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Periodontology

What is the definition of Periodontology

Periodontology deals with the diagnosis and treatment of pathologies affecting the periodontium (as the name itself suggests - all the tissues that surround the teeth, keeping them in place and protecting their integrity). Both soft tissues - gums and hard tissues - bone or even teeth, are subject to many harmful daily factors (food that’s too hot or too cold, harsh food, hurried chewing, hygiene deficiencies, overuse, etc.). These harmful factors can affect the periodontium, so the protection of the teeth, as well as the functionality of the oral cavity in general, suffers. This is the reason why there are a number of dental services meant to restore the normal state of the oral cavity and periodontium in particular.

Most periodontal diseases are of bacterial origin, and for the general public can be divided into:

  • gingivitis;
  • chronic periodontitis;
  • aggressive periodontitis;
  • epulis;
  • syndromes and symptoms that influence the periodontal tissues.

Gingivitis is quite common, representing an inflammation of the gum without damaging the dental-gingival junction, they may involve the whole gum or part of it. Gingivitis can be of several types (catarrhal gingivitis, ulceronecrotic gingivitis, hypertrophic or atrophic gingivitis). If they include other regions of the oral cavity, they can degenerate into gingivostomatitis (affecting the lips or cheeks) or in papillitis (when the interdental papillae are damaged). Approximately 80% of the adult population suffers from chronic gingivitis, so most patients that go to the Imperial Dent clinic for various dental services, even with another dental problem, show signs of this condition. The appearance of gingivitis is caused by a number of factors. These may be local:

  • insufficient oral hygiene (presence of bacterial plaque);
  • the presence of dental plaque;
  • defective obturation (in the area of the interdental papillae);
  • incorrect use of prostheses (crochet irritation);
  • orthodontic appliances (incorrect activation);
  • rails in the case of jaw bone fractures (or teeth);
  • tooth clumps, low (or too high) fixation of the lips;
  • vicious habits (holding and biting the pen);
  • harmful professional factors (stone and coal quarries, chemical enterprises, bakery);
  • chemical substances (gasoline, lakes, heavy metal salts);
  • iatrogenic chemicals (arsenic paste - interdental papillary necrosis).

The problems can also be general:

  • diseases of the blood (one of the early symptoms of leucosis);
  • cardiovascular system disorders;
  • gastrointestinal system disorders (ulcers, gastritis, colitis);
  • diseases of the endocrine system (diabetes mellitus);
  • hormonal disturbances (juvenile gingivitis);
  • drug intoxications (in the treatment of epilepsy);
  • heavy metal poisoning (mercury, lead, bismuth, etc.);
  • X-ray irradiation;
  • infectious diseases;
  • smokers, alcoholics and drug addicts.

Essentially, gingivitis is a change in the color, texture, and contour of the gingival tissue, partly or all over the tooth, sometimes accompanied by stinging sensations or even pain. Pain appears spontaneously and intensifies during meals (hot, sour, or salty types of food) as well as during brushing. In short, patients notice a few signs: nausea or pain, small bleeding, and redness of the gums.

The actual cause of gingivitis is bacteria, which form the dental plaque (tartar) in time. All of the factors mentioned above may favor the onset of the condition, but the mechanism is poor hygiene. Although most people consider it’s enough brushing twice a day, adequate hygiene often requires additional measures. Mouthwash and dental floss are not a luxury, but a necessity. By simply toothbrushing, only large particles of food are removed, and a lot of people don’t spend enough time on this process. The mouthwash eliminates bacteria in the oral cavity, and the dental floss - the remaining particles in the spaces between the teeth.

Gingivitis can be treated (in the early stages), but especially prevented by strict dental hygiene. Gingivitis treatment consists in removing bacterial plaque and/or tartar, using antiseptic solutions and correcting hygienic habits. Over time, the bacterial plaque matures, absorbing calcium and phosphate ions, turning into tartar, making it more difficult to remove from the tooth. However, if the bacterial plaque is removed daily, the tooth can be kept clean. There are also dental services that help to periodically remove tartar, thus diminishing the possible source of infection. Any situation that prevents the patient from removing the plaque has to be avoided or solved. This includes maintaining a correct contour of the dental crowns and dental roots, avoiding dental bridges that cannot be cleaned and eliminating all causes that compromise the efficiency of cleaning techniques. If the treatment of gingivitis is not done properly, they evolve into a deep, chronic periodontitis, finalized with tooth loss and thus the disappearance of the marginal periodontium.

Marginal periodontitis is an inflammatory process with damage to the ligament apparatus and of bone tissue. The diseases of the marginal periodontium have been known for a long time - since antiquity, but with the development of civilization, the spread of this disease suddenly increases and today it reaches about 95-98% in the adult population. This figure is alarming if we take into account the possible adverse consequences in the case of prolonged postponement of treatment, lack of it or incomplete dental treatment. Currently, there is a tendency to spread the aggressive forms of marginal periodontitis - not just a wide range of symptoms, but also with a rapid evolution towards the destruction of the periodontium. Subsequently, not only the oral cavity is affected - the presence of the outbreak may favor the development of more serious conditions, such as cardiac and respiratory diseases. This is one more reason to choose as early as possible for quality dental services such as those from Imperial Dent. The effort to solve local problems is insignificant compared to what is necessary to solve the generalized consequences. The epidemiological analysis carried out in three age groups (28-30, 30-44, and over 60 years) showed that at young people aged 29-44) only 4-5% have clinically healthy periodontium and maintain a good hygiene of the oral cavity. However, most people believe that their oral hygiene is good enough - a paradox that aggravates the situation. It is much better to be aware of the actual situation and the dangers than to be quiet and to ignore the incipient signs of a problem. In general, marginal periodontitis is characterized by the presence of three specific signs: inflammation (a continuation of the gingivitis, it depends on the stage of evolution, the morphology of the periodontium, the thickness, and quality of the gum gingival); - alveolysis (destruction of the alveolar bone due to the action of various bacterial and lysosomal enzymes, being one of the characteristic symptoms of periodontal disease); - the presence of periodontal pockets (the pathological deepening of the gingival-dental trench by migrating the junctional epithelium in the apical direction). The patient can determine the inflammation itself and can intuitively guess the apparition of the periodontal pockets, but visiting a dentist right from the first signs is the only way to determine the disease at its incipient stages and to treat it effectively (and with less expense). The range of dental services covers any level of teeth and periodontal damage, but the advantage of a fast and qualitative treatment from the start is obvious. Advanced parodontopathy - represents the phase when the disease continued to advance to the destruction of a large part of the bone and the periodontal ligament. At this time, dental surgeries may be required in addition to therapeutic treatment. Any of the following operations may be required: - flap surgery or bag reduction surgery, - grafts (bone or soft tissues, - guided tissue regeneration.) What should be remembered in this summary of periodontics is that, after all, oral, multilateral and quality oral hygiene, as well as periodical visits to the dentist are the key to perfect oral health.Not only the teeth need attention and care but also the tissue around them. And if any problems have occurred, only the prompt reaction can prevent the vertiginous development of the illness - an early visit to the dentist can reduce a lot the workload, spent time, money and nerves. A beautiful smile is the guarantee of a positive attitude and the mirror of a happy life!

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MD-2038, Chișinău

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