or in the periodontal pocket. The naked eye cannot be directly viewed. It must be probed to know the deposition site and deposition amount. The underarm calculus can be formed on any tooth, but with more adjacent faces and tongues.

The main source of inorganic salts in the calculus is the mineral salts such as calcium and phosphorus in saliva. The underarm calculus is mainly a mineral salt provided by the gingival crevicular fluid and exudate.

The hazard of tartar to periodontal tissue is mainly because it constitutes a good environment for plaque adhesion and bacterial growth. The calculus itself hinders the maintenance of oral hygiene, which accelerates the formation of plaque and stimulates the formation of gum tissue.

3. Traumatic occlusion: In the case of occlusion, if the occlusal force is too large or the direction is abnormal, beyond the joint force that the periodontal tissue can withstand, the occlusion that causes the periodontal tissue to be damaged is called traumatic occlusion. Traumatic occlusion includes early contact during occlusion, occlusion interference, and night molars.

4. Others: including food impaction, poor restoration, mouth breathing and other factors also promote the inflammatory process of periodontal tissue.

Systemic factors:

Local factors are the main cause of periodontal disease. Systemic factors are a promoting factor in the development of periodontal disease. Systemic factors can reduce or change the resistance of periodontal tissues to external stimuli, making them susceptible to disease and promoting the development of gingivitis and periodontitis.

Systemic factors include: endocrine disorders, such as sex hormones, adrenocortical hormones, thyroxine and other secretion abnormalities. Diet and nutrition may have vitamin C deficiency, vitamin D and calcium, phosphorus deficiency or imbalance, malnutrition and the like. The relationship between blood diseases and periodontal tissues is extremely close. Leukemia patients often have swollen gums, ulcers, and bleeding. Hemophilia can occur spontaneous bleeding of the gums. Long-term use of certain drugs, such as phenytoin, can cause fibrosis in the gums; some types of periodontal disease, such as adolescent periodontitis, often have a family history, so genetic factors are considered. In short, the cause of periodontal disease is more complicated. At the time of treatment, it is necessary to pay attention not only to the elimination of local factors, but also to the state of the whole body in order to obtain a better therapeutic effect.

Periodontitis prevention

1. Keep your mouth clean : There are more than 20 kinds of bacteria in the mouth. New plaques form 1 to 6 hours after the tooth surface is cleaned, causing dental disease. I should learn to brush my teeth when I was 3 years old. To brush your teeth within 3 minutes of eating, brush for 3 minutes each time and brush 3 times a day. If you have difficulty, you should rinse your mouth after meals and brush your teeth in the morning and evening. Especially brushing your teeth before going to bed is more important than brushing your teeth in the morning. Toothbrush should use a soft and flexible health care toothbrush, wash it after use, and place the toothbrush head up and dry. To develop the habit of brushing teeth in turn, when brushing the upper teeth, the bristles are brushed down the teeth. When brushing the lower teeth, the brush should be brushed from the bottom to the top. Do not violently brush back and forth. Otherwise, the gums will be retracted and the teeth will be wedged. Defect.

2. Pay attention to oral exercise : Regular consumption of crude fiber food, chewing, can stimulate saliva secretion, wash away dirt, help teeth self-cleaning, and strengthen periodontal tissue. To develop a habit of chewing on both sides, otherwise it will cause disuse of the gums and facial deformity. It is recommended to use a cleaned right index finger and massage it on the upper and lower gums for 2 to 3 minutes. It can enhance the blood circulation of the gums and surrounding tissues, and is beneficial to the metabolic function of periodontal tissues. Every morning, the caries are exercised, and the empty mouth is bitten (the upper and lower teeth are gently slammed) dozens to hundreds of times, about 2 to 3 minutes, the teeth can be honed first, the front jaws are extended to the front teeth, and the cusps are flanked on both sides.

Periodontitis complications Complications periodontal abscess

Mainly concurrent with the following diseases :

1, periodontal swelling or multiple periodontal abscess may occur.

2, bite weakness, dull pain, bleeding gums and bad breath.

3, when the body's resistance is reduced, periodontal bag exudate drainage is not smooth, can cause periodontal swelling, at this time the gums are oval protrusion, redness and swelling, tooth looseness increased, there is pain, the patient feels local Severe pain, sometimes multiple abscesses at the same time, called multiple periodontal abscesses. At this time, the patient may have symptoms such as elevated body temperature, general malaise, submandibular lymphadenopathy, tenderness and the like.

Periodontitis Symptoms Common Symptoms Gingival Hemorrhoids Gingival Glandular Swelling Gingival Pupils Pustules Swelling Teeth Cracks Teeth Loosening and Peeling Gingival Hemorrhoids Mucosa White Spots Periodontal Bags Forming Ginger Crimson or Dark Red

1. Early self-conscious symptoms are not obvious : patients often have only genital bleeding or bad breath, similar to sputum inflammation. At the time of examination, the swelling of the gingival margin, licking nipple and attached sputum, the softness of the sputum, the dark red or the dark red color, the bleeding is easy to detect.

2. As the inflammation spreads further, the following symptoms occur:

(1) Periodontal pocket formation: Due to the expansion of inflammation, the periodontal ligament is destroyed, the alveolar bone is gradually absorbed, and the gingiva is separated from the root of the tooth, so that the sulcus is deepened to form a periodontal pocket. The depth of the periodontal pocket can be measured with a probe. X-ray examination revealed that the alveolar bone has different degrees of absorption.

(2) Periodontal empyema: There are ulcers and inflammatory granulation tissue in the periodontal pocket wall, and there are purulent secretions in the bag, so the gums can be lightly pressed and the pus can be seen. And often have bad breath.

(3) Loose teeth: Due to the destruction of periodontal tissues, especially when the alveolar bone is absorbed, the supporting teeth are insufficient, and the teeth are loose and displaced.

At this time, the patient often feels occlusal weakness, dull pain, bleeding gums and bad breath. When the body's resistance is reduced and the periodontal bag is not well drained, periodontal swelling can be formed. At this time, the gums are oval-shaped, red and swollen, and the tooth looseness increases, which is aching. The patient felt severe strenuous pain, sometimes multiple abscesses appeared at the same time, called multiple periodontal abscess. At this time, the patient may have symptoms such as elevated body temperature, general malaise, submandibular lymphadenopathy, tenderness and the like.

Periodontitis examination

Self-examination:

1. There is blood on the bristles when brushing your teeth. There is blood on the food when you bite the food, indicating that there is gingivitis.

2. Look in the mirror. If there is redness and swelling of the gums, it will bleed when touched, indicating gingivitis.

3. The teeth have different degrees of looseness, the roots are exposed or the gums are red and swollen, and there is pus, indicating that it has progressed to periodontitis.

4. There is bad breath indicating that there may be periodontitis.

Mild bleeding of the gums is an indication of early gingivitis. At this time, brushing should not be stopped and the soft hair care toothbrush should be used to brush the teeth carefully. Generally, the bleeding of the gums can be controlled. If there is bleeding in the gums after one week, you should check with your dentist for treatment and treatment.

Regular inspection : regular oral examination, preferably once every 6 months; regular cleaning, that is, washing teeth, doctors use special equipment to remove calculus, once a year; early diagnosis, early treatment.

Laboratory inspection:

1. Blood routine examination.

2. X-ray film inspection.

3. Excretion and tissue culture + drug sensitivity and other inspection methods.

Diagnosis and differentiation of periodontitis

Differential diagnosis

1, early attention to simple periodontitis should be differentiated from marginal gingivitis.

2, when there is a periodontal abscess should be distinguished from alveolar abscess: alveolar abscess, also known as periapical abscess, is a type of periapical disease, apical periodontitis refers to inflammation occurring around the root tissue The disease is often secondary to endodontics. Endodontic inflammation caused by various factors, such as failure to effectively treat inflammation, extends from the crown pulp to the root of the tooth. When the infection in the root passes through the apical foramen on the tissue surrounding the root, it causes apical periodontitis. In the early stage of apical periodontitis, only the uncomfortable, hairy, and osmotic swell is felt. At this time, no treatment will soon develop into the suppuration stage, that is, the alveolar abscess.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.