Periodontal disease is mainly caused by dental plaque, i.e. micro-organisms that live in it. Dental or tooth plaque is a colorless plaque which over time deposits on the teeth, tongue and mouth cavity. It can be removed by regular -daily teeth brushing.
Periodontopathy is a progressive and degenerative disease of supportive tissue of teeth (parodontium), resulting in teeth oscillation , migration and the teeth loss in terminal (final) stage. Nowadays, it is increasingly present disease with very young people, where a limit for the first symptoms came down from the late thirties to the early twenties. According to the latest research, teeth loss is in even 50% caused by periodontopathy, while caries is responsible for the second half as a causative agent.
Periodontal disease cannot be cured, only stopped at a certain stage and timely slowed. Because of that prevention is the most important and it involves removal of soft and hard plaque, regular teeth brushing and visits to the dentist every 6 months.
What are the causes for periodontal disease?
Deposition of minerals from saliva in plaque creates tooth tartar.
The tartar has a double effect on development of periodontal disease:
- it prevents saliva cleaning , so the bacteria from plaque can easily destroy parodontium
- ( tissue linking the tooth to alveolar bone ) and
- it exerts mechanical pressure on the teeth gums, leading to circulatory disorder.
Symptoms of periodontal disease are:
- Constant bad breath
- Red and swollen gums that bleed even at slight touch of brush when brushing teeth (gingivitis), painful chewing
- Sensitivity of teeth to thermal, mechanical and other irritation
- Extension of the clinical tooth crown as a result of gum recession, teeth oscillation
The course of periodontal disease
The beginning of disease itself is before all characterized by red and swollen gums bleeding at a slight touch, the condition called gingivitis.
Clinical course of periodontal disease
If gingivitis is not cured, tooth tartar continuous its double role in tissue destruction:
- physical barrier exists not allowing the contact of periodontal space with oral cavity, thus preventing the saliva self- cleaning , so bacteria can easily excrete toxins and destroy parodontium ( connective tissue that connects the tooth in a dental cup -alveolus).
- tartar exerts a mechanical pressure on the tissue, thus preventing circulation and without nutrition as a consequence, tissue death is inevitable. Even when bacteria would not additionally worsen tissue destruction, it would just die due to malnutrition.
By destruction of the connecting tissue around the tooth root, the empty space remains - periodontal pocket. Over time the space deepens and progresses to the top of the tooth root. When total destruction of the tissue occurs as a consequence, there is nothing left to support and connect the tooth in the dental cup-alveolus which leads to the teeth oscillation and loss .The whole process is divided into several clinical stages, therapy is defined according to a certain stage, i.e. to degree of paradontium destruction.
Therapy of periodontopathy
When the depth of periodontal pocket (which is normally 2mm) is more than 4mm, we suggest surgical treatment, so called flap surgery. Where pockets are up to 3,4mm maximum depth, persistent and long-term therapy must be carried out .First of all it means removal of hard and soft deposits in several sessions, raising oral hygiene at the highest level, the use of inter-dental brushes and dental floss with gels for rubbing the gyms as well as anti bacterial solutions for mouthwash. It is necessary to maintain periodontopathy at the same level constantly, i.e. not to allow the disease to progress further on because it cannot be cured. If periodontal pockets are deeper than 4mm, flap surgery is the best solution where it is possible to perform, since in terminal (final) stage teeth loss is impossible to stop.