PARODONTOSIS AND MEANS OF TREATMENT IN DENTISTRY

Parodontosis– is a periodontal disease, that is a disease of the structures surrounding and maintaining our teeth – gingiva, ligaments (periodontal fiber), alveolar bone, cementum.

What can you learn from this part?

  • Parodontosis – what is it?
  • What causes parodontosis?
  • What symptoms may suggest parodontosis?
  • Can you treat parodontosis? How to prevent it?
  • What happens if you do not treat parodontosis?

Parodontosis is the second most common disease of the oral cavity, right after decay. It may be classified as a civilisational disease due to its prevalence and effects. Social effects of the spread of periodontal diseases (parodontosis) are reflected in the general influence of these diseases on patients’ bodies and in the percentage of teeth extracted because of them. For example, in the USA the same number of teeth is extracted because of parodontosis and decay, but in other parts of the world teeth are extracted because of parodontosis even more often. In Europe, 40% of all extractions is caused by periodontal diseases.

What causes parodontosis?
The risk of contracting periodontal diseases increases as we age. It also depends on geographical conditions, diet, social status, race and sex (men contract it more often). It is also possible to observe a relation between the severity of periodontal diseases and insufficient oral hygiene.

Inflammation of the gingival tissue and periodontium is related to dental plaque present on the teeth surface. Bacteria constitute 90% of the plaque. The more distinct the deposits on the teeth surface are, the bigger impact bacteria have on gingiva and other periodontal structures. Also, tartar affects gingival diseases – it is a mineralized dental plaque present on the surface of teeth, both over and under gums. It consists of crystal structure tricalcium phosphates, such as hydroxyapatites, phosphorites, brushites ( calcium-phosphate salines from saliva or inflammatory effusion). Tartar formation is connected with the mechanical effect that damages marginal peridontium and the fact that mineral scaffold of tartar causes the dental plaque to be very close to the tissues (coarse plaque surface is conducive to accumulation of living plaque) and has a direct pathogenic effect on teeth and the surrounding structures. Areas exceptionally susceptible to tartar formation include tooth surface around salivary gland openings, uneven tooth surface (overhanging fillings, prosthetic elements, etc.). Deposits, also called concrements, may be present on all tooth surfaces that are hard to clean (interdental spaces, areas under the tongue). Supragingival tartar is usually yellow – it may become darker as a consequence of a diet (tea, coffee) or nicotine. Subgingival tartar is usually dark due to blood disintegration appearing together with inflammation of the gingival tissue and other peridontium structures.

Other factors modifying the course of illness might be divided into local (amount and content of saliva, overhanging or not tight fillings, faulty prosthetic elements, breathing through the mouth, anatomical defects of the oral cavity tissue, traumatic occlusion, some irritations – chemical, thermal, allergic and systemic (general disease, e.g. immunological, hormonal, metabolic).

What symptoms may suggest parodontosis?
The following are periodontal disease symptoms that should worry us:

  • uncovered tooth necks and hypersensitivity of teeth,
  • tooth mobility,
  • gingiva bleeding (independent or while brushing teeth),
  • gingival hyperplasia (vivid red structure, swelling),
  • different smell from the mouth,
  • tooth displacement (leaning, protruding, gaps).

Other symptoms should be consulted with a dentist after clinical and radiological tests. Periodontal diseases might be cyclical, with more severe periods and remission.

Can you treat parodontosis?
Of course, you should treat it! The treatment usually consists of three phases:

I – Initial phase where the causes of the disease are removed
During this phase, in order to remove dental plaque and tartar and achieve satisfactory oral hygiene, you should:

  • have your teeth cleaned professionally by a doctor or a hygientist;
  • have tooth plasty in places where dental plaque accumulates;
  • eliminate irritating factors;
  • learn how to professionally take care of your oral cavity;
  • maintain hygiene standards at home and remember about self-control.

Professional cleaning includes removal of all supragingival and subgingival tooth deposits by a doctor or a hygientist.

The following tools should be used:

  • mechanical equipment to remove dental plaque (ultrasounds, air scalers);
  • manual tools (sickles, currets);
  • mechanical tools to remove soft plaque and stains (sandblasting device);
  • tools to polish (handpieces with rubber, strips, polishing pastes, etc.)

The best method of preventing deposits and peridontal diseases is to have the above procedures done once during each half year (healthy people) or once every four months (people with recognized parodontosis). It is also important to use pharmacological preparations to support the actions of doctors. Usually these might be mouth washes, preparations for rubbing (gels) or sucking (chewing gums). It is important to care about the hygiene not only in the dental clinic, but also at home – this is how the problems get eliminated and not the use of magic pills, as some patients tend to think.

We also need to eliminate other factors detrimental to the oral cavity hygiene, e.g. wrong fillings or prosthetic elements, and we have to treat problems with the occlusion or other tooth defects (e.g. orthodontic).

II – Correction phase where the remains of the disease need to be removed
During this phase patients undergo surgical procedures to correct or regenerate damaged periodontium structures (with the use of next generation implantable materials) or plastic muco-gingival surgery (coating uncovered necks, gum plasty, etc.). These procedures aim at a full reconstruction of structures damaged because of a disease and maintenance of the teeth – periodontium structures.

III – Phase maintaining treatment results
Dental visits, professional teeth cleaning, laser therapy, pharmacological treatment.

Prevention:

  • The best way to prevent dental deposits (and periodontal diseases in consequence) is to have dental visits once in every six months (healthy people) and once in every four months (patients diagnosed with parodontosis).
  • It is also important to use pharmacological preparations that support doctors’ actions. Usually these might be mouth washes, preparations for rubbing (gels) or sucking (chewing gums).
  • The most important thing is to care about the hygiene not only in the dental clinic, but also at home – this is the only way to eliminate tooth and periodontium diseases

Another effective way of preventing diseases is to maintain a healthy lifestyle and a proper diet (vegetables, fruit, whole wheat, healthy proteins).

Parodontosis consequences:
The most common consequences include weakness and loss of structures around the teeth which, in time, may lead to loosening, displacement and eventually loss of teeth. Unfortunately, parodontosis may also lead to systemic complications. Bacteria and their products might get through blood vessels to the circumference and contribute to harmful atherosclerotic lesions, diseases of the heart or the cardiovascular system, heart attacks, abnormal carbohydrate metabolism, pneumonia or premature childbirth.

It is vital to be aware that the treatment of periodontal diseases is conducted to obtain esthetic and functional effects, so a beautiful smile, but first and foremost to take care of our health in general. With reference to the concept of nature: healthy periodontium is a trio of esthetic-functional-health effects!