Periodontitis is a chronic infectious disease (commonly known as pyorrhea) that causes the destruction of the teeth support apparatus, consisting of the attachment fibers (called periodontal ligament) and the alveolar bone. It is a slow painless process that the patient sometimes cannot detect on his own. Over time it is characterised by the formation of pockets or spaces between the tooth and gums in the worst case the patient might lose his teeth. The pathology is caused by particular bacteria, which flourish and build up next to the gums, forming a plaque which cause persistent inflammation causing the progressive deterioration of the tooth’s supporting structures. The likelihood of suffering from this pathology depends largely on the genetic predisposition to harbor the pathogenic microorganisms that cause it in the mouth and the simultaneous inability of the immune system to counteract them. If plaque is not removed it increases and accumulates in the gingival sulcus. Furthermore, the plaque hardens on the root surface of the tooth and becomes tartar; a rough surface where bacteria can adhere more easily. As the bone support gradually decomposes, the teeth start to feel loose and gingival inflammation evolves into periodontitis.
How do I recognize a parodontitis?
Unfortunately it is a subtle pathology: in most cases it does not cause any pain and often the patient, doesn’t feel any discomfort so consequently doesn’t visit the dentist. In this way the disease progresses slowly but surely and periodontitis can lead to tooth loss without ever causing pain. Some of the most common symptoms that should be a wakeup call for the patient are gum inflammation, gingival bleeding, increased tooth mobility and retraction of the gums. If these situations happen, the patient should really go to his dentist as soon as he can.
How is it prevented and how is it treated?
A key element of prevention is oral hygiene, especially daily hygiene through the use of a toothbrush, dental floss, brush and if necessary mouthwash. However, home oral hygiene alone is not enough: it is essential to follow a screening program (check-up and follow-up visits) and maintenance (professional hygiene sessions) planned by the dentist over time. During the professional treatments in the studio the infection is first removed with the deep cleaning of the roots of the teeth that have pockets. The hygiene procedure, called scaling and root planing, involves 4 or more sessions. The sessions can be performed once a week or we also can disinfect the mouth in two sessions lasting between 2 or 3 hours to be carried out every other day. Chlorhexidine-based oral antiseptics are also used both during professional treatment and in the following days to eliminate the infection. The patient must be motivated to collaborate by taking care of his oral hygiene on a daily basis (following the instructions of the dentist and dental hygienist) and avoiding habits that may worsen the situation. Following the first treatments, if the patient’s condition begins to stabilize we move on to continue with the other necessary dental treatments (fillings, prosthesis), the potential extraction of the elements that can no longer be treated and with the maintenance phase.
A pathology not to be overlooked
Periodontitis might lead to the complete loss of affected teeth over time due to bone resorption caused by infection. On top of that, it is a disorder not to be overlooked because it can worsen other pathologies. The bacteria that cause periodontopathy can easily enter into circulation through the mucous membrane of the mouth, spreading to the various organs and systems, thus increasing the possibility of infections in the long run, especially in patients already suffering from other diseases (such as diabetes, heart disease, and ETEC immunodepression) or other physiological states (pregnancy and advanced age). Furthermore, the inflammation associated with chronic gingival infection leads to an increase in systemic inflammatory indices which in turn increase the risk of cardiovascular diseases and exacerbate arteriosclerotic phenomena or diseases such as rheumatoid arthritis, connective tissue disease and vasculitis.