or pyorrhea is a set of inflammatory diseases affecting the periodontium, i. E, the tissues that surround and support the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. Periodontitis is caused by microorganisms that adhere to and grow on the tooth's surfaces, along with an over-aggressive immune response against these microorganisms. A diagnosis of periodontitis is established by inspecting the soft gum tissues around the teeth with a probe (i. E, a clinical examination) and by evaluating the patient's x-ray
films (i. E. A radiographic examination), to determine the amount of bone loss around the teeth. specialists in the treatment of periodontitis are periodontists; their field is known as" periodontology" or" periodontics
. Signs and symptoms 1: total loss of attachment (clinical attachment loss, cal) is the sum of 2: gingival recession, and 3: probing depth
in the early stages, periodontitis has very few symptoms; and in many individuals the disease has progressed significantly before they seek treatment. Symptoms may include: redness or bleeding
of gums while brushing teeth, using dental floss or biting into hard food (e. G. Apples) (though this may occur even in gingivitis
, where there is no attachment loss)
spitting out blood after brushing teeth
halitosis, or bad breath
, and a persistent metallic taste in the mouth
gingival recession, resulting in apparent lengthening of teeth. (this may also be caused by heavy-handed brushing or with a stiff tooth brush.)
deep pockets between the teeth and the gums (pockets are sites where the attachment has been gradually destroyed by collagen-destroying enzymes, known as collagenases)
, in the later stages (though this may occur for other reasons, as well)
patients should realize gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume painless bleeding after teeth cleaning
is insignificant, although this may be a symptom of progressing periodontitis in that patient. Prevention
daily oral hygiene measures to prevent periodontal disease
include: brushing properly on a regular basis (at least twice daily), with the patient attempting to direct the toothbrush bristles underneath the gum-line, helps disrupt the bacterial-mycotic growth and formation of subgingival plaque.
Flossing daily and using interdental brushes (if the space between teeth is large enough), as well as cleaning behind the last tooth, the third molar, in each quarter
using an antiseptic mouthwash: chlorhexidine
gluconate-based mouthwash in combination with careful oral hygiene may cure gingivitis, although they cannot reverse any attachment loss due to periodontitis.
Using periodontal trays to maintain dentist-prescribed medications at the source of the disease: the use of trays allows the medication to stay in place long enough to penetrate the biofilms where the micro-organism are found.
Regular dental check-ups
and professional teeth cleaning as required: dental check-ups serve to monitor the person's oral hygiene methods and levels of attachment around teeth, identify any early signs of periodontitis, and monitor response to treatment.
Microscopic evaluation of biofilm may serve as a guide to regain commensal health flora.
Typically, dental hygienists (or dentists) use special instruments to clean (debride) teeth below the gumline and disrupt any plaque growing below the gumline. This is a standard treatment to prevent any further progress of established periodontitis. Studies show that after such a professional cleaning (periodontal debridement), microbial plaque tends to grow back to precleaning levels after about three to four months. Nonetheless, the continued stabilization of a patient's periodontal state depends largely, if not primarily, on the patient's oral hygiene at home, as well as on the go. Without daily oral hygiene, periodontal disease will not be overcome, especially if the patient has a history of extensive periodontal disease. Periodontal disease and tooth loss
are associated with an increased risk, in male patients, of cancer
. Contributing causes may be high alcohol consumption or a diet
low in antioxidants.