Traumatic periodontitis

Periodontal inflammation, or traumatic periodontitis, can be triggered by a traumatic factor. Most often, trauma is seemingly habitual, unconscious actions:

• Those who sew, especially professionally, may have a habit of biting threads with their teeth.
• Many office workers have a habit of chewing pens and pencils.
• The habit of constantly chewing on something - a match, a toothpick, or another object.
• The habit of cracking nuts with teeth, constant consumption of seeds.
• The habit of opening bottle caps with teeth.

Traumatic periodontitis can also be caused by incorrect, overly aggressive use of dental floss, mechanical trauma - a bruise, a blow, a piece of hard food (bone) getting on a tooth, incorrect filling or a poorly fitted crown. In addition, periodontal tissues are constantly injured by the absence of a tooth and overload of other teeth, malocclusion, professional actions - mouthpieces of musical wind instruments.

Traumatic periodontitis is localized in the upper part of the periodontium – the apical part, less often – in the marginal part – along the edges.

A single intense trauma provokes an acute form of periodontitis, which is accompanied by bleeding gums, pain, mobility of the damaged tooth. Chronic trauma causes a slow development of the inflammatory process. The periodontium tries to adapt to the pressure for some time, gradually its tissues become denser, the interdental spaces become wider. Depletion of the adaptive resources of the gum tissue and periodontium leads to the onset of inflammation and the beginning of the destruction of the apex of the tooth root.

Treatment of traumatic periodontitis

First of all, actions are taken to eliminate the damage from traumatic injury: crowns are corrected, excess filling, damaged tooth particles are removed, etc. Then symptomatic treatment is indicated, including painkillers, anti-inflammatory drugs, and very effective physiotherapy. If a tooth is displaced, the viability of the pulp and the integrity of the root are checked using X-rays and electroodontodiagnostics. A repeat X-ray 3 weeks after treatment is mandatory.

Treatment of traumatic periodontitis is aimed at stopping the focus in order to prevent the spread of infection to nearby structures. Also, the number of priority tasks includes eliminating the cause of inflammation - correction of the installed crown, grinding of the filling material, orthopedic methods of bite correction, and so on.

Pain relief is mandatory, since traumatic periodontitis is characterized by severe pain symptoms for two reasons:

• Pain from the bruise or blow itself. Pain from mechanical trauma associated with dental problems (an incorrectly placed crown or filling).
• Pain caused by inflammation in the periodontal tissues.

In addition to anesthesia, physiotherapy procedures are very effective, which are carried out from the first day of seeking help. If the tooth has shifted as a result of injury, after checking the viability of the pulp (electric excitability) and an X-ray, endodontic treatment and strengthening of the tooth with the help of orthopedic structures are carried out.

Treatment of traumatic periodontitis does not involve the prescription of antibiotics, if they are used, then as local applications, but are more effective in terms of stopping inflammation, antiseptics. For the traumatic type of inflammation, the main thing is to relieve pain, swelling and provide temporary rest to the injured tooth. Further treatment is prescribed depending on the situation and possible complications. The prognosis is also associated with several factors:

• The severity of the injury, the force of the impact.
• Single injury or chronic injury.
• Time of patient's request for help.
• Concomitant diseases of the oral cavity (periodontosis, caries, gingivitis, pulpitis, etc.).

The prognosis of treatment is related to the severity of the traumatic injury, as well as when the patient consulted a dentist. If diagnostics and therapy were carried out in a timely manner, the prognosis is favorable in 95% of cases. If the injury provoked inflammation that was not treated, the process often becomes chronic and affects a large area of the periodontium, scars are possible at the site of tissue fiber rupture, granulomas and other complications may form.