First, the cause of the disease
1, plaque
Microorganisms adhering to the surface of teeth cannot be removed by gargling or washing with water.
2. Dental calculus
Dental calculus refers to mineralized plaque deposited on the surface of teeth, which can be divided into supragingival calculus and subgingival calculus according to its deposition position and nature.
(1) The supragingival calculus is located on the tooth surface above the gingival margin and can be directly seen by naked eyes. There are many deposits in the neck of teeth, especially at the opposite opening of the large salivary gland duct, such as the buccal side of maxillary molars and the lingual side of mandibular anterior teeth. The main sources of inorganic salts in supragingival calculus are mineral salts such as calcium and phosphorus in saliva.
(2) The subgingival stones are located on the root surface below the gingival margin, and cannot be directly seen by naked eyes in the gingival pocket or periodontal pocket. Only by probing with a probe can we know its deposition position and amount. The main source of inorganic salts in subgingival stones is gingival crevicular fluid.
The harm of dental calculus to periodontal tissue mainly constitutes a good environment for plaque adhesion and bacterial growth.
3. Traumatic occlusion
When occluding, if the occlusal force is too large or the direction is abnormal, which exceeds the combined force that periodontal tissue can bear, so that periodontal tissue is damaged, it is called traumatic occlusion. Traumatic occlusion includes early contact, occlusion interference, night grinding and so on.
4. Others
Factors including food impaction, poor prosthesis and oral respiration also promote periodontal tissue inflammation.
Second, the clinical manifestations
Early symptoms are not obvious, and patients often only have secondary gingival bleeding or bad breath, similar to gingivitis. During examination, the gingival margin, gingival papilla and attached gingiva are swollen, soft, crimson or dark red, and it is easy to bleed during exploration. With the further spread of inflammation, the following symptoms appear:
1, periodontal pocket formation
Due to the expansion of inflammation, periodontal ligament is destroyed, alveolar bone is gradually absorbed, gingiva is separated from root, gingival sulcus is deepened, and periodontal pocket is formed. The depth of periodontal pocket can be measured with a probe.
2. Periodontal abscess
Ulcer and inflammatory granulation tissue are formed on the wall of periodontal pocket, and purulent secretion remains in the pocket. You can see the pus overflow by gently pressing the gum. And often have bad breath.
Step 3 loosen your teeth
Due to the destruction of periodontal tissue, especially when alveolar bone absorption is aggravated, the strength of supporting teeth is insufficient and teeth are loose and displaced. At this time, patients often feel weak occlusion, dull pain, bleeding gums and bad breath.
When the body's resistance is decreased and the periodontal pocket drainage is not smooth, periodontal abscess can be formed, which is a common accompanying symptom of deep periodontal pocket in the late stage of periodontitis. At this time, the gums are oval, red and swollen, and the surface is bright; Tooth looseness increases and there is knocking pain; The patient was accompanied by severe local jumping pain. At the same time, patients may have symptoms such as elevated body temperature, general malaise, submandibular lymph node enlargement and tenderness.
Third, the treatment method
(a) local treatment
1, which is a local stimulus.
It can be used for supragingival scaling or subgingival scaling, adjusting occlusion when necessary, eliminating food impaction and correcting bad restorations.
2. Treatment of periodontal pocket
When the periodontal pocket overflows with pus, it can be washed with 1% ~ 3% hydrogen peroxide solution and bagged with 10% iodine mixture or spiramycin, metronidazole and other medicine films. After removing local factors, shallow periodontal pocket can be cauterized with iodophenol solution; Deep periodontal pocket needs periodontal surgery to eliminate periodontitis. When the periodontal pocket reaches the root tip and the teeth are obviously loose, it can be considered to be removed.
3. Loose tooth fixation
If the teeth are still loose, temporary or permanent periodontal splint can be used to fix the loose teeth.
4. Treatment of periodontal abscess
When abscess is limited, incision and drainage can be performed. Periodontal bags should also be washed and coated with medicine film or iodine glycerin.
(2) Systematic therapy
Enhance the body's resistance and actively treat systemic diseases related to periodontitis. When periodontal abscess occurs, patients with severe systemic reaction should take relevant antibacterial drugs orally.
In a word, the treatment of periodontitis includes a series of comprehensive treatment measures. In order to consolidate the curative effect and prevent recurrence, oral hygiene education and regular review should be carried out.
Fourth, preventive measures.
Prevent and reduce systemic diseases, strengthen nutrition and improve the body's resistance, thus enhancing the disease resistance of periodontal tissue; Strive to keep the oral cavity clean and hygienic; Resolutely quit smoking, drinking, unilateral chewing and other bad habits that are harmful to periodontal tissue.