Symptoms of periodontal disease

Parodontosis or pyorrhoea alveolaris - alveolar pyorrhea according to statistics provided by WHO, ranks third after the notorious tooth diseases - caries and periodontitis.

In the 21st century, more than 80% of children under the age of 14 already have signs of an initial stage of periodontitis - gingivitis. Periodontal disease develops slowly, asymptomatically and is a systemic neurodystrophic disease that affects urban residents more often than people living in rural areas (ratio 70/30). The destructive process destroys the gum - they become loose, itch, pus appears, the teeth loosen, the alveolar processes atrophy, the cervical teeth become bare. Clinically, the disease is sluggish, in the initial stage the symptoms of periodontal disease are not manifested. The dystrophic process is not accidentally called pyorrhea, since its first visible sign can be pyorrhoea. Since the disease affects literally all the peri-toothed tissues, it is also called amphodontosis - from the Greek amphí (about) and the tooth (odús).

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

• Endocrine pathologies.
• Hypertension.
• Vegeto-vascular dystonia.
• Atherosclerosis.
• Cardiovascular diseases.
• Diabetes.
• Neurogenic dystrophic processes.
• Osteoporosis.
• Avitaminosis.
• Autoimmune diseases.
• Inactive way of life, hypodynamia.
• Hypoxia.

According to the international classifier of diseases, periodontal disease is defined as follows: ICD-10.K05.4

[1], [2]

Can I get parodontosis?

Since the disease is not inflammatory, that is, it is not provoked by a microbial or viral factor, the question of whether it can be infected with periodontal disease belongs to the category of myths and delusions.

Neither through common utensils, household items, bedding or other accessories and even through kisses, the transmission of periodontal disease from person to person is impossible. Also, it can not be transmitted by airborne or by oral route. Of course, this does not mean that the patient should forget about the rules of personal hygiene, including oral hygiene, because damaged gum tissues are a vulnerable place for the penetration of pathogenic bacteria. Also, do not use the phrase - "periodontosis of teeth", because the disease only affects the periodontal tissue, that is, the tissues and gums, but not the bone tissue of the tooth.

If we consider the correct version of the hereditary etiologic factor of the alveolar pyorrhea, then even the question of whether it is possible to catch periodontal disease will not be correct. Genetic predisposition can play a negative role, but does not affect the prevalence, epidemiology of periodontitis. It is established that if both parents of the child suffered from pyorrhea, the probability of its development in the heir rises to 60%. However, many doctors are inclined to believe that periodontal disease is caused by many other non-contagious polyethological factors, which are actively investigated and refined at the present time.

[3], [4], [5]

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 already developed dystrophic process. People who have problems with teeth, gums, should carefully monitor the slightest discomfort and the presence of atypical plaque, secretion, pain or softening of the gums.

The first symptoms of periodontal disease can be: 

• Excessively large amount of plaque on the teeth, but this is not a specific sign.
• Dental calculus is a more characteristic symptom of the onset of periodontitis.
• Discomfortable sensations when eating spicy foods, hot or cold dishes.
• Itching gums.
• Transient pulsation in the gums.
• Possible periodic bleeding gums with mechanical action on them (brushing teeth, taking solid food).
• Perhaps the appearance of atypical cavities - pockets, cracks in which food remains.
• Purulent discharge from the "pockets".
• Cuneiform defects of teeth (erosion of teeth).
• A whitish coating on the gums.
• Exposure of the neck of the teeth, the teeth become visually longer.
• Retraction of the gums.

The first symptoms of periodontal disease, which should alert a person, is 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 it is possible to stop the process of dystrophic destruction of the gum and transfer it to the stage of supervised remission.

Pain in periodontal disease

The initial stage of the disease occurs not only without clinical visible manifestations, but also painlessly. Pain in periodontal disease can be considered a characteristic sign of the developed pathological process and its aggravation. Gums sore, their sensitivity to temperature factors - when absorbing cold or hot food, pain with biting hard food - these are quite typical symptoms of alveolar pyorrhea in the second or third stage. Thus, most often painful sensations in periodontal disease are associated with food, more precisely - with a mechanical traumatic factor, when the atrophied gum tissue, periodontium reacts sensitively to the lowest pressure. In addition, the pain symptom can be caused by an abscess that develops in the formed cavity - the gum pocket. The pain is pulsating, it 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 stage of exacerbation of the generalized form of periodontitis. Pioreas most often develops and proceeds without obvious painful sensations, which are more inherent in another disease of the oral cavity - periodontitis, periosteum.

Periodontitis and periodontitis

Both periodontitis and periodontitis break the integrity of the periodontium - the main support of the tooth, which keeps and gives it stability. This similarity of the two diseases is almost exhausted. Despite their etiological and clinical differences, periodontal disease and periodontitis are often confused, of course, this does not apply to dentists who clearly differentiate these nosologies in this way:

Alveolar pyorrhea, periodontitis	Periodontitis
There is no inflammatory process and bacterial, microbial pathogen	Inflammatory disease of the tissue, ligamentous apparatus, associated with a provoking bacterial factor
Slow, sluggish, but progressive development of the disease, rarely exacerbated and almost without remissions	Presence of periods of exacerbation, the possibility of persistent remission and cure
The defeat of the upper and lower gums, teeth of both upper and lower	Locality of the process - damage to one or more teeth. Rare distribution to nearby teeth
Development of the disease for many years	Rapid development and transitions from one stage to another
Cleaning the teeth, eating provokes bleeding gums rarely, only with a neglected form of the disease	Gum bleeding is one of the primary symptoms of the disease
Loosening, mobility of teeth is possible only in the third stage of the disease, when the disease acquires a generalized acute form. Mobility can not be eliminated	Dentility is one of the first signs of the disease, which is quickly eliminated with timely adequate treatment
Cavity pockets are rarely deep, in some cases they may be absent	Periodontal pockets are very deep, they can not be cleaned and sanitized at home
In cavities, pockets, as a rule, there is no granulation. It is possible with an exacerbation of the process, most often with a purulent, neglected form	Granulation, proliferation in the pockets are typical signs of periodontitis
Absence of swelling of the gums	Swelling of the gums associated with inflammation
Presence of wedge-shaped visible defects (tooth grinding)	The absence of wedge-shaped defects
Sensitivity to temperature factors, response to acidic, spicy food	Caries
Interdental spaces	The presence of interdental gaps is identical to periodontitis
The goal of the treatment is to suspend, slow down the process and minimize the risk of concomitant inflammation	The goal of the treatment is to neutralize the inflammation, eliminate the cause, transfer the process to the stage of persistent remission leading to recovery

In dental practice there is a clinical paradox - periodontitis is considered a more dangerous disease, as it rapidly develops, requires antibacterial treatment and possible prosthetics. However, periodontal disease is also a very difficult disease due to the fact that its causes are still unclear, therefore, effective, effective 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.

Periodontitis and gingivitis

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

In the clinical sense, periodontal disease can not be imagined without progressive gingivitis. Gingivitis (gingivitis) is the result of irregular and poor-quality oral care, when bacteria and microbes are able to unhindered reproduction in the tissues of the gums. However, with gingivitis, the integrity of the gum and the ligamentous apparatus of the teeth does not collapse, and not every such process can lead to alveolar pyorrhea. Gingivitis, identified and stopped at an early stage, remains an unpleasant, but very instructive memory, that is, the illness ends with a cure.

The initial stage of development of gingivitis is characterized by a constant, visible dental plaque, which accumulates and creates a favorable environment for the spread of bacteria in the gum. It becomes inflamed, becomes swollen, red, can bleed, especially with the slightest mechanical effect. Teeth are not damaged and do not hurt, thus, they can be completely preserved, eliminating the inflammatory process. If gingivitis is not treated, it progresses to periodontitis. Statistics say that over the past 20 years, periodontitis and gingivitis have become almost "inseparable" and significantly "younger". Previously, these processes were typical for people older than 40-50 years, today about 75-80% of children under the age of 14 already have signs of gum disease, therefore, 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 the dystrophy of the bone tissue of the alveolar processes.
2. The second stage is a degenerative, destructive process that provokes proper pyorrhea - the secretion of pus.

Stages of periodontal disease: 

The first stage: 

• Light, transient discomfort in the gums.
• Burning and itchy gums.
• Sensitivity of the gums.
• Resistant plaque, stone.
• Absence of inflammation or other signs of gum disease.
• Preservation of the strength of the teeth (they do not stagger and do not hurt).

The second stage: 

• Transient, periodic bleeding gums.
• The appearance of the first signs of gingivitis is the secretion of pus.
• Loose structure of the gums.
• Frequent stuck food (even soft) in the interdental spaces.
• Perhaps the appearance of cavities - pockets in the gums (nonspecific sign).
• Abscesses in the cavity pockets.
• Resorption of inter-root partitions of teeth.
• Mobility of teeth.
• Transient aching pain with biting off solid food.

The third stage of periodontitis: 

• Sensible atrophy of gum tissue.
• Total atrophy of alveolar processes.
• Total exposure of the neck of the teeth of the upper and lower jaw.
• Progression of mobility, shakiness of teeth.
• Increase the number and depth of the pockets of the gums.
• Displacement of teeth.
• Constant aching pain.
• Frequent abscesses.
• Loss of teeth.
• The defeat of the bone tissue of the jaw, up to osteomyelitis.

The initial stage of periodontal disease

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

The initial stage of alveolar pyorrhea, periodontitis is accompanied by such symptoms:

• Itching, burning, possible pulsation in the gums - immediately in the upper and lower.
• Exposure of necks, roots of teeth by one third, not more.
• Reduction of the normal level of the height of the interdental partitions.
• Lack of loosening of the teeth, they hold fast and are perfectly preserved.
• Bleeding of the gums is not typical for the first stage of periodontal disease, but some traumatic mechanical factors can provoke it (nuts cracking, snacking of solid objects, food, etc.).
• Persistent tartar, but not plaque. Stone after removal in the dental hospital is quickly formed again.

The initial stage of periodontal disease is rarely diagnosed and treated. As the process proceeds painlessly and does not cause obvious discomfort, a person does not pay attention to the smallest signs, and gets to the doctor when the degeneration of the tissues acquires a generalized, combined with inflammation form.

Periodontal disease of moderate severity

In dental practice, the alveolar pyorrhea is divided into certain forms and degrees of severity - light, medium and heavy.

Criteria that help to clarify the diagnosis and specify the degree of severity of dystrophy of periodontal tissues are the following indicators:

• Information about how bare the neck and roots of teeth.
• Assessment of the state of the interdental septa.
• Assessment of the degree of mobility, looseness of teeth.

Periodontal disease of moderate severity is considered to be an already developed process, in which the outcrop 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 septa is formed and pathological instability and mobility of the teeth develop. The gums begin to separate from the tooth, which leads to the appearance of peculiar cavities 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 periodontitis of moderate severity is already a serious pathological destructive process, difficult to treat and supervise.

Exacerbation of periodontitis

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

So, the deterioration in health due to the increase in blood sugar in diabetes mellitus, can lead to the fact that exacerbation of periodontitis will switch the attention of both the patient and the doctor to the condition of the gums. Acute forms of periodontal disease occur infrequently and rarely are independent. This is due to the natural mechanisms of the disease: since periodontal disease is not inflammation, but dystrophic, atrophic changes in tissues, the disease develops long, slowly, has a slow, chronic form without all sorts of temperature changes, and so on.

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

In general, the exacerbation, acute symptoms are not typical for periodontal disease, rather being a characteristic sign of another disease - periodontitis.

[6], [7], [8]

Acute parodontosis

Parodontosis is a slow, 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 exacerbation of internal diseases.

Acute parodontosis is a difficult condition, which is treated in a complex way - with the help of antibiotic therapy and surgically. Often cases of incorrect definition of the process, in which an acute form of alveolar pyorrhea is considered an exacerbation of periodontitis, that is, classical inflammation. It should be noted that for periodontal disease, in contrast to periodontitis, there are no typical exacerbations in principle, since dystrophy, atrophy develops a long period, often without any obvious symptoms and pains.

Neurodystrophic periodontal lesions in periodontal disease rarely affect pain receptors, rather damaging the structure of the tissue. Signs of difference of alveolar pyorrhea from periodontitis can be such differential signs:

• There is no inflammation and swelling of the gums.
• There are no acute pains, painful sensations are transitory and bear noel character.
• There is a visible gingival retraction.
• There is a visible outcrop of the root, the neck of the tooth.
• Cavity pockets may be absent, if there is, then not as deep and extensive as in periodontitis.
• Most often there is no microbial attack, but there is tartar.
• Teeth do not stagger, there is good stability of teeth in the 1 st and 2 nd stages of periodontitis.
• There is a wedge-shaped defect (tooth grinding).

Thus, acute periodontitis is more a clinical rarity than a typical form of the disease. If the symptomatology shows a clinic of an acute process, first of all it is necessary to exclude periodontitis or other inflammatory diseases of teeth and gums.

[9], [10]

Chronic parodontosis

The chronic form of periodontal disease is, in fact, the typical clinical picture of this disease. Chronic parodontosis can be considered a kind of linguistic error - a tautology. Sluggish, prolonged, asymptomatic process, absence of pain symptoms, slowly progressing development, systemic - this is far from a complete list of characteristics of a neurodystrophic disease called alveolar pyorrhea, or periodontitis.

Like any other chronic form of pathology, chronic periodontitis is difficult to treat. In addition, its root causes, etiology is still being clarified, and there is no single statistically verified version explaining why pyorrhea becomes a real disaster of the 21st century. Accordingly, therapeutic actions aimed at inhibiting the destruction of tissues, last for a long time and also fall into the category of chronic, and sometimes lifelong activities.

Earlier chronic periodontitis nosologically combined with periodontitis and was one of the forms of gingivitis. Actually, there was only one name, which defines all the periodontal diseases - pyorrhea. In the future, doctors differentiated the inflammatory and dystrophic process, giving them more precise and concrete forms.

Alveolar pyorrhea became parodontosis, gingivitis is considered an independent disease, which can be a primary link in the development of periodontitis, and periodontitis often proceeds acutely and is isolated in a separate category.

Summarizing, it can be summarized that periodontal disease is the chronic course of a dystrophic, destructive process in the tissues of the gum and ligamentous apparatus. The acute forms of this pathology are more likely due to the combined process, when bacterial, microbial infections attach to the periodontal disease.

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

Running periodontal disease

The launched form of periodontitis is more than a common phenomenon. Because the disease develops slowly, often for decades, without clinical symptoms and is rarely accompanied by pain, started periodontal disease can be considered a typical condition rather than a unique case.

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

Symptoms of neglected periodontal disease:

• Mobility, shakiness of teeth is a sign of a running process. Mobility is not a characteristic feature of alveolar pyorrhea, therefore its formation can be considered the main symptom of severe, systemic degeneration and degeneration of tissues, ligaments.
• Displacement, movement of teeth.
• The gap between the teeth.
• It is possible to turn the teeth on its axis.

Running periodontal disease is very difficult, long and painful to treat. The most common method that helps to relieve the condition of the jaw is the splinting, that is, the unification of the loosened teeth into a single block. For this, a special tape made of a durable material - fiberglass is used. Also shown is a patchwork technique of surgical treatment, in which tissue is cut, dental plaque and deposits, inflamed elements are cleaned. The cavity is disinfected with antiseptics, and incisions on the gums 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 for restoring and strengthening periodontal disease. Regular rinses, dental curative pastes, physiotherapeutic procedures are also prescribed. If the gum treatment process is successful, the next stage of therapy for the neglected form of periodontitis is total prosthesis with removable dentures. Implants can be used after a longer treatment, but, as a rule, they carry the risk of rejection and development of gum disease.

Generalized periodontitis

Clinically, the alveolar pyorrhea is divided into generalized periodontal disease, systemic and local periodontitis. Generalized pyorrhea is a combination of a dystrophic process with inflammation or, conversely, depending on what was the trigger of 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 periodontitis, which is formed against the background of endocrine, autoimmune pathologies. In turn, the systemic periodontitis leading to the generalized, is based on the local form, when the dystrophy is subjected to a limited zone of the jaw, which in principle is not characteristic for periodontal disease.

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

Genitalization occurs as a result of the flow of periodontal disease into the second and third stage, when periodic bleeding gums appear due to the dystrophy of the vascular system, increased permeability of the vessel walls. Previously developed and untreated gingivitis provokes infiltration of the gingival epithelium in the zone of the enamel boundary. Uncharacteristic "pockets" for the first stage of periodontitis are formed, purulent discharge appears, the neck of the teeth is 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, teeth lose stability, become mobile.

Generalized periodontitis is the total dystrophy of the upper and lower jaws simultaneously, more precisely the gums with relative safety of the teeth, steadily losing their stability.

Purulent periodontitis

Purulent periodontitis is an inflammatory stage of the disease. Actually, pus is one of the typical consequences of destruction, atrophy of periodontal tissues, it is no accident that pyorrhea in Greek is defined as the excretion of pus.

It is believed that purulent periodontal disease is a developed form of the process that proceeds in two stages, closely interrelated with each other:

1. Dystrophic changes in the tissues of the gums, ligamentous apparatus lead to their atrophy (tissue nutrition is disrupted).
2.  Atrophied tissues lose elasticity, collagen production decreases, cavity alveolar pockets appear, in which pathogenic organisms accumulate. Breeding, microbes release the products of decay into the cavity, pus appears, that is, inflammation forms.

Purulent form of periodontitis acquires, starting with the second stage of the process, when bleeding, itching in the gums increases their sensitivity, but does not stop the process of tissue atrophy. Gradually develops inflammation, which is not typical for the first, the initial stage of periodontal disease. The terminal, terminal stage is typical of the general poor state of the body. The temperature of the body rises due to chronic abscesses, intoxication syndrome develops, suppuration becomes permanent and persistent.

Characteristic signs that accompany purulent form of alveolar pyorrhea:

• Pain when eating, chewing even crushed foods.
• Characteristic odor from the mouth.
• Chronic bleeding gums even in the absence of traumatic factors - brushing teeth, chewing food.
• Loss of sensitivity, sensation of numbness of teeth.
• An admixture of blood in the saliva.
• Swelling of the gums.
• Cyanotic color of the gum.
• Large cracks in the interdental spaces, stuck even chopped food.
• The sensitivity of the neck of the tooth to any thermal changes, the response to acute, acidic food.
• Visible exfoliation of the gum from the tooth.
• Granulation of the cavity pocket.
• Total mobility of the teeth, their displacement, often torsion around the axis.
• Formation of widespread subgingival purulent abscesses.
• Elevated body temperature, signs of general intoxication of the body.

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

The only way to avoid such a phenomenon does not exist, treatment is carried out in a complex, long-term, most often with the use of surgical methods. Prevention as such is not, it is a lifelong implementation of a doctor's recommendation aimed at slowing the current dystrophic process and maintaining remission for as long as possible.

What is dangerous periodontal disease?

What is dangerous periodontal disease? First of all, its asymptomatic development, when the dystrophic process is not manifested by any characteristic feature. The disease can last several years without symptoms, damaging the gum, breaking the periodontium and creating conditions for total destruction of the teeth and jaw.

There is a clinical syndrome familiar to all dentists and gastroenterologists: the more diseases of teeth and gums are started, 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, the danger, periodontal disease is in the sense of a violation of the normal functioning of the stomach and intestines, which is due to poor chewing, grinding food.

In addition to the question - what is dangerous periodontal disease, dentists respond in this way: 

• Running periodontal disease can provoke periodontitis - acute inflammation of the tissue and loss of teeth.
• Exacerbation of gingivitis, ulcerative gingivitis.
• Retrograde pulpitis.
• Inflammatory process in the lymphatic system (lymphadenitis).
• Osteomyelitis of the bone tissue of the jaw.
• Periostitis.
• Increase the load on the teeth, which are temporarily unaffected by periodontal disease.
• Purulent intoxication of the body in the generalized, neglected form of periodontitis.
• Impossibility of local prosthetics, when only surgical treatment can help.

Dystrophy of the osseous, connective, peri-tootal tissue provokes its sclerosis and leads to a deficiency of collagen. The destroyed alveolar processes do not allow preserving the teeth with the help of standard treatment and sparing prosthetics, in addition, generalized periodontal disease at the neglected stage destroys the vascular and nervous zone that feeds the jaw bone, which is often the cause of a serious, dangerous disease - osteomyelitis.

Alveolar pyorrhea is dangerous in itself as a systemic chronic disease, which until now does not have a common etiologic base, therefore, is considered incurable.

Consequences of periodontitis

The dangers and consequences of periodontal disease is a rather large list of problems, discomforting conditions, and sometimes serious diseases. Provoke an exacerbation of periodontal disease, leading to disastrous pathological results can banal cold, severe fatigue and even stress, as well as puberty, pregnancy and menopause, that is hormonal changes, can affect the severity of the dystrophic destructive process.

The general social and psychoemotional consequences of periodontitis can be as follows:

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

Physiological consequences of alveolar pyorrhea:

• Frequent common abscesses developing in the pathological cavities of the gums are pockets.
• Pulpitis is a chronic inflammatory process in the pulp.
• Inflammation of periodontal disease.
• Inflammation of the periosteum - periostitis.
• Osteomyelitis of the bones of the upper and lower jaw.
• Intoxication of the body in a complex, prolonged purulent process. Pus, after falling into the digestive tract, provokes chronic inflammatory diseases of the stomach, intestines of the microbial etiology.
• Purulent periodontitis can provoke inflammation of the respiratory system.
• Pyorrhea is one of the reasons for the overall intokisaktion of the body, when the decay products enter the bloodstream, lymph.
• Purulent periodontitis, especially its generalized form, may be one of the causes of endocarditis, inflammation of the kidneys.
• Parodontosis is often one of the factors that aggravate the inflammatory processes in the joints.

If the periodontium continues to break down and the process does not stop with systemic, complex treatment, there comes a period when for a fairly short time all teeth are eliminated - drop out or surgically removed. The tooth bed after removal is subjected to epithelization and scarring, but periodontal disease can not be considered docked and neutralized. Loss of teeth stops the expiration of pus - pyorrhoea, but not the dystrophy of the gums. The bone tissue of the periodontal tissue continues to decay, atrophy and resolve. A pathological regularity is formed: the effects of periodontal disease lead to internal diseases, which in turn are also a supporting cause of further development of alveolar destruction.

In order that the complications and pathological results of periodontal disease do not acquire a total character, the disease must be stopped in the initial stage.

[15], [16], [17]