What is pyorrhea disease

Periodontal Disease: Diagnosis, Causes & Treatment

What is Periodontal Disease?

Periodontal disease is inflammation of the tooth bed. It usually begins with an inflammation of the gums called gingivitis. If the condition lasts for a long time, the inflammation also spreads to the surrounding connective tissue and the jawbones. It can go painless for years and thus go unnoticed, only to cause pain in the advanced stage. The transition from gingivitis to periodontal disease occurs in stages: the gums separate from the tooth and form pockets. These offer bacteria the best development opportunities. The pockets deepen over time and the gums recede. Tissue and bone breakdown follow. At the end of this process, the tooth will no longer be held and will loosen.

What is Periodontal Disease?

Periodontitis is an inflammation of the gums that can develop as a result of an unnoticed inflammation of the gums. Bacteria trigger an inflammatory infection in the tissue around the tooth, right into the jawbone. It often happens that periodontitis is not noticed for years, as the course is completely painless at first.

If the inflammatory disease is left untreated, it will result in the loss of one or more teeth.

What is the difference between periodontal disease and periodontal disease?

Both terms refer to the same disease: inflammation of the tooth bed. The medically correct name is "periodontitis". In general usage, however, the word “parodontosis” has also established itself.

Where does periodontal disease come from and how does it proceed?

If the immune system is intact, it can defend itself against bacteria. If the body's defenses are weakened, however, it is no longer able to fight the pathogens that stick to the surface of the tooth. The result can be inflammation of the gums (gingivitis). Often times the gums are swollen and bleed when you brush your teeth. If the inflammation continues and spreads to the tooth bed, periodontosis has developed. The gums recede and separate from the tooth. In the tooth pockets that form, bacteria find ideal living conditions and multiply. They penetrate further into the tissue, right up to the root of the tooth and the tooth holding apparatus. There they can attack the structures that support the teeth - dental cement and jawbones. If these are no longer able to fulfill their supporting function, a gingival pocket with bone loss in the tooth bed forms around the tooth. If the defect is not treated in time, the tooth loosens and can fall out.

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How is periodontal disease diagnosed?

The dentist can diagnose periodontitis using a small measuring probe: To do this, he measures the respective pocket depth on each individual tooth. It also determines the so-called blood index (periodontal screening index PSI). This gives him a precise overview of the condition of the teeth and the degree of possible inflammation.

What are the symptoms of periodontal disease (periodontitis)?

Typical signs of the disease are bleeding gums and bad breath. If these changes occur more frequently, the dentist should be consulted urgently. Other abnormalities can also mark periodontitis as known symptoms: the gums recede, the tooth necks are exposed, the teeth react painfully to cold and hot stimuli, teeth become loose, further inflammations develop in the body, the immune system is weakened. These are side effects that indicate an advanced stage of the disease.

What treatment does the dentist perform for periodontal disease or periodontal disease?

To stop periodontal disease from damaging the gums and underlying tissues, it is important to eliminate the disease-causing bacteria and fight the inflammation. The dentist cleans the tooth surface and eliminates the bacteria under local anesthesia. If the inflammation cannot be stopped, a minor surgical procedure is necessary. The gum margins are detached from the tooth and bone so that the dentist has a better view of the inside of the gum pockets. Deposits and diseased tissue can now be thoroughly removed.

Treatment of exposed tooth necks as a result of periodontal diseases

The type of periodontal treatment chosen also depends on the stage of the disease. The dentist or periodontist can treat the necks of the teeth that are already exposed through gum recession with a microsurgical procedure under the operating microscope. Aesthetic rehabilitation is carried out on the neck of the tooth using our own tissue. The procedure is usually carried out under local anesthesia and is therefore not very stressful for the patient.

Use of Emdogain for periodontal disease

If periodontosis is diagnosed in good time, treatment with Emdogain can be used to stabilize the tooth bed. It promotes the restoration of the tooth support system if periodontal disease has damaged it or has already destroyed it. The artificially produced material is applied to the surface of the tooth root and can thus contribute to the formation of new tooth cement, fibers and jawbones. Emdogain consists of proteins that can be absorbed by the body. Emdogain is used in the form of gel for treatment. This - early - stabilization of the tooth bed can prevent tooth loss.

Periodontal treatment with the laser

Depending on the depth of the gingival pockets, lasers can be used for periodontal treatment. This gentler, non-surgical treatment is usually chosen when the tooth pockets are still of medium depth (4-5 mm). In conjunction with scaling and root planing, lasers are used for deep periodontitis and gum pain is permanently eliminated.

Treat periodontal disease painlessly

The most important goal in periodontal treatment is the removal of the so-called biofilm (plaque) and thus the periodontal bacteria. After the gingival pockets have been cleaned, the roots are smoothed. With this deeper cleaning, the roots are cleaned, smoothed and polished. Evidence can hardly be formed here in the future. Thanks to local anesthesia, pain-free periodontal treatment is now the rule. Following this conventional cleaning of the gingival pockets, laser therapy is often used for additional disinfection. A naturopathic approach alone is not sufficient as an alternative periodontal treatment. In addition to thorough hygiene measures, it is important to strengthen the immune system so that the bacteria in the oral cavity can be fought.

Is periodontal disease (periodontal disease) contagious?

Everyone affected should know that periodontal disease is contagious. Around 22 million bacteria live in our mouth. Some of these can damage teeth and gums. Like many other infectious diseases, periodontal bacteria can also be transmitted through saliva. Typical situations for transmission routes are kissing, using the same cutlery or toothbrush. In order not to infect others, sick people should behave considerately in everyday life, follow hygiene rules and always remember that periodontitis is contagious.

What secondary diseases can untreated periodontitis cause?

Periodontitis is an inflammatory disease that affects the entire organism. Bacteria can get into the blood and thus to distant places in the body via the open wound surfaces of the diseased tooth pockets. For patients, this increases the risk of developing secondary diseases.

These include atherosclerotic vascular diseases that can lead to heart attacks and strokes, as well as respiratory diseases. The risk of premature birth increases for pregnant women.

Periodontal Disease and Osteoporosis / Periodontal Disease and Diabetes

But there are also diseases that favor the development of periodontal disease: For example, osteoporosis can cause the jawbone to break down and thus trigger inflammation of the gums. A weakened immune defense caused by diabetes mellitus also creates a favorable environment for periodontal disease. Diabetes restricts the blood flow to the tissue and periodontal bacteria can more easily establish themselves.

What is the best way to prevent periodontal disease (periodontal disease)?

Prevention by the patient

If you follow a few important rules, you can effectively prevent periodontal disease.

  • Regular brushing of your teeth removes food residues and prevents acid build-up. Brush at least twice a day, but wait half an hour after meals. Otherwise the enamel can be damaged.
  • Dental floss and interdental brushes help remove plaque thoroughly.
  • Use the correct brushing technique (without pressure with circular movements away from the gums and towards the tooth)
  • Use a tongue scraper to regularly remove bacteria on the tongue.
  • It is particularly important for smokers to maintain thorough oral hygiene. You have a five to six times higher risk of developing periodontal disease.

Preventive measures by the dentist

A comprehensive periodontal prophylaxis also includes regular visits to the dentist.

  • Professional teeth cleaning by the dentist removes plaque from the teeth very thoroughly. The dentist also reaches places that the patient cannot clean himself. We recommend two professional tooth cleanings a year.
  • Preventive examinations - every six months - enable periodontitis to be recognized at an early stage.

Periodontal Disease - Which Toothpaste?

Periodontal patients are recommended to brush with so-called gentle toothpastes. As the amount of cleaning material used to remove plaque is low, they are gentle on the gums and the dentin that may be exposed. The lower the specified RDA / REA value, the finer the cleaning particles in the toothpaste. Even if the choice of periodontal toothpaste does not have a significant influence on combating the disease, it can support the treatment.

In the case of additional inflammation of the gums (gingivitis), toothpastes with anti-inflammatory and astringent properties can be used.

Prevention of hereditary predisposition

A very close check by the dentist is recommended for patients with a hereditary predisposition to periodontal disease. This also includes the strict use of prophylaxis options, such as professional teeth cleaning at least twice a year. Hereditary periodontitis is much more aggressive than other forms. It can occur despite the best oral hygiene.

What is the right diet for periodontal disease?

Numerous studies show that a balanced diet can have a major impact on the health of your teeth. A lot of fresh fruit and vegetables as well as dairy products are important on the nutrition plan. Red meat is not part of a cheap periodontal diet, or it is seldom part of it.

Nitrate-rich foods can have a positive effect on gingivitis. These include leaf and root vegetables such as lettuce and lamb's lettuce, spinach, radish, beetroot or radishes. Antioxidants such as vitamins C and E, as well as omega-3 fatty acids, also play an important role. Probiotic dairy products are also recommended: They help strengthen the immune system and thus support the body in fighting harmful bacteria.

How useful is a new denture for periodontal disease?

If a patient has lost his tooth due to periodontal disease, it makes sense to replace it soon. There are both medical and aesthetic reasons for this. A periodontal denture ensures that the jawbone is stressed again by chewing. This is important because it counteracts bone loss.

Periodontal treatment should be completed or advanced as far as possible before a denture is provided. If dentures are inserted during acute periodontitis and before a gingivitis heals, this can lead to visible transitions between dentures and tooth necks. Then black borders often appear.

If the dentition has been fitted with a dental implant or a bridge, regular prophylaxis appointments with the dentist should be made afterwards.

Which dentures is the best solution for periodontal disease?

Before a tooth is replaced, the gingivitis should ideally be healed. If the healing process does not go as desired, the planned restoration with the dentures depends on the status of the rest of the teeth. The dentist then decides on the special procedure based on the loosening, number and position of the remaining teeth.

Basically, both the use of a bridge and a dental implant are recommended in the case of teeth that are not very loose and only slightly damaged bones. If the bone is already more severely affected and the teeth are no longer sustainable, it should be carefully checked whether the use of an implant still makes sense. If the dentition is already severely damaged by the inflammation of the gums, the most popular solution is a removable denture.

Is an implant restoration an option?

Following periodontal treatment and loss of the tooth, the gap that has formed in the row of teeth can be replaced with an implant. Regular prophylaxis by the dentist and thorough, daily cleaning by the patient are then important. This is because the presence of bacteria that cause gingivitis also increases the risk of implantitis. If inflammation of the gums occurs again despite regular cleaning of the fixtures, periodontal treatment can be carried out in the same way as on a natural tooth.

Invisible braces (Invisalign) for periodontal disease?

If a patient wears invisible braces (Invisalign) to straighten their teeth, this has no negative impact on the course of periodontal disease.

Is there periodontal disease (periodontitis) in children?

It happens that children also get periodontal disease. The causes are manifold. Some medications can trigger periodontal disease. The main reason is usually a weak or poor immune system that is unable to fight off bacteria. Then a particularly aggressive course of the disease is to be expected, which leads to rapid and extensive bone loss. If periodontal disease occurs in children in a severe form, it can also be due to systemic causes or immune deficiencies.

What does periodontal treatment cost?

The price for the treatment is usually between 80 and 150 euros and varies with the treating dentists and periodontists. The statutory health insurance companies cover costs of 30 to 40 euros for periodontal treatment.

So that a periodontal treatment is not a question of cost, it is advisable to take out private additional dental insurance. With this protection, the high additional payments can be absorbed. It is best to have dental insurance that covers all relevant dental treatments, i.e., in addition to tooth-preserving measures, it also insures dentures and dental prophylaxis.

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FAQs about periodontal disease

Is Periodontal Disease Hereditary?

Scientific studies by the Charité show that periodontosis can also be caused by genetics. Accordingly, two specific DNA sequences are clearly associated with an increased risk of different forms of periodontitis. Thus, there are actually patient groups in whom the development of periodontitis is predisposed and independent of other risk factors such as smoking, oral hygiene or age.

If there is a certain genetic constellation, there is a high risk of developing periodontitis. Then it is all the more important to switch off other risk factors such as smoking and to pay attention to particularly good oral hygiene.

Is periodontal disease curable?

Periodontitis is a chronic disease that can be stopped but not completely cured. With the right treatment, the progression of the disease can be stopped and the associated tooth loss prevented. Patients suffering from chronic gingivitis must be treated for life. After the actual treatment is completed, maintenance therapy begins. This prevents periodontitis from returning in the long term. As part of the aftercare, the gingival pockets are checked and cleaned at regular intervals. Thorough oral hygiene is a top priority and professional teeth cleaning should be done twice a year. Follow-up examinations take place every 3 to 12 months.

Is periodontal disease communicable?

The infectious disease periodontitis is contagious. The aggressive bacteria can, for example.when using the same cutlery or when kissing. Not every person who is contaminated with periodontal bacteria also inevitably suffers from dental disease. However, the carrier of the bacteria is always contagious, even if the infectious disease does not break out. Whether it breaks out or not depends on other risk factors such as the individual immune system, taking medication, smoking, stress and diet.

To avoid infection, family members of periodontal patients should also undergo therapy, even if they do not show any signs themselves.

What to eat with periodontal disease

Dietary recommendations can help alleviate the symptoms of periodontal disease and have a preventative effect for healthy people. In order to successfully treat the disease, however, professional treatment by a dentist and careful oral hygiene are necessary.

What you should eat and drink:

  • 1.5-2 liters of mineral water or unsweetened tea per day
  • 2 servings of fruit and 3 servings of vegetables per day
  • Whole grain products (such as millet, amaranth, oats)
  • 1 serving of sea and oily fish per week
  • Natural milk and sour milk products
  • High quality oils (such as walnut, rapeseed or flaxseed oil)
  • Nuts, pumpkin seeds, sesame seeds

You should avoid:

  • sugar
  • Extreme meat consumption (maximum 2 times a week)
  • Hard, tough and sticky foods
  • Very hot or cold foods

Which germs cause periodontal disease?

Bacterial strains that are able to trigger periodontal disease are also called periodontal marker germs or guiding germs. If these bacterial strains are present in relevant numbers, periodontitis is very likely.

The identification of these bacteria plays an important role, among other things, for the targeted antibiotic treatment of periodontitis. A bacterial test is used to search for the following marker germs:

  • Porphyromonas gingivalis (P.g.)
  • Tannerella forsythia (T.f.)
  • Treponema denticola (T.d.)
  • Aggregatibacter actinomycetemcomitans (A.a.)
  • Prevotella intermedia (P.i.)

Where from / why do you get periodontal disease?

Increasing plaque formation leads to the formation of tartar. As a result, the tooth surfaces become rough and offer bacteria an ideal nesting place. The plaque bacteria create toxins that then get into the gums. The body's own defense reaction is then expressed in inflammation of the gums. If this is not treated in time, the chronic inflammation of periodontitis develops.

Chronic gingivitis is mainly due to poor oral hygiene. Further risk factors are a weakened natural defense system, smoking, stress, general illnesses such as diabetes, the use of certain medications such as B. antihypertensive, vasodilator agents.

All statements without guarantee.