Should periodontitis teeth be extracted or not?

Written by Li Bao Hua
Dentistry
Updated on September 30, 2024
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Whether to extract a tooth affected by periodontitis depends on the condition of the periodontitis. In the early stages of periodontitis where there is no absorption of the alveolar bone, and the inflammation is limited to the gums, symptoms may include bleeding gums, red and swollen gums, or pus from the gums. In such cases, it is possible to preserve the tooth after basic treatment. This means that after cleaning the teeth and removing dental calculus, and applying medication to the gums to control inflammation, the tooth can be preserved. However, if the periodontitis is severe and there is significant absorption of the alveolar bone along with loose or falling teeth, it is difficult to preserve the teeth, and extraction may be necessary.

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Written by Fang Xiao
Dentistry
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What are the symptoms of periodontitis?

The main symptoms of periodontitis include: 1. Inflammation of the gums, which may present as bleeding, swelling, and a soft texture. Patients may experience bleeding while brushing their teeth, biting into hard objects, or even spontaneously. 2. Formation of periodontal pockets, where ongoing inflammation can lead to the development of periodontal pockets, resulting in the loss of periodontal attachment and causing bad breath. 3. Resorption of the alveolar bone, which can lead to weakened chewing capability. 4. Loose teeth, shifting of teeth, or even tooth loss, accompanied by secondary jaw trauma, gum recession, increased space between teeth, weakened chewing capability in the molars, fan-shaped spreading of the anterior teeth, periodontal abscess, food impaction, root caries, tooth sensitivity, etc. Therefore, it is important to maintain oral hygiene by brushing teeth morning and evening, rinsing after meals, and regularly visiting a dental department at an accredited hospital for teeth cleaning and periodontal care.

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Written by Li Bao Hua
Dentistry
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How is periodontitis caused?

Periodontitis is a destructive inflammatory condition of the periodontal supporting tissues. The primary initiating factor of periodontitis is dental plaque, which occurs due to not brushing or rinsing promptly after eating. Over time, soft deposits accumulate around the teeth, which can calcify into tartar. The tartar contains a large amount of biofilm, such as the dental plaque biofilm, which can damage and cause bleeding or congestion in the gingival tissues, manifesting as bleeding when brushing teeth or eating. If gingivitis is not treated in time, it may lead to periodontitis. Periodontitis is also related to other systemic factors, such as genetic factors or smoking, mental stress, etc. Sometimes, discoloration of the tooth surfaces or food impaction can also cause periodontitis.

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Written by Li Bao Hua
Dentistry
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Is cleaning teeth useful for periodontitis?

Periodontal cleaning is useful and necessary for gum disease. Cleaning for periodontal disease is a basic treatment method. Gum disease results from the progression and severity of gingivitis, which occurs when teeth are not adequately cleaned after brushing or mouth rinsing is not done promptly after eating. Food residues or plaque accumulate around the gums, causing prolonged irritation, congestion in the gum tissues, or bleeding during eating, which are also the earliest symptoms of gingivitis. This can further lead to the formation of tartar, which attaches to the root surfaces above and below the gums, known as supragingival and subgingival tartar, respectively. Subgingival tartar poses a greater risk as it may lead to the resorption of the alveolar bone. Therefore, it is essential to remove local irritants through dental cleaning in treating periodontitis, followed by subsequent treatments.

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Written by Li Bao Hua
Dentistry
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Is gum recession the same as periodontitis?

Gingival recession is not true periodontitis. Periodontitis is an inflammation of the periodontal supporting tissues, primarily clinically manifested as gingivitis or periodontitis. Gingivitis is an early stage of periodontitis, characterized by bleeding during brushing or eating, disappearance of the normal shape or state of the gums, and symptoms such as red and swollen gums, pus discharge, and disappearance of the papillae. The presence of dental calculus, soft plaque, and bacterial plaque around the teeth are stimulants, suggesting these are indicators of periodontitis. Gingival recession may be a temporary phenomenon due to reasons such as occlusion. Severe gingival recession can cause exposure of the tooth root surfaces, leading to sensitivity of the roots. If periodontitis has already caused the teeth to become loose, it is necessary to promptly proceed with guided bone regeneration.

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Written by Li Bao Hua
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How is periodontitis treated at the dentist?

The treatment plan for periodontitis and caries requires first taking an X-ray to understand the severity of the periodontitis. If the periodontitis is not severe and is merely inflammation of the gum tissue, characterized by red, swollen gums, pus discharge, or bleeding, this situation can be addressed by dental cleaning to remove local irritants, followed by medicated rinsing around the gums to improve inflammation. If the periodontitis is more severe, involving absorption of the alveolar bone, then guided bone regeneration procedures are necessary. After basic treatment of the periodontitis, the teeth enter a maintenance phase, requiring regular follow-up visits.