The calculus deposits penetrate deep into the periodontal tissues and cause periodontal infection, which surgical and non-surgical treatment modalities can manage. Read the article to learn more about the treatment for periodontitis.
Periodontitis is a gingival disease that spreads to the alveolar bone around the tooth and the other bones, such as bundle bone, and causes tooth loss. The gum infection or the soft tissue infection, if untreated, can spread to the underlying bone and cause loss of bone support, which results in weakening of the teeth support and mobility.
Periodontitis is caused by various factors or sequences as follows:
1. Plaque Formation:
The sugary and sticky foods we eat produce a film-like deposit on the teeth after reacting with the bacteria found in the oral cavity. This film-like covering around the teeth is plaque, which can be removed by proper brushing and flossing. However, plaque recurs often.
2. Dental Calculus Formation:
If the plaque is not removed even after brushing and flossing, it causes the formation of dental calculus. The dental calculus causes infection in the gums when left untreated for a long time. The gums get irritated and inflamed, resulting in gingivitis. The gums get swollen, and bleeding occurs due to the infection in the gums.
3. Periodontal Pockets Formation:
The dental calculus formed has to be removed by dental scaling and oral health maintenance. If the dental calculus is left untreated, the calculus or tartar gets deposited in the gums surrounding the teeth. The tartar or calculus then goes deep into the gums that cause more accumulation of bacteria. This weakens the teeth and creates periodontal pockets. The periodontal pockets are formed subgingivally between the gums and teeth. It is filled with more calculus deposits and bacteria. This leads to further spread, causing weakening of the teeth, including the surrounding bones and tissues, and gradually resulting in loss of the teeth.
The risk factors for periodontitis include medical and dental conditions, which are as follows,
A. Dental Conditions:
Eating more sugary and sticky food.
Avoidance of dental scaling.
Patient with gingivitis.
Patients who use or smoke tobacco.
Patients who use betel nuts.
B. Medical Conditions:
Patient with diabetes.
Patient with rheumatoid arthritis.
Patients who are obese.
A patient who takes drugs for a medical condition that causes dry mouth.
History of periodontitis in the family.
Patient with nutritional deficiencies.
Patient with vitamin C deficiency.
Patient with leukemia.
Patient with HIV.
Patient with a tumor.
The normal gingiva appears pale pink, and the gingival consistency will be firm and thick.
In patients with periodontitis, the following symptoms are seen:
The color of the gums changes from pale pink to red. It can be bright red, red, or blackish red.
Swelling or increase in the size of gums.
Gums become soft and wet.
A foul smell after eating.
Pus discharge between the gums and teeth.
Poor bone support.
Gingival recession occurs. The gingival recession is a condition in which the gingiva recedes or reduces, and the teeth roots get exposed clinically.
Repeated calculus deposits occur in the teeth' lingual surface.
Mobility of teeth.
Pain in the gums.
Tenderness in the gums while eating or chewing.
Sensitivity of teeth.
Attrition of teeth. That is, the surface of the teeth gets eroded.
Supra eruption and mesial drift of the teeth occurs due to loss of bone support.
Bleeding gums after brushing and flossing.
Spacing between teeth and alteration in biting patterns.
Periodontitis can be diagnosed by medical history, clinical examination, radiographs, and periodontal pocket depths.
1. Medical History:
The medical history involves asking the patient about history of certain medical conditions such as diabetes, medications such as iron capsules, and many more.
2. Clinical Examination:
The clinical study involves the examination of gums with calculus or plaque. This calculus or plaque may gradually develop into periodontitis.
The radiographs of the teeth and surrounding gums show the level of bone attachments, bone loss, and the depth of periodontal pockets.
4. Periodontal Pocket Depth:
The periodontal pocket depth can be determined with a periodontal probe. It measures the distance between the gingival margin and the base of the pocket. The more the pocket depth, the more the accumulation of bacteria that causes periodontitis.
The treatment involves scaling the teeth and cleaning the periodontal pockets. So, this kind of scaling and cleaning of the periodontal pockets prevents further damage to the surrounding bones like alveolar bone. Proper oral hygiene maintenance will help to enhance the treatment's success. Tobacco usage also has to be stopped to prevent the occurrence and progression of periodontal pockets and periodontitis.
A. Non-surgical Treatments:
The non-surgical treatment involves medications, scaling, and root planing.
B. Surgical Treatments:
Severe periodontitis can be treated with periodontal surgery, which includes the following:
Flap Surgery - It involves placing gum tissue on the root surface after cleaning it. The deep cleaning is done around the root surfaces, and the gum tissues are raised, exposing the underlying bone. After deep cleaning, the underlying bone gets recontoured, and further bone loss can be prevented. The bone loss present also will get improved. After the tissues get healed, the periodontitis gets cured, which makes cleaning and maintaining oral hygiene easy. It is also known as pocket reduction surgery.
Soft Tissue Grafts - The person with periodontitis will have a gingival recession. The gum recession is the receding of the gum towards the root. The soft tissue grafts involve placing donor tissue from the palate or other sites to the receding gingival area. This helps in preventing the further development of periodontitis. It helps restore the gum tissues, covers the exposed roots, and provides esthetic to the dentition.
Bone grafting - In periodontitis, bone loss occurs, and the teeth get mobile. The bone grafting procedure replaces the bone and supports the teeth. The bone grafts can be the patient's bone, donor bone, or synthetic bone grafts. It is placed in the affected area surrounding the teeth. It helps in bone regrowth and prevents further teeth loss; that is, it helps reduce the mobility of the teeth.
Guided Tissue Regeneration - In guided tissue regeneration, a perio-material placed between tooth and bone. It is a biocompatible material. It helps prevent invading bacteria from causing periodontitis. It helps in bone regrowth which was lost in periodontitis.
Tissue-Stimulating Proteins - Tissue stimulating proteins are proteins available in the form of a gel. They are placed in the affected area around the tooth surface. These proteins help develop bone growth, similar to the enamel and dentin.
This periodontal condition has symptoms like swollen gums, pain, or tenderness in the gums. The patient can visit the dentist when they experience such symptoms. But the patient can visit the dentist, do a regular check-up, and do dental scaling once in six months to prevent periodontitis.
The major complication of periodontitis is the loss of tooth. The tooth gets mobile, and the bone support gets weaker. The teeth loss due to periodontitis cannot be treated chiefly, and the teeth have to be extracted. Periodontitis is linked to certain medical conditions such as diabetes, coronary artery disease, and respiratory disease. If you have diabetes or coronary artery disease, you will develop periodontitis. But if you have periodontitis, it is not compulsory to have a history of diabetes or coronary artery disease. But there are chances for diabetes and coronary artery disease.
Periodontitis can be prevented by maintaining good oral hygiene. Oral hygiene has to be maintained continuously, which can be done with the help of the following:
1. Oral Hygiene:
Oral hygiene involves the correct usage of toothbrushes and toothpaste, floss, interdental brushes, and mouthwash.
2. Dental Check-up:
Regular dental check-ups should be done six months once. Even after regular brushing, flossing, and using mouthwashes and interdental brushes, certain people may have developed dental calculus mildly, and sometimes the stains can also be seen mildly. The reason for this dental calculus can be genetic or other medical conditions or specific medications. Dental stains can be due to some medication or fluoride levels in the water. These can be removed with dental scaling or bleaching procedures. The interval between two scalings varies from one person to another and is decided by the treating dentist.
Periodontitis is an infection in the periodontal tissue surrounding the teeth surface, gradually causing bone loss that might result in tooth mobility. This can be prevented by maintaining good oral hygiene. The treatment depends on non-surgical procedures to surgical procedures depending on the severity of the spread of periodontitis. Reach out to a dentist at the earliest if you have any signs of periodontitis to prevent tooth loss.
Last reviewed at:
23 Mar 2022 - 8 min read
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