Parodontosis - a systemic disease of metabolism

According to one of the latest studies conducted by Queen Mary University in London, problems with teeth and gums - such as caries, periodontitis and periodontitis - have 3.9 billion inhabitants of our planet. And this is 20% more than in 1999. Some periodontal disease is present in 47% of adult Americans, and almost 14.5% of Germany's population suffers from periodontal disease.

Parodontosis of the teeth is a pathological change in periodontal tissue - alveolar bone, dental cement, periodontal ligament. That is the whole supporting apparatus of our teeth.

[1], [2], [3], [4], [5], [6], [7]

Causes of periodontitis

Absolutely exhaustive answer to the question of what happens periodontal disease, yet. But numerous scientific studies of the pathogenesis of periodontal disease have shown that this disease does not belong to the inflammatory ...

This is a dystrophic lesion of periodontal disease, associated with a violation of its nutrition. Periodontitis develops for a long time due to the influence of such factors as functional disorders of the endocrine system of the body, pathology of the vascular system, digestive system disorders (gastrointestinal tract), persistent deficit of certain vitamins (in particular vitamin C).

And here we must immediately clarify the difference between periodontal disease and periodontitis, since these are two different diseases that have not only very similar names, but also some similar symptoms. But the causes and mechanisms of the development of these diseases differ significantly.

If the causes of periodontal disease are systemic, and the bacterial effect on the surrounding tissues only aggravates the clinical picture of the course of the disease, the initial cause of periodontitis is always the infection that accumulates in the plaque. Penetrating between the tooth and the gum, the pathogens find an ideal breeding ground, and then the periodontal inflammation begins. And the inflammatory process with periodontitis, in the first place, affects the softer tissues of the marginal periodontal (forming dentogingival pockets). In the absence of adequate treatment, the deeper layers of the peri-toothed tissues are involved in the inflammatory process, which leads to an increase in the mobility of the teeth and their subsequent loss.

With periodontal disease, the clinical morphological picture is completely different. Everything begins in the bone tissue of the jaw without the slightest hints of inflammation. Under the influence of atherosclerotic changes in blood vessels and metabolic disorders (diabetes mellitus, osteoporosis), a progressive pathological process is triggered, in which the alveolar processes (part of the jaw bone carrying the teeth) occur atrophy (decrease in size and size), the process of keratinizing the epithelium in the gum, and in the periodontal vessels there are sclerotic changes. But inflammatory foci in the mucous gums, which can appear with the course of the disease, dentists refer to the secondary symptoms of periodontal disease.

Periodontal disease in pregnancy can occur due to disruption of hormonal balance, plaque and poor oral hygiene.

It should be noted that British and American scientists came to the conclusion that periodontal disease is the first stage in the loss of bone mass in the human body, known as osteoporosis. A change in periodontal tissue was detected in 75% of patients with diabetes mellitus.

By the way, since parodontosis is a dystrophic lesion of the alveolar bone, the periodontal disease in children is not diagnosed: in childhood and adolescence, the bone system of the organism actively develops with the formation of new bone tissue. However, children with diabetes have another pathology (periodontalysis), in which, like periodontitis, there is a purulent inflammation of the gums with the formation of "pockets", the septa between the alveoli collapse, and the teeth become mobile.

[8], [9], [10]

Symptoms of periodontal disease

Parodontosis has a long latent period and for many years develops asymptomatically, slowly destroying the periodontal tissues. The first "bell" of the presence of this pathology is a feeling of discomfort and slight itching, which sometimes arise in the gum area.

For an easy form of periodontitis, itching and slight burning in the gums, retraction of the gum (decrease in the volume of the gingival tissue or its "subsidence") are characteristic. As a result, the neck of the teeth is exposed to a third of its height, the height of the interdental alveolar septa decreases, the sensitivity of the neck of the teeth increases, sometimes with pain when eating or breathing in cold air. Appears dental plaque - dense pigmented dental deposits.

Symptoms of periodontal disease of the middle and severe forms are expressed similarly, but the exposure of the neck of the teeth is already half or two-thirds of their height, the teeth lose a strong fixation in the gum and become mobile. At the same time, the gums do not bleed, but turn pale, the gingival papillae are completely smoothened. There are persistent dental deposits, but the gingival pockets and pus discharge are absent.

Further (if there is no proper treatment), the periodontal ligament breaks, crevices appear between the teeth, the chewing function and normal articulation are disrupted. Indistinction between the cutting edges and the chewing surfaces of the teeth (traumatic occlusion) is expressed. The bite is completely broken (teeth are shifted forward), V-shaped lesion of tooth enamel appears in the neck area from the outside (wedge-shaped defects). In some teeth, the bone bed is completely absorbed, and the teeth - without pain and blood - drop out ...

In its pure form, parodontosis occurs in no more than 20-25% of cases, the rest of the patients face not only dystrophy of the peri-toothed tissues, but also their inflammation that joins the course of the disease development.

In this case, the symptoms of periodontal disease include: the presence of permanent swelling and redness of the mucosa; bleeding gums and its detachment from the tooth; severe pain when pressing on a movable tooth; formation of a gingival pocket and the presence of pus; smell from the mouth; general poor state of health, often with an increase in temperature (due to infectious intoxication of the body). With such a "bouquet" of symptoms, dentists often indicate in the diagnosis - "purulent periodontal disease" or "complicated periodontitis".

Classification of periodontitis

To date, the periodontists themselves have counted a dozen different classifications of periodontal disease. And note that this situation is caused by two circumstances: differences in the principles of systematization and the lack of unity of terminology ...

For almost half a century, there has been a debate over the definition of the forms of periodontitis. According to one version, the classification of periodontal disease includes atrophic, dystrophic, hemorrhagic, inflammatory stage and purulent stage (alveolar pyorrhea). According to the second version, this disease has only two forms - dystrophic and inflammatory-dystrophic. However, gurus of periodontology believe that the inflammatory-dystrophic form is the same periodontitis, but complicated by inflammation.

A classification of periodontal disease, which is held by most domestic specialists in clinical dentistry, implies the presence of three forms of the disease - depending on the degree of its severity. This is an easy, medium and heavy form. In accordance with the forms stand out and the symptoms of periodontal disease.

[11], [12], [13], [14]

Diagnosis of periodontal disease

In the diagnosis of periodontal disease history and clinical picture of the disease is not enough, and an accurate diagnosis is established by X-ray examination, which makes it possible to identify the bone of the alveolar processes of the patient's jaws.

Thus, the presence of local pathological changes in periodontium is determined by orthopantomography (panoramic radiography, OPTG). The study of the functional state of the blood vessels of the periodontal and the determination of the degree of their sclerotic changes is carried out with the help of rheoparodontography. And the level of oxygen in the tissues of periodontal specialists of dental clinics is revealed with the help of polarography. A significant reduction in this level is an objective indicator of the presence of periodontal pathology.

Differential diagnosis of periodontal disease is carried out with the purpose of excluding periodontitis. This is especially important when the course of periodontal disease is complicated by inflammation of the periodontal tissues. And the key distinctive diagnostic sign of these two periodontal pathologies experts consider the absence of parodontosis pathological dentogingival pockets. In addition, with the help of X-ray, the doctor should be convinced of the presence of changes in the bone pattern characteristic for periodontal disease, and also assess the condition of the interalveolar septa of the teeth and the surfaces of the alveolar processes.

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Treatment of periodontitis

To stop the pathological process and preserve all teeth, the treatment of periodontitis is carried out in a complex way - with the use of physiotherapy methods and drug therapy. Treatment is carried out only in dental clinics.

An obligatory condition for the complex treatment of periodontal disease is the treatment of the underlying disease that caused it (see Causes of Periodontitis). To reduce vascular permeability, the intake of ascorbic acid (vitamin C), rutin (vitamin P), and 15-20 injections of vitamin B1 (5% solution of thiamine chloride) are prescribed. And to stimulate the protective forces of the body the doctor can prescribe a course of injections of such biogenic stimulants, as an extract of aloe or fibs (15-20 injections per 1 ml subcutaneously). However, it should be borne in mind that both of these drugs are contraindicated in severe cardiovascular pathologies, hypertension, nephrozonephritis, acute gastrointestinal disorders and pregnancy in later periods.

To activate blood circulation and lymph flow in the tissues of the gums, dentists prescribe massage (including equipment), hydromassage, darsonvalization, electrophoresis with vitamins, and with increased sensitivity of hard tissues of teeth - electrophoresis with a solution of sodium fluoride. Also, such physiotherapeutic procedures as galvanization and ultrasound are used.

In the treatment of periodontitis at an early stage, it is recommended to use alcoholic tincture of propolis: in the form of turund (thin gauze tampons) placed in the gingival pockets (for 5 minutes - 1-2 times per day) or in the form of rinses: 15 ml per 100 ml of water, 4 -5 times a day for 3-4 days. Propolis is a good preventive agent that prevents the spread of the disease to healthy gum tissue.

Combined herbal preparation Maraslavin (liquid in vials) contains extracts of herb wormwood Pontic, herb chabera, buds of clove, fruits of black pepper and ginger root. It has antimicrobial, anti-inflammatory, analgesic, keratoplastic and hemostatic effect in dental diseases. Maraslavin is used in the form of rinses, baths and applications. Rinsing is carried out undiluted solution of the drug - 1-2 tablespoons 5 times a day.

Treatment of periodontal disease complicated by inflammation

In the case of the appearance of periodontal inflammation of the gingiva and the formation of periodontal pockets with a depth of more than 3 mm with pus, a treatment similar to that of parodontitis is performed.

Dentists remove tartar - supragingival, and then subgingival. Further, with local anesthesia, a special dental procedure is performed - a closed curettage (scraping) of the contents of the gingival pockets. If the patient has significant purulent discharge, then before the procedure, the gingival pockets are processed using 3% hydrogen peroxide solution, rivanol solution or chymotrypsin.

When the depth of the gingival pockets exceeds 5 mm, their open curettage is used, at which the gum is dissected. Diathermocoagulation can also be applied, followed by treatment of the exposed tooth root.

Prevention of periodontal disease

The earlier you treat gum problems with specialists, the more successful will be the treatment of periodontal disease. So early detection of the disease is the prevention of periodontal disease, which is a chronic disease.

Of course, hygiene of teeth and oral cavity is very important: you need to regularly brush your teeth and rinse your mouth after eating. Smokers should remember that periodontitis and smoking are bad both individually and in combination. Because nicotine narrows the vessels and worsens the nutrition of the tissues, and the inhaled tobacco smoke dries out the mucous membranes.

If there is a suspicion of periodontal disease, start hygienic gum massage. In the morning or evening after brushing your teeth, you need to massage your gums (from the outer and inner sides) with your fingers for 3-5 minutes - stroking and rubbing your movements.

To prevent periodontal disease, teeth and gums should be strengthened: there are solid fruits and vegetables. And to strengthen the bones (including the jaws), use foods rich in calcium (milk, cottage cheese, brynza, sea fish, red cabbage, oat flakes) and vitamin C (parsley, dill, citrus, cranberries, beef liver, Brussels sprouts, Bulgarian pepper, dog rose).

Parodontosis is a systemic disease of the metabolism, therefore it is necessary to strengthen one's health systematically.