Periodontitis or periodontal disease

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1. Overview

Periodontitis is an inflammation of the tissues supporting the teeth. It is an irreversible lesion, which leads to loss of teeth from the dental arches.

The science that deals with the diagnosis and treatment of periodontitis is called periodontology. The diagnosis is always decided by a dentist after periodontal clinical examination, subjective examination and radiographs presented by the patient.


1. Overview
2. Signs and symptoms
3. Prognosis
4. Genetic factor
5. Treatment

2. Signs and symptoms

Subjective clinical signs (those described by the patient) and periodontitis objectives are:
- Deposits of tartar, plaque and food debris;
- Odor (halitosis) especially in the morning, but also during the day;
- Bleeding during teeth brushing (this may be absent, especially in smokers);
- The patient observe the tooth roots “uncovered” by gum;
- Some front teeth look more elongated than others;
- Gums around the teeth can become congested, bright red to violet, which is associated with paina.

Because gingivitis usually does not cause pain, most people will not need treatment. Periodontitis occurs when gum disease progresses. Gums detach from the teeth, leaving deep spaces where bacteria can grow and destroy bone in which the teeth are fixed.

3. Prognosis

Periodontitis prognosis depends on a number of factors: the type of disease, patient hygiene, patient motivation, social level of the patient and dentist professionalism.

Today’s treatment can not cure periodontitis, but can stop the disease, which can lead to a very advanced stage, when there are cases in which teeth cannot be saved, supportive tissue damage (bone and periodontium) is high.

Treatment is long lasting and its effects are visible: stop tooth mobility, treats the gingival and periodontal inflammation, while gums are reattached to the teeth. Even if the disease is stopped, gum will not grow and will not reach the initial stage, so the retraction will remain.

4. Genetic factor

Genetic (inherited) factors have some influence on how the tissue reacts, but if oral hygiene is good, it won’t reach an alarming degree of periodontitis. Treatment is aimed at slowing disease progression and control etiologic factors through monitoring by the dentist, and through a concerted effort of the patient on oral hygiene.

Untreated, the disease will worsen tooth loss and shortly after, there will occur complication of the alveolar process by impossibility to wear fixed prosthetics, movable on implants or mobile. The treatment aims to support the teeth on the arch as long as possible.

5. Treatment

The treatment is always completed by the patient by keeping a very good oral hygiene. Lack of motivation of the patient for oral hygiene involves medical decision to cancel the treatment.

There are two types of treatment depending on periodontal disease:

1. The first type uses an ultrasound device combined with hand tools (Gracey curette); surgery is done without giving gum away;

2. The second type uses the same ultrasound machine, hand tools, Gracey curette, material addition if necessary; the intervention is done by removing gum through a flap to see the bone defect .

The key for long term success is proper hygiene at home and regular dental checks every 6 months. Your dentist will help you learn the proper techniques of brushing and other hygiene methods (flossing, mouth water, etc.).

You must be aware of the contraindication to smoke, which is very important. Regular treatments are differently in each patient, depending on plaque deposition; these are performed starting from 1 month to 12 months, these hygiene treatments being extremely important to avoid the risk of periodontal disease recurrence.



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