Symptoms of periodontal disease

Periodontosis or pyorrhoea alveolaris – alveolar pyorrhea, according to statistics provided by WHO, ranks third after the infamous dental diseases – caries and periodontitis.

In the 21st century, more than 80% of children under 14 years of age already have signs of the initial stage of periodontosis - gingivitis. Periodontosis develops slowly, asymptomatically and is a systemic neurodystrophic disease that affects city dwellers more often than people living in rural areas (70/30 ratio). The destructive process destroys the gums - they become loose, itch, pus appears, teeth become loose, alveolar processes atrophy, and the necks of the teeth become exposed. Clinically, the disease is sluggish, in the initial stage, the symptoms of periodontosis are not manifested. It is no coincidence that the dystrophic process is called pyorrhea, since its first visible sign can be purulent discharge (pyorrhoea). Since the disease affects literally all periodontal tissues, it is also called amphodontosis - from the Greek amphí (about) and tooth (odús).

The etiology of the disease has not yet been clarified, but it is believed that, unlike the inflammatory process - periodontitis, periodontosis is caused by internal pathological factors, that is, chronic diseases of human organs and systems and an unhealthy lifestyle. Possible factors that provoke symptoms of periodontosis:

• Endocrine pathologies.
• Hypertension.
• Vegetative-vascular dystonia.
• Atherosclerosis.
• Cardiovascular diseases.
• Diabetes mellitus.
• Neurogenic dystrophic processes.
• Osteoporosis.
• Avitaminosis.
• Autoimmune diseases.
• Sedentary lifestyle, physical inactivity.
• Hypoxia.

According to the international classification of diseases, periodontosis is defined as follows: ICD-10.K05.4

[ 1 ], [ 2 ]

Is it possible to get periodontal disease?

Since the disease is not inflammatory, that is, it is not provoked by a microbial or viral factor, the question of whether it is possible to become infected with periodontosis belongs to the category of myths and misconceptions.

It is impossible to transmit periodontosis from person to person through shared dishes, household items, bedding or other accessories, or even through kisses. It is also not capable of being transmitted by airborne droplets or orally. Of course, this does not mean that the patient should forget about the rules of personal hygiene, including oral hygiene, because damaged gum tissue is a vulnerable place for the penetration of pathogenic bacteria. Also, you should not use the phrase "periodontosis of teeth", since the disease affects only the periodontium, that is, the tissues and gums, but not the bone tissue of the tooth.

If we consider the version about the hereditary etiological factor of alveolar pyorrhea to be correct, then the question - "is it possible to get infected with periodontosis" will not be correct. Genetic predisposition can play a negative role, but does not affect the prevalence, epidemiology of periodontosis. It has been established that if both parents of a child suffered from pyorrhea, the probability of its development in the heir increases to 60%. However, many doctors are inclined to believe that periodontosis is caused by many other non-contagious polyetiological factors, which are currently being actively studied and clarified.

[ 3 ], [ 4 ]

The first signs of periodontal disease

The initial stage of the disease has no characteristic, specific signs. Alveolar pyorrhea develops asymptomatically and its first manifestations can be considered an already developed dystrophic process. People who have problems with teeth and gums should closely monitor the slightest discomfort and the presence of atypical plaque, discharge, pain or softening of the gums.

The first symptoms of periodontal disease may be:

• There is an excessive amount of plaque on the teeth, but this is not a specific sign.
• Tartar is a more characteristic symptom of the onset of periodontal disease.
• Discomfort when eating spicy foods, hot or cold dishes.
• Itchy gums.
• Transient pulsation in the gums.
• Periodic bleeding of the gums is possible due to mechanical impact on them (brushing teeth, eating hard food).
• It is possible that atypical cavities may appear – pockets, cracks in which food remains.
• Purulent discharge from the "pockets".
• Wedge-shaped defects of teeth (tooth wear).
• Whitish coating on the gums.
• The necks of the teeth become exposed and the teeth become visually longer.
• Gum retraction.

The first symptoms of periodontosis that should alert a person are the constant formation of tartar and atypical exposure of the upper part of the teeth - necks and roots, even in the absence of any painful sensations. The sooner treatment is started, the faster the process of dystrophic destruction of the gum can be stopped and transferred to the stage of supervised remission.

Pain due to periodontal disease

The initial stage of the disease proceeds not only without clinically visible manifestations, but also painlessly. Pain in periodontosis can be considered a characteristic sign of the developed pathological process and its exacerbation. Soreness of the gums, their sensitivity to temperature factors - when consuming cold or hot food, pain when biting hard food - these are quite typical symptoms of alveolar pyorrhea in the second or third stage. Thus, most often, pain in periodontosis is associated with food, more precisely - with a mechanical traumatic factor, when atrophied gum tissue, periodontium reacts sensitively to the slightest pressure. In addition, the pain symptom can be caused by an abscess that develops in the formed cavity - a gum pocket. The pain is pulsating, can be quite strong and can be accompanied by an increase in body temperature.

It should be noted that pain in alveolar pyorrhea is not a typical symptom and is rarely acute, except in the acute stage of generalized periodontosis. Pyorrhea most often develops and proceeds without obvious pain sensations, which are more characteristic of another disease of the oral cavity - periodontitis, periostitis.

Periodontosis and periodontitis

Both periodontosis and periodontitis disrupt the integrity of the periodontium – the main support of the tooth, which holds it and gives it stability. This is practically the only similarity between the two diseases. Despite their etiological and clinical differences, periodontosis and periodontitis are often confused with each other, of course, this does not apply to dentists, who clearly differentiate the specified nosologies in this way:

Alveolar pyorrhea, periodontal disease	Periodontitis
There is no inflammatory process and no bacterial or microbial pathogen	An inflammatory disease of tissue and ligamentous apparatus associated with a provoking bacterial factor
Slow, sluggish, but progressive development of the disease, rarely worsening and with virtually no remissions	The presence of periods of exacerbation, the possibility of stable remission and cure
Damage to the upper and lower gums, teeth, both upper and lower	Locality of the process – damage to one or several teeth. Rarely spreads to nearby teeth
Development of the disease over many years	Rapid development and transitions from one stage to another
Brushing teeth and eating food rarely provoke bleeding gums, only in advanced stages of the disease	Bleeding gums are one of the primary symptoms of the disease.
Loosening and mobility of teeth is possible only at the third stage of the disease, when the disease acquires a generalized acute form. It is not possible to eliminate mobility.	Tooth mobility is one of the first signs of the disease, which is quickly eliminated with timely and adequate treatment.
Cavity pockets are rarely deep and in some cases they may be absent.	Periodontal pockets are very deep and cannot be cleaned and sanitized at home.
In cavities and pockets, as a rule, there is no granulation. It is possible during an exacerbation of the process, most often in a purulent, advanced form	Granulations and growths in pockets are typical signs of periodontitis.
No swelling of the gums	Swelling of the gums associated with inflammation
Presence of wedge-shaped visible defects (tooth wear)	Absence of wedge-shaped defects
Sensitivity to temperature factors, reaction to sour, spicy foods	Caries
Interdental spaces	The presence of interdental spaces is identical to periodontal disease
The goal of treatment is to stop, slow down the process and minimize the risk of associated inflammation.	The goal of treatment is to neutralize inflammation, eliminate the cause, and move the process into a stage of stable remission leading to recovery.

There is a clinical paradox in dental practice – periodontitis is considered a more dangerous disease, as it develops quickly, requires antibacterial treatment and possible prosthetics. However, periodontosis is also a very difficult disease due to the fact that its causes are still unclear, therefore, effective, efficient treatment leading to recovery has not yet been found. Thus, any periodontal pathology can be a serious threat to the oral cavity, regardless of what it is caused by – internal systemic factors or inflammation.

Periodontosis and gingivitis

Gingivitis is, in fact, the initial stage of the development of alveolar pyorrhea, therefore periodontosis and gingivitis are links in the same pathological chain.

In the clinical sense, periodontosis cannot be imagined without progressive gingivitis. Gingivitis is a consequence of irregular and poor oral hygiene, when bacteria and microbes are able to reproduce unhindered in the gum tissue. However, with gingivitis, the integrity of the gum and ligamentous apparatus of the teeth is not destroyed, and not every such process can lead to alveolar pyorrhea. Gingivitis, detected and stopped at an early stage, remains an unpleasant, but very instructive memory, that is, the disease ends in a cure.

The initial stage of gingivitis development is characterized by constant, visible plaque, which accumulates and creates a favorable environment for the spread of bacteria in the gum. It becomes inflamed, swollen, red, and can bleed, especially with the slightest mechanical impact. The teeth are not damaged or hurt, so they can be saved by eliminating the inflammatory process. If gingivitis is not treated, it progresses to periodontosis. Statistics say that over the past 20 years, periodontosis and gingivitis have become almost "inseparable" and have become significantly "younger". Previously, these processes were typical for people over 40-50 years old, today about 75-80% of children under 14 years of age already have signs of gum inflammation, therefore, they are at risk of developing gingivitis.

Stages of periodontal disease

Alveolar pyorrhea develops rather slowly and without clinical manifestations in the initial period. In dental practice, there are definitions of two stages and three typical stages of the disease.

1. The first stage is dystrophy of the bone tissue of the alveolar processes.
2. The second stage is a degenerative, destructive process that provokes pyorrhea itself – the release of pus.

Stages of periodontal disease:

First stage:

• Mild, transient discomfort in the gums.
• Burning and itching of the gums.
• Sensitivity of gums.
• Persistent plaque, tartar.
• No inflammation or other signs of gum disease.
• Maintaining the strength of teeth (they do not wobble or hurt).

Second stage:

• Transient, periodic bleeding of the gums.
• The first signs of gingivitis appear – the release of pus.
• Loose gum structure.
• Frequent getting of food (even soft food) stuck in the spaces between teeth.
• The appearance of cavities – pockets in the gums is possible (non-specific symptom).
• Abscesses in cavity pockets.
• Resorption of interroot septa of teeth.
• Teeth mobility.
• Transient aching pain when biting into hard food.

The third stage of periodontosis:

• Noticeable atrophy of gum tissue.
• Total atrophy of the alveolar processes.
• Total exposure of the necks of the teeth of the upper and lower jaws.
• Progression of tooth mobility and looseness.
• Increase in the number and depth of gum pockets.
• Teeth displacement.
• Constant aching pain.
• Frequent abscesses.
• Loss of teeth.
• Damage to the jaw bone tissue, including osteomyelitis.

Initial stage of periodontosis

The initial period of periodontal dystrophy is characterized by burning and itching in the gums, which do not receive adequate nutrition from the already affected tissues and vessels. The initial stage of periodontosis is a favorable period in a therapeutic sense, when the disease can be suspended and transferred to the form of long-term remission. With proper oral care, the use of prescribed medications, rational nutrition and regular examinations, periodontosis can be "frozen" and the risk of its transition to the second and third stages can be minimized.

The initial stage of alveolar pyorrhea, periodontosis is accompanied by the following symptoms:

• Itching, burning, and possible pulsation in the gums - both upper and lower.
• Exposure of the necks and roots of teeth by one third, no more.
• Reduction of the normal level of the height of the interdental septa.
• There is no loosening of the teeth, they are firmly held and completely preserved.
• Bleeding gums are not typical for the first stage of periodontosis, but some traumatic mechanical factors can provoke it (cracking nuts, biting hard objects, food, etc.).
• Stubborn tartar, but not plaque. Tartar quickly re-forms after removal in a dental clinic.

The initial stage of periodontosis is extremely rarely diagnosed and treated. Since the process is painless and does not cause obvious discomfort, a person does not pay attention to the smallest signs, and goes to the doctor when tissue dystrophy acquires a generalized form, combined with inflammation.

Moderate periodontosis

In dental practice, alveolar pyorrhea is divided into certain forms and degrees of severity – mild, moderate and severe.

The following indicators are considered to be criteria that help to clarify the diagnosis and specify the degree of periodontal tissue dystrophy:

• Information about how exposed the necks and roots of the teeth are.
• Assessment of the condition of the interdental septa.
• Assessment of the degree of mobility and looseness of teeth.

Periodontosis of moderate severity is considered to be an already developed process, in which the exposure of the root exceeds 40-50% of the normal length of the tooth itself. Also, with this form of the disease, a significant increase in the height of the interdental partitions is formed and pathological instability and mobility of the teeth develops. The gum begins to separate from the tooth, which leads to the appearance of peculiar cavity pockets, in which there is a favorable environment for the reproduction of microbes and bacteria. In addition, the epithelium of the "pockets" is constantly exposed to inflammation, pus begins to ooze from them.

The second stage or moderate periodontosis is already a serious pathological destructive process that is difficult to treat and manage.

Exacerbation of periodontal disease

Dentists, periodontists, and surgeons note that exacerbation of periodontal disease in almost 90% of cases is associated with the acute stage of a concomitant disease.

Thus, deterioration of health due to increased blood sugar levels in diabetes mellitus can lead to the fact that exacerbation of periodontosis will switch the attention of both the patient and the doctor to the condition of the gums. Acute forms of periodontosis are rare and are extremely rarely independent. This is due to the natural mechanisms of disease development: since periodontosis is not an inflammation, but dystrophic, atrophic changes in tissues, the disease develops slowly, slowly, has a sluggish, chronic form without any possible temperature jumps, etc.

An exacerbation of pyorrhea is possible only with its generalized, combined dystrophic-inflammatory form, when cavitary abscesses develop, and intoxication of the body is possible due to purulent discharge. The first and second stages of the disease can last for decades, but the terminal, third stage is characterized by a rapid period of development and a sad outcome - tooth loss.

In general, exacerbation and acute symptoms are not typical for periodontosis, but rather are a characteristic sign of another disease – periodontitis.

[ 5 ], [ 6 ], [ 7 ]

Acute periodontosis

Periodontosis is a sluggish, chronic disease, therefore its acute form is extremely rare, mainly in elderly people, when pathological processes acquire a systemic, complex character - pyorrhea is combined with an exacerbation of internal diseases.

Acute periodontosis is a serious condition that is treated in a complex manner - with the help of antibacterial therapy and surgery. There are frequent cases of incorrect definition of the process, in which the acute form of alveolar pyorrhea is considered to be an exacerbation of periodontitis, that is, classic inflammation. It should be noted that for periodontosis, unlike periodontitis, exacerbations are not typical in principle, since dystrophy, atrophy develops over a long period, most often without any obvious symptoms and pain.

Neurodystrophic periodontal disease in periodontosis rarely affects pain receptors, rather damaging the tissue structure. The following differential signs can distinguish alveolar pyorrhea from periodontitis:

• There is no inflammation or swelling of the gums.
• There is no acute pain, the pain is transient and aching in nature.
• There is visible gingival retraction.
• There is visible exposure of the root and neck of the tooth.
• There may be no cavity pockets, and if they do exist, they are not as deep and extensive as in periodontitis.
• Most often there is no microbial plaque, but there is tartar.
• The teeth do not wobble, there is good stability of the teeth in stages 1 and 2 of periodontosis.
• There is a wedge-shaped defect (tooth wear).

Thus, acute periodontosis is a clinical rarity rather than a typical form of the disease. If the symptoms show the clinical picture of an acute process, it is necessary to first exclude periodontitis or other inflammatory diseases of the teeth and gums.

[ 8 ], [ 9 ]

Chronic periodontosis

The chronic form of periodontosis is actually the typical clinical picture of this disease. Chronic periodontosis can be considered a kind of linguistic error - a tautology. A sluggish, long-term, asymptomatic process, the absence of painful signs, slowly progressing development, systemic nature - this is far from a complete list of the characteristics of a neurodystrophic disease called alveolar pyorrhea, or periodontosis.

Like any other chronic form of pathology, chronic periodontosis is difficult to treat. In addition, its root causes, etiology are still being clarified, and there is no single statistically confirmed version explaining why pyorrhea is becoming a real disaster of the 21st century. Accordingly, therapeutic actions aimed at slowing down tissue destruction last a long time and also fall into the category of chronic, and sometimes lifelong measures.

Previously, chronic periodontosis was nosologically combined with periodontitis and was one of the forms of gingivitis. In fact, there was only one name that defined all periodontal diseases - pyorrhea. Later, doctors differentiated the inflammatory and dystrophic processes, giving them more distinct and specific forms.

Alveolar pyorrhea has become periodontosis, gingivitis is considered an independent disease, which can be the primary link in the development of periodontosis, and periodontitis most often occurs acutely and is singled out as a separate category.

To sum up, we can conclude that periodontosis is a chronic course of a dystrophic, destructive process in the gum tissues and ligamentous apparatus. Acute forms of this pathology are most likely caused by a combined process, when bacterial, microbial infections join periodontosis.

[ 10 ], [ 11 ], [ 12 ], [ 13 ]

Advanced periodontosis

Advanced periodontosis is a more than common occurrence. Since the disease develops slowly, often over decades, is asymptomatic, and is rarely accompanied by pain, advanced periodontosis can be considered a typical condition rather than a unique case.

In dental practice, there is a definition of three stages of the dystrophic process; the last one, the third one, can be called advanced.

Symptoms of advanced periodontosis:

• Mobility, looseness of teeth is a sign of an advanced process. Mobility is not a characteristic feature of alveolar pyorrhea, therefore its formation can be considered the main symptom of severe, systemic dystrophy and degeneration of tissues, ligaments.
• Displacement, movement of teeth.
• Gaps between teeth.
• It is possible to rotate the teeth along their axis.

Advanced periodontosis is very difficult, long and painful to treat. The most common method that helps to alleviate the condition of the jaw is splinting, that is, combining loose teeth into a single block. For this, a special tape made of durable material - fiberglass - is used. A flap technique of surgical treatment is also indicated, in which tissues are cut, dental plaque and deposits, inflamed elements are cleaned out. The cavity is disinfected with antiseptics, and the incisions on the gum are sutured. The recovery period can last up to a year, during which the patient needs to visit the dentist's office quarterly for repeated procedures to restore and strengthen the periodontium. Regular rinses, dental medicated pastes, physiotherapy procedures are also prescribed. If the gum treatment process is successful, the next stage of therapy for advanced periodontal disease is total prosthetics using removable dentures. Implants can be used after longer treatment, but, as a rule, they carry the risk of rejection and the development of gum inflammation.

Generalized periodontosis

Clinically, alveolar pyorrhea is divided into generalized periodontosis, systemic and local periodontosis. Generalized pyorrhea is a combination of a dystrophic process with inflammation or vice versa, depending on what triggered the disease. Pathological destruction extends to the entire jaw and all periodontal tissues, hence the name of the process - generalized, that is, total. This form most often develops as a consequence of the previous stage - systemic periodontosis, which is formed against the background of endocrine, autoimmune pathologies. In turn, systemic periodontosis, leading to generalized, is based on the local form, when a limited area of the jaw is subject to dystrophy, which is not typical for periodontosis.

Generalized pyorrhea, periodontosis is a disease that can be called a mixed, neurodystrophic process, in which dystrophy develops primarily, and inflammation is considered an inevitable consequence of total destruction of the gums. Such a condition of the jaw was previously called amphodontosis, which in Greek means ampho - near, around, close, and odus is a tooth, that is, "disease around the tooth."

Generalization occurs as a result of periodontosis flowing into the second and third stages, when periodic gum bleeding occurs due to dystrophy of the vascular system and increased permeability of the vessel walls. Previously developed and untreated gingivitis provokes infiltration of the gum epithelium in the enamel border zone. "Pockets" that are not typical for the first stage of periodontosis are formed, purulent discharge appears, the necks of the teeth are exposed, and this phenomenon affects literally all the teeth. Dystrophy of the bone tissue of the alveolar processes leads to osteoporosis of the alveolar walls, the teeth lose stability and become mobile.

Generalized periodontosis is a total dystrophy of both the upper and lower jaw, or more precisely, the gums, with relative preservation of the teeth, which are steadily losing their stability.

Suppurative periodontosis

Purulent periodontosis is an inflammatory stage of the disease. Actually, pus is one of the typical consequences of destruction, atrophy of periodontal tissues, it is no coincidence that pyorrhea in translation from Greek is defined as the release of pus.

It is believed that purulent periodontosis is an advanced form of the process, which occurs in two stages, closely interconnected with each other:

1. Dystrophic changes in the gum tissue and ligamentous apparatus lead to their atrophy (tissue nutrition is disrupted).
2. Atrophied tissues lose elasticity, collagen production decreases, alveolar pockets appear, in which pathogens accumulate. Reproducing, microbes release decay products into the cavity, pus appears, that is, inflammation is formed.

Periodontosis acquires a purulent form starting from the second stage of the process, when bleeding and itching in the gums increase their sensitivity, but do not stop the process of tissue atrophy. Inflammation gradually develops, which is not typical for the first, initial stage of periodontosis. The final, terminal stage is typical of the general poor condition of the body. The body temperature rises due to chronic abscesses, intoxication syndrome develops, suppuration becomes constant and persistent.

Characteristic symptoms that accompany the purulent form of alveolar pyorrhea:

• Pain when eating, chewing even chopped foods.
• Characteristic odor from the oral cavity.
• Chronic bleeding of the gums even in the absence of traumatic factors – brushing teeth, chewing food.
• Loss of sensitivity, feeling of numbness in the teeth.
• Blood in saliva.
• Swollen gums.
• Bluish color of the gums.
• Large gaps between teeth, even chopped food gets stuck.
• Sensitivity of the tooth neck to any thermal changes, reaction to spicy, sour foods.
• Visible separation of the gum from the tooth.
• Granulation of the cavity pocket.
• Total mobility of teeth, their displacement, often twisting around the axis.
• Formation of widespread subgingival purulent abscesses.
• Elevated body temperature, signs of general intoxication of the body.

Purulent periodontosis is the terminal stage of a chronic degenerative-destructive process, the result of which is total loss of teeth.

There is no single way to avoid such a phenomenon; treatment is complex, long-term, most often using surgical methods. There is no prevention as such, it is lifelong compliance with the doctor's recommendations aimed at slowing down the current dystrophic process and maintaining remission for as long as possible.

Why is periodontosis dangerous?

What is dangerous about periodontosis? First of all, its asymptomatic development, when the dystrophic process does not manifest itself with any characteristic signs. The disease can proceed asymptomatically for several years, damaging the gums, destroying the periodontium and creating conditions for the total destruction of teeth and jaws.

There is a clinical syndrome familiar to all dentists and gastroenterologists: the more advanced the disease of teeth and gums, the more often diseases of the digestive tract are diagnosed. There is also a feedback: the worse the gastrointestinal system works, the more potential risks for oral diseases. As a rule, periodontosis is dangerous in the sense of disruption of the normal functioning of the stomach and intestines, which is caused by poor chewing and grinding of food.

In addition, when asked what is dangerous about periodontosis, dentists answer this way:

• Advanced periodontosis can provoke periodontitis – acute inflammation of the tissue and tooth loss.
• Exacerbation of gingivitis, ulcerative gingivitis.
• Retrograde pulpitis.
• Inflammatory process in the lymphatic system (lymphadenitis).
• Osteomyelitis of the jaw bone tissue.
• Periostitis.
• Increased load on teeth temporarily unaffected by periodontosis.
• Purulent intoxication of the body in generalized, advanced form of periodontosis.
• The impossibility of local prosthetics, when only surgical treatment can help.

Dystrophy of bone, connective, periodontal tissue provokes its sclerosis and leads to collagen deficiency. Destroyed alveolar processes do not allow preserving teeth with the help of standard treatment and gentle prosthetics, in addition, generalized periodontosis in an advanced stage destroys the vascular and nerve zone that feeds the bone tissue of the jaw, which is often the cause of a serious, dangerous disease - osteomyelitis.

Alveolar pyorrhea is dangerous in itself as a systemic chronic disease, which still does not have a generally accepted etiological basis, and therefore is considered incurable.

Consequences of periodontal disease

The dangers and consequences of periodontosis are a fairly large list of problems, discomfort conditions, and sometimes serious diseases. A common cold, severe fatigue, and even stress can provoke an exacerbation of periodontosis, leading to harmful pathological results, as well as puberty, pregnancy, and menopause, that is, hormonal changes, can affect the severity of the degenerative destructive process.

The general social and psycho-emotional consequences of periodontosis may be as follows:

• Psychological discomfort from visible defects of teeth (their lengthening, exposure of roots).
• Anxiety associated with the information about the incurability of periodontal disease, in addition there is a real potential for the loss of almost all teeth.
• Difficulties with prosthetics in frequency and treatment in principle. Periodontosis is treated for a very long time, almost for life.

Physiological consequences of alveolar pyorrhea:

• Frequent widespread abscesses that develop in pathological cavities of the gums – pockets.
• Pulpitis is a chronic inflammatory process in the pulp.
• Periodontal inflammation.
• Inflammation of the periosteum - periostitis.
• Osteomyelitis of the bone tissue of the upper and lower jaw.
• Intoxication of the body during a complex, protracted purulent process. Pus, having entered the digestive tract, provokes chronic inflammatory diseases of the stomach, intestines of microbial etiology.
• Purulent periodontosis can provoke inflammation of the respiratory system.
• Pyorrhea is one of the causes of general intoxication of the body, when decay products enter the bloodstream and lymph.
• Purulent periodontosis, especially its generalized form, can be one of the causes of endocarditis, inflammation of the kidneys.
• Periodontosis is often one of the factors that aggravate inflammatory processes in the joints.

If the periodontium continues to deteriorate and the process is not stopped by systemic, comprehensive treatment, a period comes when, within a fairly short time, all teeth are eliminated - they fall out or are removed surgically. The dental bed after removal undergoes epithelialization and scarring, but periodontosis cannot be considered stopped and neutralized. The loss of teeth stops the flow of pus - pyorrhea, but not the gingival dystrophy itself. The bone tissue of the periodontium continues to deteriorate, atrophy and dissolve. A pathological pattern is formed: the consequences of periodontosis lead to internal diseases, which in turn are also a supporting cause of further development of alveolar destruction.

In order for complications and pathological results of periodontosis not to become widespread, the disease must be stopped at an early stage.

[ 14 ], [ 15 ], [ 16 ]