What is periodontitis?
Periodontal disease is a pathology that affects tooth support structures: the gums, periodontal ligament, radicular cement and the alveolar bone. In common language, the term “pyorrhoea” is often used, despite having fallen into disuse for some time now in the medical field. Different forms of periodontal disease exist, according to causes, extent and seriousness. Usually the initial stage of this pathology is gingivitis, which then leads to periodontitis.
What is the difference between gingivitis and periodontitis?
Both terms are not synonymous, let’s take a look at the differences:
Gingivitis refers to inflammation of gum tissue around the tooth; characteristic symptoms are linked to a burning sensation, pain associated with reddening, swelling and sometimes bleeding.
Periodontitis is an actual infection of periodontal tissue, meaning the entire tooth support structure, such as the alveolar bone, ligament and gums. This type of disease may result in the distancing of the tooth from surrounding tissue and in more serious cases, even in tooth looseness and loss. Symptoms may include abscesses, pus and the formation of “periodontal pockets” where bacteria which worsen the disease reside, sometimes also causing “bad breath”.
What are the causes?
They are inflammatory diseases with a bacterial aetiology that mainly affect predisposed subjects; in such patients, a lack of good oral hygiene means that the build-up of bacterial plaque attacks periodontal tissue, damaging and weakening the tooth. It is worth noting that with crowded teeth, a toothbrush is less effective and there is a greater vulnerability to the formation of tartar along the gumline and below. Moreover, bad habits, smoking in particular, can worsen the clinical picture. Stress (which weakens immune defences), pregnancy and some diseases (such as diabetes with high glycaemia, HIV infections, some forms of immune-based polyarthritis, radio and chemotherapy, etc.) accelerate the advancement of this disease.
Are they reversible?
In most cases, gingivitis is reversible after the removal of causes. Periodontitis is an irreversible disease, making it more difficult to manage; with suitable treatment, it is possible to slow its progression, avoiding early tooth loss. Action is possible with causal therapy, followed by frequent oral hygiene sessions, root planing and laser therapy; in more advanced cases, regenerative surgery with bone or gum grafts may also be used.
Is saliva PH analysis useful?
Saliva pH analysis helps to establish which dental and gum problems we are most predisposed to. For example, low and therefore acidic pH saliva means that bacteria are able to develop acids which attack dental enamel, resulting in decay; in a high and therefore basic environment, it is easier for calcium contained in saliva to form tartar, which may lead to gum and periodontal problems.
What does periodontal probing mean?
It is used to diagnose and quantify the loss of tooth support tissues caused by bacteria, and to detect the presence of infective and inflammatory manifestations, typical of periodontal disease (bleeding, pus). It is performed using a millimetric manual tool (a periodontal probe) around the entire circumference of each tooth. This clinical examination is completed by the degree of mobility of each tooth. “Periodontal probing” is useful for diagnosing periodontitis of different degrees of severity.
Can periodontal disease be associated with other diseases?
Periodontal disease is not always associated with other diseases, however it is often correlated with blood vessel lesions caused by arteriosclerosis and therefore with resulting cardiovascular diseases. In diabetic subjects it has also been seen that periodontal treatment probably contributes towards the achievement of better glycemic control and how periodontal disease plays an aspecific role in negative events associated with pregnancy (e.g. preterm birth and/or the birth of underweight babies).
In addition to traditional treatments, the surgery Dental@Med in Foligno provides patients with laser therapy, which to date remains one of the best techniques for the disinfection of periodontal pocket tissue.