Periodontal disease (periodontitis)
Bleeding gums – underestimated risk of periodontal disease?
Plaque – How plaque makes teeth and gums sick
A pain-free periodontal treatment / gum treatment is also possible with a pronounced periodontosis
Loose teeth – the end result of an untreated periodontal disease?
Bone atrophy is a hallmark of periodontal disease and osteoporosis and must be prevented before implantation with dental implants
If periodontal pockets become a risk due to periodontal disease
Parodontosis (periodontitis) – leave the dentist to treat painlessly
Gum loss – gum retraction – When the gums go back through periodontal disease
Gingivitis (gingivitis) – Recognize the precursor of a periodontal disease and treat it purposefully
Parodontosis (periodontitis) – leave the dentist to treat painlessly
Periodontitis (med.) Or in common usage periodontosis is an inflammation of the teeth caused by infection (gingivitis), which leads to tooth loss even more frequently than caries. This Zahnbettentündung occurs nowadays more and more often. The reason for periodontitis is actually positive: the increased life expectancy due to the advancement of dentistry.
Thanks to better dental hygiene in recent decades, which has made possible an optimized removal of dental plaque, even older people have their natural teeth longer. On the one hand represents a desirable development, on the other hand, with the increased occurrence of typical geriatric diseases, such. As the Zahnbettentzündung – periodontal disease (med. Periodontitis), connected. The development of appropriate diagnostic and therapeutic procedures in the periodontal treatment is therefore one of the greatest challenges of modern dentistry in the fight against gum disease.
Table of Contents
Dentist Seidel periodontosis
What is a periodontitis?
It is an inflammatory disease caused by bacteria (inflammation of the teeth, gingivitis), which affects millions of people worldwide and is caused by an accumulation of bacteria on the gum line (gingivitis). Special bacteria, genetic predisposition and lack of oral hygiene influence the chronic disease course of periodontal disease. Countless bacteria in the mouth adhere to the tooth surfaces and gums on a daily basis by eating and drinking in biofilms (plaque). If not thoroughly removed, they trigger inflammatory infections in the tissues surrounding the tooth and gums. In the course of the jaw bone (tooth bed) can be attacked. Dentists then speak of a tooth decay.
Periodontal disease is a chronic, cyclically progressive disease. For this reason, the thorough and regular prophylaxis and long-term follow-up or follow-up appointments after a periodontal treatment are fundamentally important.
What forms of periodontal disease (med?
First, a distinction must be made between apical and marginal periodontitis. They are caused and treated in different ways.
Apical periodontitis (med. Periodontitis)
In the apical form, there is a dying or dead tooth with bacterial infection at the tip of the tooth root. He is mostly caused by deep tooth decay. If no timely treatment, the inflammation leads to the degradation of the jaw bone in this area. Despite often severe toothache, the disease is not always easy to diagnose.
The treatment takes place in the form of a root canal treatment or a Wurzelspitzenresektion. If both treatments are unsuccessful and do not cure the inflammation of the bone, the tooth must be removed to protect the periodontium from degradation.
Marginal periodontosis (med. Periodontitis)
The marginal periodontosis, which accounts for the majority of the disease, manifests itself in the context of often mild but permanently untreated gingivitis. The cause is bacterial dental plaque, which is the result of a lack of oral hygiene. It is the most aggressive form of inflammation that can damage the gums and eventually the periodontium.
Where does periodontitis come from and how does it go??
The bacteria that have attached to the tooth surface are usually disabled by the body’s own antibodies in good immune systems. If the immune system is weakened or overwhelmed by the amount of bacteria (eg in poor oral hygiene), it comes first to a gingivitis, the so-called gingivitis. It is manifested by swelling and bleeding when touched or brushed.
As soon as the inflammation on the dental bed passes, one speaks of a periodontitis. The gums go back through the inflammation and dissolves from the tooth. Here are now periodontal pockets, which provide an even better breeding ground for the bacteria and promote processes of further inflammation. A cleaning with the toothbrush is often no longer enough.
The bacteria can find an optimal way from the periodontal pockets to the tooth root and the retaining tissue (periodontium), sometimes into the jawbone. Thus, it attacks the tooth-supporting structures (dental cement, jawbone). When the tooth support function has collapsed, a periodontal pocket (a defect) with bone loss in the tooth bed forms around the tooth. By allowing the process to progress, these periodontal defects deepen and there is a risk that the tooth will fail in the long run.
Which symptoms occur in periodontal disease (periodontitis)?
The symptoms of periodontitis are primarily frequent bleeding gums and halitosis. As soon as you observe these problems, you should go to the dentist. He will then determine, on the basis of specific examination methods, whether it is actually periodontitis. In the course of the disease come to the gingival bleeding still receding gums and thereby over time also exposed tooth necks.
These not only look ugly and may give the impression of unkempt teeth, but are also very sensitive to pain. When you eat hotter or cold, or when the cold necks of the cervix come into contact with your teeth, you can often feel a sharp, short, and very unpleasant pain. In addition, inflammatory diseases can occur as a result of weakened defense processes of the body as a concomitant of a progressive periodontal disease.
Symptoms of periodontal disease at a glance:
- Bleeding gums
- exposed cervicals and thus tenderness (hot, cold)
- possibly inflammatory diseases in the body
- loosening of teeth
Is periodontal disease (periodontal disease) contagious?
Many people do not know, but periodontal disease is an infectious infectious disease. There are more than 600 different bacteria in the human oral cavity, of which only a small proportion is pathogenic. These pathogens include the bacteria responsible for the development of periodontitis. Scientific studies prove that Transferability of part of these pathogenic agents.
Transmission takes place via the saliva, in which the pathogens are located. This makes it possible to transfer it to infants as well as to older children or the partner. Whether the disease breaks out depends on the immune system of those affected and other factors such as smoking, diet or the intake of medication. If a family member suffers from periodontal disease, it may be useful, after consultation with the treating dentist, to perform a periodontitis therapy even for the currently symptom-free family members.
How to prevent periodontitis?
Good prophylaxis is the best basis to prevent the onset of periodontitis. A thorough and, above all, regular tooth cleaning and hygiene is, of course, the basic prerequisite for this – you have them in your own hands.
Dentist Seidel recommends for periodontal diseases:
Change the toothbrush regularly, use dental floss and a mild mouthwash to keep the bacteria at bay. In addition, once or twice a year, it is advisable to have a professional tooth cleaning at the dentist where all dental plaque (tartar) is gently removed and the periodontal pockets are cleaned.
How does the dentist diagnose a periodontal disease (med.?
Basically, the earlier a periodontal disease is recognized, the greater the chances of recovery. Usually, special genetic tests may be considered for this purpose. Anyone who believes that it is based primarily on poor oral hygiene is wrong. The fact is that nearly one third of the population has a genetic predisposition to periodontal disease.
A Paro-genetic test or germ test for periodontal bacteria can help determine how high the individual’s risk is to get it. This test is a painless smear that can be done in the dental practice within a very short time. If the genetic test has increased the risk, special dental hygiene is required. Smoking should be avoided as much as possible in this case as it promotes the application of bacteria.
What treatments does the dentist use for periodontitis or periodontitis?
As part of a periodontal therapy, the dentist or periodontist, depending on the stage of the disease, treated the various effects of periodontitis. These include the exposed tooth necks.
Treatment of exposed tooth necks as a result of periodontitis
Exposed tooth necks and gums (gum recession) not only look ugly, they also cause toothache when touched or temperature changes – whether hot or cold.
Through microsurgical procedures under the surgical microscope, aesthetic rehabilitations on the neck of the tooth or on the implant shoulder can be performed with own tissue. This surgery usually puts little strain on the patient and is usually done in local anesthesia without toothache (toothache) in periodontal treatment.
Use of Emdogain in periodontitis
Emdogain is a product that promotes restoration of the periodontium after it has been destroyed due to periodontal disease. Thus, it can help to preserve the affected tooth – or teeth in the periodontium – instead of extracting it.
Emdogain is a body-absorbable material of proteins premixed for ease of application in the form of a gel. From the human body itself, this protein is produced during tooth development. The artificially produced Emdogain used in the treatment of periodontitis in our practice is applied to the tooth root surface and leads to the restoration of cementum, fibers and jawbones. A tooth failure is thus prevented by a stabilization of the dental bed.
Since periodontal disease is a slow-moving disease with active and passive phases, timely recognition of it is extremely important for a positive course of therapy.
Periodontal treatment with the laser
Due to a certain paradigm shift in periodontitis therapy in recent years, the non-surgical periodontal treatment of periodontal pockets of medium depth (4-5 mm) has come to the fore. Most patients with inflammation of the gums are now treated in this way.
Lasers, especially in conjunction with scaling and root planing, are able to exploit their advantages in deep periodontitis and safely eliminate gum pain.
Overview of therapeutic procedures of our oral surgery dental practice in case of periodontitis:
- Bacteriological and genetic screening tests
- Preliminary diagnostics
- Pretreatment and maintenance of dentures (prophylaxis and dental hygiene with qualified personnel)
- Deep cleansing of the gum pockets
- open gum treatment
- Guided Bone Regeneration (GBR / GTR technique) (bone regeneration in the sense of the SIC
- after germination of a periodontitis
- Microsurgical gum aesthetics
- Treatment of gum decline
- Preprosthetic treatment for the consolidation of important abutment teeth
- Antimicrobial photodynamic therapy with the laser
Read more about:
- The laser can do that at the dentist
How much is a periodontal treatment??
The cost of a periodontal treatment may vary depending on the dentist or periodontist. However, these are usually covered by the statutory health insurance only up to a share of 30 or 40 euros. In contrast, the private funds are different: they usually carry 100 percent of the treatment costs, which can usually be between 80 and 150 euros.
How to best prevent periodontal disease (periodontitis)?
Periodontal disease is an insidious disease of the gums, which in the worst case progresses to the destruction of the periodontium. Nevertheless, many people get sick of it. The prevention is very simple. The simplest method of protecting teeth and gums from inflammation is extremely careful oral hygiene combined with the regular visit of the dentist, which should be recorded as a must on the calendar at least once a year.
Periodontitis prevention by the patient
Periodontists recommend: Prevent a periodontal disease with your daily, thorough oral care. This includes regular cleaning of the teeth with a soft toothbrush. This cleaning is done at least twice a day. After a meal, wait around half an hour to brush your teeth to preserve the enamel.
The interdental spaces as well as the natural periodontal pockets in the interdental spaces become carefully with dental floss cleaned. Instead, use interdental brushes to clean the interdental space, but do not dispense with the floss and use it to thoroughly clean the space between your teeth and gums from the smallest food particles and debris.
Even more important is a careful oral hygiene for smokers, as they have a greatly increased risk (five to sixfold) to get periodontal disease. Since even poorly treated diabetes is one of the risk factors, this underlying disease must be effectively treated.
Periodontitis (Periodontitis) – which toothpaste?
If symptoms are already evident, the choice of toothpaste no longer contributes significantly to the fight against periodontal disease. This is because the disease spreads below the gumline in the dental bed, which is not reached by either the toothpaste or the toothbrush. If there is an additional inflammation of the gums, a so-called gingivitis, offer themselves Toothpastes with proven anti-inflammatory and astringent (contracting) effect. Recommended are mouthwashes with the active ingredient triclosan. In the best case, however, the consultation with the dentist, who recommends the mouthwash or paste ideal for the individual case, takes place before a self-selected treatment.
Nevertheless, the treatment of a periodontal disease with the right toothpaste can be supported by dodging so-called gentle toothpastes. These contain a lower proportion of cleaning agents for the removal of the plaque and protect the gums and often freed by gum recession dentifrice. How mild a toothpaste is, is shown by the RDA / REA value stated on the tube. The lower this value, the finer are the cleaned bodies.
Preventive measures against periodontal disease by the dentist
The measures taken by the patient are supported by the regular professional cleaning of the teeth by the dentist. This usually takes place once a year. The professional cleaning of the teeth is supplemented with regular checks of the gums. If, despite all the care in oral hygiene, a slight inflammation of the gums develops, it can be treated promptly and with simple means to prevent the development of periodontitis. An important point is the correct cleaning of the teeth in everyday life. For many a patient is so intensively concerned with the cleaning of the teeth that he severely damaged the enamel. Your dentist will advise you on the correct handling of toothbrush and floss and recommends a toothpaste that is tailored to your individual needs.
Periodontitis Prevention of hereditary preloading
The hereditary form of periodontitis has a more aggressive disease course. Despite consistently excellent oral hygiene, periodontitis can occur. In this case, the disease progresses much faster than normal and leads to more massively massive bone loss.
These patients require very tight control and intensive prophylactic measures. This means that in addition to careful oral hygiene, a check-up with professional teeth cleaning is recommended twice a year.
Periodontitis and diabetes
More than six million people suffer from diabetes mellitus. Much of them are often affected by inflammatory diseases, with the tendency for periodontal disease is particularly high in this group of people.
The reason for this is that diabetics often need to take medications that may cause dry mouth or that are designed to counteract high blood pressure. These drugs can also increase the risk of developing periodontal disease.
Accordingly, it is important for people who suffer from diabetes mellitus to place particular value on thorough oral hygiene. In addition, it is not enough to go to the dentist twice a year. At least every six months a professional tooth cleaning should be carried out.
Implants for periodontitis?
Before implant placement, treatment of any periodontal disease that may be present is a prerequisite. The treatment is crucial for long-term success and reliably prevents future implant complications.
Should a tooth be so badly damaged by periodontitis that loose teeth have to be removed by a tooth extraction, treatment with implants is always an alternative to traditional dentures.
Is an implant treatment in spite of periodontitis in question?
Although implantation was generally rejected in the case of a pronounced periodontal disease, today implant-prosthetic rehabilitation is standard after successful periodontal treatment and regular prophylaxis.
Of course, a special attention is following the implant supply on the Cleaning of the fixtures by the patient to lay. The reason: Especially with a presence of certain marker germs (bacteria), which cause gingivitis, an increased risk of implant inflammation (peri-implantitis) is to be expected. If a dental implant has gingivitis, it can be treated like a natural tooth in the sense of a periodontal disease.
Invisible braces (Invisalign) in periodontitis (periodontitis)?
Especially designed for adults who want to straighten their teeth invisibly, often comes with the invisible braces on the question of whether a periodontal disease (periodontitis) through the braces stand. The good news: If you wear invisible braces, you do not have to worry about them having a negative impact on your periodontal disease (periodontitis).
Is there periodontitis in children?
Although it is rarely the case, periodontal disease can sometimes occur in children. If the disease is severe at a young age, it is often a sign of systemic disease or immune deficiency. Even taking some medications can lead to the onset of periodontal disease. Above all, a weak or non-functioning defense of the bacterial stimuli can trigger a particularly aggressive form of this disease with rapid and extensive bone loss even in childhood. The regular visit to the dentist helps to quickly recognize the disease and take countermeasures.
Dr. Frank Seidel
Last update of this page on 24.10.2019 by author dr. Frank Seidel.
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