Periodontitis: symptoms and treatment

Periodontitis (or pyorrhea) is a bacterial infection of the periodontium. The affected areas are gums, jawbones and root skin.

Periodontitis is an aggressive disease that is manifested by inflammation around the tooth.
The disease is mainly due to the formation of plaque and tartar on the surface of the tooth.

It is a severe form of gingivitis (inflammation of the gums).
Children with milk teeth can also suffer from this disorder.



  • Juvenile periodontitis affects adolescents and causes only mild symptoms at the beginning.
    The disease progresses faster than the form that affects adults.
    Affected teeth are molars and incisors.
  • Prepubertal periodontitis is a rare disease that affects milk teeth shortly after eruption.
    The child also suffers from a deficiency of neutrophil leukocytes.
    Affected patients are usually diagnosed at the age of 4 years.
  • Periodontitis caused by HIV is a type characterized by rapid progression and is similar to acute necrotizing ulcerative gingivitis (ANUG).
    The loss of periodontal tissue can be up to 1 cm in a few months.
    Some of the symptoms are pain, spontaneous bleeding and erythema.

Causes of periodontitis

Poor oral hygiene: Neglect of oral hygiene is the main reason for the occurrence of this dental problem.
The bacteria in the mouth constantly form a colorless, sticky layer (plaque) on the teeth. To prevent the formation of plaque, you should brush your teeth with toothpaste and floss.
Over time, plaque hardens and forms tartar, which harbors bacteria.
With normal brushing, the tartar cannot be removed. Only a dentist can remove the tartar professionally.

Bad habits: People who smoke or chew tobacco are more prone to this dental problem.

Diseases: Patients suffering from gum disease or chronic disorders that attack the immune system (such as diabetes, HIV, cancer, etc.) are more prone to this dental problem.

Medications: There are certain medications (such as phenytoin) that are used to treat epileptic seizures. Taking phenytoin tablets can have a negative effect on the gums. Antidepressants and oral contraceptives can also have a negative effect on oral health.

Symptoms of periodontitis

  • Gum swelling
  • Intense bad breath
  • Wounds
  • Toothache
  • Wiggling teeth
  • Bleeding when brushing and biting hard foods
  • Pus between gums and tooth

The symptoms of this gum disease often do not appear until the disease has reached an advanced stage.

Therapy and medication for periodontitis

The goals of periodontal treatment are to clean the area around the teeth and prevent damage to the surrounding bone.
Periodontitis is a serious condition and there are no natural remedies to eliminate the symptoms.

Non-surgical treatment
If periodontitis is not yet too advanced, less invasive therapies are planned, such as:

Cleaning. During tooth cleaning, tartar and bacteria are removed from the tooth surface and under the gums.
This can be done using instruments or an ultrasound device.

Root planing. Root smoothing smoothes the surface of the root, preventing further accumulation of bacterial toxins and tartar.

One of the newest non-surgical procedures is laser treatment.
A laser is a device used to emit rays that can destroy pathogenic microorganisms.

Antibiotics. The dentist may advise topical or oral antibiotics for the bacterial infection.
Topical antibiotics include mouthwashes or gels with medicinal agents that penetrate between teeth and gums.
You should talk to the doctor before taking any medication during pregnancy.

Surgical intervention for periodontitis

In advanced periodontal disease, gum tissue may no longer respond to non-surgical treatments and good oral hygiene. Then surgery may be necessary, such as:

Reduction of the tooth pocket. In this surgery, the dental surgeon makes tiny incisions in the gums and folds them backwards to expose the root of the tooth for more effective cleaning.
Since periodontitis often also causes bone loss, the underlying bone can be reconstructed before the gum tissue is sutured back in its place.
After healing, these areas are easier to clean and the gum tissue is kept healthy.
How long does it take until you can bite normally again?
If the procedure went well, the recovery time can range from a few days to about a week.

Soft tissue grafts. If you lose the gum tissue due to periodontitis, the gums retract.
Therefore, it may become necessary to strengthen the damaged tissue.
This can be done by removing a small amount of tissue from the palate or another area.
This procedure can help prevent the further receding of gums, cover the exposed roots, and improve the appearance of the teeth.
A soft tissue graft is chosen especially for vertical periodontitis. If the disease has developed horizontally, a bone graft is preferable.

Bone graft. This procedure is performed when periodontitis has destroyed the bone surrounding the root of the tooth.
The graft can consist of small fragments of your own bone, but can also be made of synthetic material or from a donor.
The bone graft helps to prevent the loss of teeth.
It also serves as a platform for the regrowth of natural bone.

Controlled tissue regeneration. This allows the regrowth of bone that has been destroyed by bacteria.
The dentist places a piece of biocompatible tissue between the tooth and the existing bones.

Application of derivatives of the melting matrix. Another technique provides for the application of a special gel, which is injected into the diseased tooth root.
This gel contains the same proteins that are present in tooth enamel during tooth formation and stimulate the growth of healthy bone.

Prevention of periodontitis

Good oral hygiene is the best and cheapest way to prevent this gum disease.
Brushing your teeth twice a day, including flossing, is the basis for maintaining good dental health.
Also, rinses with doctor-prescribed mouthwash can help reduce the number of bacteria in the mouth.

Acute necrotizing ulcerative gingivitis

This disease, also called “trench mouth,” is a serious gum disease characterized by painful bleeding, inflammation, and ulcers. It causes severe pain and discomfort.
Another name for this disease is also stomatitis Plaut-Vincent.
It is a rare type of periodontal disease. Most adults under the age of 35 are more likely to develop this problem.

Causes of acute necrotizing ulcerative gingivitis
Basically, this disease is triggered by a bacterial infection. Usually, various types of microorganisms (including bacteria) are present in the oral cavity, but they do not cause any damage to teeth or gums.
However, when the growth of harmful bacteria in the mouth gets out of hand, they begin to attach to the gums and cause an infection.
As a result, the soft tissues of the gums that hold the teeth are damaged.
In the worst case, ulcers also develop on the gums.
The factors mainly blamed for this type of uncontrolled growth of the bacteria that cause the disease are:

  • Lack of proper oral hygiene
  • Nutritional deficiencies
  • Mental stress
  • Smoke

Normally, people affected by AIDS develop this disease.

Symptoms of necrotizing ulcerative gingivitis

The first signs of acute necrotizing ulcerative gingivitis are bad breath and a foul taste in the mouth.
Since these symptoms do not cause any further discomfort, they are usually ignored.
Later, more severe symptoms suddenly appear:

Severe gum pain. This pain worsens when eating.
The gums appear swollen and red and prone to increased bleeding. The gums can also bleed when brushing your teeth.
The patient may have a fever.
A grayish film may form on the surface of the gums.
Ulcers due to this disease can manifest themselves in painful crater-shaped wounds that form mainly on the gums or between the teeth.
In some people, the infection could cause swelling of the lymph nodes on the head, neck or jaw.

Jaw infection

A jaw infection may be due to bacteria or fungi.

How does the jaw become infected?
As already indicated, untreated periodontitis can cause infection of the jawbone.
Periodontitis is characterized by a severe gum infection.
The infection destroys soft tissues and bones that hold the tooth.

Tooth decay, chipping, or a small crack in the tooth can make it easier for bacteria to seize the internal area of the tooth, reaching the root where they cause an infection.
This infection causes swelling and inflammation, as a result of which pus is formed.
Over time, the pus collects in a tooth abscess. Without treatment, the infection caused by the abscess can spread to the jaw and other areas of the head or neck.

Jawbone loss

Jawbone loss is an irreversible symptom of periodontal disease.

It is common knowledge that the teeth sit firmly in their cavities.
What holds the teeth in their cavity (regardless of the force applied)?
It’s a combination of two things: the periodontal fibers that fix the tooth to the bone and the bone density of the jawbone.
As you get older and neglect dental hygiene, there are many changes that become apparent in the oral cavity.
Above all, plaque and tartar around the teeth destroy the gums and cause many gum diseases. If these then spread to the jaw, they cause periodontal disease and jawbone loss.

Causes of jawbone loss
As already mentioned, periodontal diseases are one of the main causes of jawbone loss. The untreated gingivitis (inflammation of the gums) progresses towards the underlying bone to the jaw and causes bone loss.
Sometimes bone loss occurs with pulpitis, which causes necrosis of the tooth pulp (pulp).
The result is a tooth abscess.
In this disease, the destruction of the periapical bone occurs, that is, the bone near the tip of the root of the tooth.
Sometimes an isolated infection of the jawbone can also cause bone loss.

Natural remedies

There are no natural remedies for periodontitis, but you can prevent it with vitamins, especially vitamin C, which promotes gum health, as well as vitamin D, which protects against osteoporosis.
A healthy diet without milk and dairy products is important for bone health.

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